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known as Multiple Personality Disorder
Defined
as the occurrence of two or more personalities within the same
individual, each of which during sometime in the person's life
is able to take control. This is not often a mentally healthy
thing when the personalities vie for control.
Symptoms
are of course somewhat self-explanatory, but it is important to
note that often the personalities are very different in nature,
often representing extremes of what is contained in a normal person.
Sometimes, the disease is asymmetrical, which means that what
one personality knows, the others inherently know.
The patient has at least two distinct identities or personality
states. Each of these has its own, relatively lasting pattern
of sensing, thinking about and relating to self and environment.
At least two of these personalities repeatedly assume control
of the patient's behavior.
Common forgetfulness cannot explain the patient's extensive inability
to remember important personal information.
This behavior is not directly caused by substance use (such as
alcoholic
blackouts) or by a general medical condition.
Associated
Features:
Trauma
Depression
Mood
swings
Suicidal
tendencies
Sleep
disorders (insomnia, night terrors, and sleep walking)
Panic
attacks
Phobias
Alcohol
and drug abuse,
Differential
Diagnosis
Some disorders have similar or even the same symptoms. The clinician,
therefore, in his/her diagnostic attempt has to differentiate
against the following disorders which need to be ruled out to
establish a precise diagnosis.
Effects
of a substance - Alcohol Intoxication
General Medical Condition - (e.g., complex partial seizures)
Post-Traumatic
Stress Disorder (PTSD)
Cause:
When faced
with overwhelmingly traumatic situations from which there is no
physical escape, a patient may resort to "going away"
in his or her head. This ability may be used and is extremely
effective defense against acute physical and emotional pain, or
anxious anticipation of that pain. By this dissociative process,
thoughts, feelings, memories, and perceptions of the traumatic
experiences can be separated off psychologically, allowing the
patient to function as if the trauma had not occurred.
Often, even
after the traumatic circumstances are long past, the left-over
pattern of defensive dissociation remains. Chronic defensive dissociation
may lead to serious dysfunction in work, social, and daily activities.
Repeated dissociation may result in a series of separate entities,
or mental states, which may eventually take on identities of their
own. These entities may become the internal "personality
states," Changing between these states of consciousness
is described as "switching."
Treatment:
Treatment
methods include psychotherapy and the use of specific medications
either on their own or , which is more effective in conjunction
with each other.
Psychotherapy
is the treatment of choice for individuals suffering from any
type of dissociative disorder. Approaches vary widely, but generally
take an individual modality (as opposed to family, group or couples
therapy) and emphasize the integration of the various personality
states into one, cohesive whole personality. The role of hypnosis
remains controversial partly because of concerns that hypnosis
may increase the risk of creating false memories.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
The use of
medication, except for the treatment of acute, specific concurrent
Axis I disorders, is not recommended. Maintenance and effective
use of prescriptions given the multiple personality states is
difficult to attain. If medication is prescribed, it should be
carefully monitored.
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