Dissociative Disorder Clinic

Psynchronize Minds’ Dissociative Disorder Clinic under the Guidance of Dr. Nirzaree Parikh Understanding Dissociative Disorders: Dissociative disorders involve an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness, and memory. People from all age groups and racial, ethnic, and socioeconomic backgrounds can experience these disorders Types of Dissociative Disorders According to ICD-10: Dissociative Convulsions (ICD-10: F44.5) Dissociative Motor Disorder (ICD-10: F44.4) Definition: These are convulsions that resemble epileptic seizures but lack a neurological basis. They are a type of dissociative disorder where psychological stress is converted into physical symptoms. Symptoms: Seizure-like episodes without loss of consciousness. No neurological abnormalities on EEG or other tests. Episodes often triggered by emotional stress or trauma. Movements can be more varied and less stereotyped than those seen in epilepsy. Diagnosis: Exclusion of epileptic seizures through neurological testing. Psychological evaluation to identify underlying stressors or trauma. Treatment: Psychotherapy, particularly cognitive-behavioral therapy (CBT). Stress management and counseling. Sometimes, medication for co-occurring conditions like anxiety or depression. Dissociative Motor Disorder (ICD-10: F44.4) Definition: Characterized by a loss or alteration in voluntary motor function, which cannot be explained by medical or neurological conditions. Symptoms: Paralysis, muscle weakness, or abnormal movements (e.g., tremors, dystonia). Symptoms often follow a stressful event or psychological conflict. Inconsistencies in the physical examination (e.g., Hoover's sign). Diagnosis: Detailed clinical evaluation to rule out neurological disorders. Consideration of the temporal relationship between symptoms and psychological stress. Treatment: Psychotherapy, especially CBT and psychodynamic therapy. Physical rehabilitation to restore motor function. Addressing any underlying psychological issues such as trauma or stress. Dissociative Sensory Disorder (ICD-10: F44.6) Definition: Involves a loss or alteration in sensory function that cannot be attributed to a medical condition. Symptoms: Anesthesia or hypersensitivity in various parts of the body. Loss of sensory modalities like vision, hearing, or touch. Symptoms are typically inconsistent with known neurological pathways. Often associated with a psychological conflict or stressor Diagnosis: Comprehensive assessment to exclude neurological and medical causes. Psychological evaluation to explore potential stressors or trauma Treatment: Psychotherapy, particularly CBT and trauma-focused therapy. Sensory retraining and rehabilitation. Stress management techniques and supportive counseling. These dissociative disorders are understood as physical manifestations of psychological distress, and effective treatment often involves addressing both the psychological and physical aspects of the condition. Dissociative Amnesia: Inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. Dissociative Fugue: Sudden, unexpected travel away from home or one's customary place of work, with an inability to recall one's past, confusion about personal identity, or the assumption of a new identity Dissociative Identity Disorder (DID): Presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior, accompanied by an inability to recall personal information beyond what is expected through normal forgetfulness Depersonalization/Derealization Disorder: Persistent or recurrent feelings of detachment from one’s self (depersonalization) or the external world (derealization), as if one is an outside observer of their thoughts, feelings, body, or parts of their life. Mixed Dissociative Disorder, is complex mental health condition, encompasses a range of symptoms that involve disruptions in memory, identity, emotion, perception, and behavior. Here's a concise breakdown of its key aspects: Nature of the Disorder: It is a type of Dissociative Disorder not specified elsewhere in major diagnostic manuals, combining features of several dissociative disorders. It includes symptoms such as amnesia, identity confusion, and depersonalization/derealization, without fitting neatly into a single diagnostic category. Symptoms and Manifestations: Causes and Risk Factors: Amnesia: Inability to recall important personal information, typically of a traumatic or stressful nature, that cannot be explained by ordinary forgetfulness. Identity Confusion or Alteration: Persistent uncertainty or confusion about one's identity, or the presence of two or more distinct identities or personality states that recurrently take control of the individual's behavior. Depersonalization/Derealization: Experiences of feeling detached from one's own thoughts, feelings, body (depersonalization), or sensing that one's surroundings are unreal (derealization). Causes and Risk Factors: Trauma is a principal cause, with many individuals having histories of severe physical, emotional, or sexual abuse during childhood. Stressful or life-threatening events can also trigger dissociative symptoms. There is evidence suggesting a biological predisposition to dissociative disorders, possibly involving brain function abnormalities Diagnosis: Diagnosis involves a comprehensive assessment, including a detailed psychiatric interview, a review of symptoms, and sometimes psychological testing. Treatment: Psychotherapy (talk therapy) is the primary treatment approach. It may involve cognitive-behavioral therapy, dialectical behavior therapy, and therapies aimed at processing trauma and integrating dissociative parts of the personality Medication may be used to treat concurrent symptoms like depression or anxiety but is not a primary treatment for dissociative symptoms. Support Groups and education about the disorder can also be helpful for patients and their families Prognosis and Management: The prognosis varies. Some individuals achieve significant improvement and integration of their identities, while others may experience chronic symptoms. Ongoing therapy and support are often necessary to manage symptoms and work towards recovery. Challenges: Individuals with Mixed Dissociative Disorder often face challenges in their personal and professional lives, including difficulties in maintaining relationships and employment. Stigma and misunderstanding about dissociative disorders can also pose significant barriers to seeking and receiving appropriate care. Dissociative motor disorder and dissociative sensory disorder, as categorized in the International Classification of Diseases, Tenth Revision (ICD-10), are forms of dissociative disorders that affect physical movement and sensory experiences, respectively, without a physical cause. Here's a breakdown of each according to ICD-10 guidelines: Dissociative Motor Disorder (F44.4): Symptom Presentation: This disorder is characterized by a loss of ability or impairment in motor function, which can include paralysis, weakness, or abnormal movements. The symptoms cannot be explained by a neurological or medical condition. Awareness and Attitude: Individuals may show an indifference or lack of concern (la belle indifférence) about their symptoms, although this is not always present. Diagnosis Criteria: For a diagnosis, there must be evidence that the motor dysfunction is associated with psychological factors, as the symptoms often occur in response to stressful events, interpersonal conflicts, or traumatic experiences Exclusion of Other Causes: It is crucial to rule out neurological conditions, substance abuse, or other medical explanations for the symptoms. Dissociative Sensory Disorder (F44.6): Symptom Presentation: This category includes disorders involving sensory functions, notably loss of touch or pain sensation, and can also affect sight, hearing, or smell. The sensory loss is not consistent with medical or neurological conditions. Psychological Factors: As with dissociative motor disorder, dissociative sensory disorder symptoms are linked to psychological factors and may arise following stressful or traumatic events. Diagnosis Criteria: The diagnosis requires a thorough examination to exclude neurological diseases, fabricated disorders (malingering), or substance-induced causes. Variability and Selectivity: Symptoms can vary over time and may affect selective sensory modalities, which can be suggestive of the dissociative nature of the disorder. Dissociative convulsions, also known as psychogenic nonepileptic seizures (PNES), represent a complex psychological condition that mimics the symptoms of epilepsy but without the characteristic electrical discharges in the brain that define epileptic seizures. This condition falls under the umbrella of Functional Neurological Disorder (FND), a medical term used to describe neurological symptoms that can't be explained by traditional neurological diagnoses. The cause of dissociative convulsions is not fully understood, but it is believed to be linked to psychological stress or trauma rather than the physical brain disturbances associated with epilepsy. Patients with this condition may experience convulsions, shaking, loss of consciousness, or sensations that resemble those of an epileptic seizure. However, when monitored with an electroencephalogram (EEG) — a test that measures electrical activity in the brain — their results do not show the typical patterns seen in epilepsy Diagnosing dissociative convulsions involves ruling out epilepsy and other neurological conditions, which can be a lengthy and complex process. Treatment typically focuses on addressing the underlying psychological issues through therapy, such as cognitive-behavioral therapy (CBT), and sometimes medication to manage symptoms. It's a condition that underscores the intricate relationship between the mind and body, highlighting the impact of psychological factors on physical health. As awareness and understanding of dissociative convulsions grow, so does the hope for effective management and support for those affected. Symptoms and Characteristics: Memory loss of specific times, people, and events Out-of-body experiences, such as feeling detached from oneself Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors A sense of being detached from emotions Identity confusion or having multiple identities Psychometric Assessments Available: Dissociative Experiences Scale (DES) Structured Clinical Interview for DSM-5 Dissociative Disorders (SCID-D) Challenges Faced by Individuals: Social Isolation: Difficulty in maintaining relationships due to fluctuations in identity or memory gaps. Workplace Issues: Inconsistencies in performance and attendance due to episodes of dissociation. Mental Health Struggles: Increased risk of substance abuse, depression, anxiety, and suicidal thoughts Tips to Manage at Home: Routine Maintenance: Establishing a daily routine can provide structure. Stress Management: Techniques such as mindfulness, meditation, and yoga can help Journaling: Keeping a diary may help in grounding and processing experiences. Worldwide Impact: Dissociative disorders can lead to significant societal impacts, including increased healthcare utilization, reduced workforce productivity, and challenges in the legal and educational systems. When to Seek Help: Persistent feelings of disconnection Memory loss affecting daily functioning Severe distress or problems in social, occupational, or other areas Medical Treatment and Psychological Services: Therapy: Cognitive-behavioral therapy, dialectical behavior therapy, and Eye Movement Desensitization and Reprocessing (EMDR). Medication: No specific medication for dissociative disorders, but treatment may include medications for depression, anxiety, or other co-occurring conditions Why Choose Dr. Nirzaree Parikh for Treatment: With extensive experience in the field of mental health, Dr. Parikh offers a compassionate, patient-centered approach. Utilizing the latest research and techniques, Dr. Parikh and the Psynchronize Minds team are equipped to provide comprehensive care tailored to each individual’s needs At Psynchronize Minds, we understand the complexity of dissociative disorders and are dedicated to providing a path toward healing and integration. Our commitment to excellence in care and the unique expertise of Dr. Nirzaree Parikh makes us a leading choice for those seeking support in managing dissociative disorders.