Patients with depersonalization/derealization disorder are often challenging to treat. Many different types of psychotherapy have been used to treat depersonalization disorder, including psychodynamic, cognitive, cognitive-behavioral, hypnotherapy, and supportive therapy. However, many patients do not have a strong response to these types of standard psychotherapy. Stress management strategies, distraction techniques, reduction of sensory stimulation, relaxation training, and physical exercise may be somewhat helpful in some patients.
As far as pharmacotherapy, there are mixed results. Some evidence indicates that SSRI antidepressants, such as fluoxetine (Prozac), may be helpful. Recent studies, however, found no efficacy for fluvoxamine (Luvox) and lamotrigine (Lamictal) for depersonalization disorder. Some patients with depersonalization disorder respond sporadically and partially to the usual groups of psychiatric medications, singly or in combination: antidepressants, mood stabilizers, typical and atypical neuroleptics, anticonvulsants, etc.
Dissociative identity disorder, formerly known as multiple personality disorder, is a complex psychological condition characterized by two or more distinct personality states. The disruption in identity involves a marked separation from a person’s sense of self, accompanied by changes in effect, behavior, thoughts, consciousness, memory, perception, and/or sensory-motor functioning. These signs and symptoms may be observed by others or reported by the individual.
A person with this condition has recurrent gaps in the recall of everyday events, personal information, and/or traumatic events that are inconsistent with ordinary forgetting. The symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures). In children, the symptoms are not better explained by imaginary playmates or other fantasy play.
Dissociative identity disorder is strongly linked to severe experiences of early childhood trauma, usually abuse. Physical and sexual abuses are the most frequently reported sources of childhood trauma. The disorder is thought to be more common during natural disasters, wartime, or times of major social dislocation.
Various types of treatment approaches may be required to treat a patient with dissociative identity disorders. Options include psychoanalytic psychotherapy, cognitive therapy, behavioral therapy, hypnotherapy, electroconvulsive therapy, group therapy, family therapy, self-help groups, art therapy, movement therapy, and eye movement desensitization and reprocessing. Pharmacotherapy often includes antidepressant and anti-anxiety medications to treat depression and PTSD symptoms.
Mental Health Library Sources:
Information included in all topics of the Mental Health Library comes from the Desk Reference to the Diagnostic Criteria From DSM-5 and Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Complete diagnostic and treatment information may be found within these publications.
Information within the Mental Health Library is not intended to be used for self-diagnosis purposes. Rather, it is provided as a public educational service to make people aware of mental health conditions. Please consult a qualified mental health professional for a diagnosis of any suspected mental health illness.
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