Post-traumatic stress disorder (PTSD) is a common mental health disorder born out of trauma. It can cause symptoms like nightmares, anxiety, and flashbacks. In some cases, these symptoms can be separated into different subtypes. PTSD with dissociative symptoms includes symptoms consistent with dissociative disorders and is a similar mental health problem that is also related to trauma.

What is PTSD with dissociative symptoms, and what are its symptoms?

What Is Dissociation?

Dissociation is a psychological phenomenon in which you feel disconnected from yourself or the world around you. Some describe it as an out-of-body experience. Dissociation is described as a general sense of distance from the world around you, looking at the world through a pane of glass or looking down on yourself as an impartial observer. As bizarre as it sounds, dissociation isn’t a psychotic break. In fact, it’s a natural function of your brain that is supposed to happen in response to serious psychological trauma.

Many people experience a dissociative episode during traumatic events, like a serious car accident or assault. It’s thought that dissociation is the brain’s way of shielding you from psychological trauma. However, normal dissociation is brief and ends when the traumatic event is over. In some cases, dissociative episodes can return at random, even without any trauma or danger around you. This is called a dissociative disorder.

Dissociative disorders involve a disconnection with yourself or the world around you that is involuntary and disruptive to your daily life. Dissociative episodes can also be associated with post-traumatic stress disorder. Both disorders are closely related to past trauma and may have many overlapping symptoms.

Dissociative disorders often develop after a traumatic event in a person’s life—much like PTSD. Symptoms of dissociative disorders can include amnesia, loss of identity, and catatonic states. PTSD with dissociative symptoms can involve intense dissociative flashbacks, where you feel distant from the real world around you. Sometimes, stress and triggers can worsen symptoms.

How Does PTSD Affect the Brain?

Post-traumatic stress disorder involves the brain and body’s fight-or-flight response. Those with PTSD may experience extreme mental andhollywood ptsd treatment emotional responses to danger. When experiencing a traumatic event, the brain prepares the body to take action quickly, and you become more vigilant and alert. However, the stress response diminishes once the dangerous situation ends.

PTSD causes you to relive the fight-or-flight response to the traumatic event whenever something triggers you. Researchers think that PTSD affects the hippocampus, which is the part of the brain that converts short-term memory into long-term memory. The hippocampus also helps you to remember to escape dangerous events when you encounter them again.

Triggers, memories, and emotions that remind you of the traumatic experience can cause the hippocampus to believe the event was happening again. This causes flashbacks, which are dissociative episodes that make you believe you are experiencing the traumatic event again. You may also experience severe anxiety and nightmares due to your traumatic memories.

What Causes PTSD?

PTSD is caused by traumatic events. First responders and military members are highly likely to develop PTSD. Going through combat situations where your life, the lives of loved ones, or the lives of vulnerable people are in danger is a major risk factor for PTSD. Of course, civilians can also experience traumatic situations that can cause PTSD, such as:

  • Serious injuries, accidents, or health issues
  • Exposure to war
  • Witnessing an accident or violent act
  • Natural disasters
  • Being tortured or physically or sexually assaulted
  • Childhood or domestic abuse
  • Loss of a loved one
  • Hearing about a traumatic event that a loved one went through

Of everyone who experiences trauma, it’s estimated that a third of them will develop PTSD. However, it’s unknown why some people develop PTSD after a traumatic event while others don’t. It’s common that people who go through the same traumatic situations don’t experience the same symptoms and emotions afterward.

Similar to other mental health issues, there are several factors that can increase your risk of developing PTSD, including your genetics, environment, and how you process the event in the aftermath.

For example, talking about your experience with loved ones or a mental health professional right after the event can help you process what happened and avoid developing PTSD. Those who have high-stress jobs, such as first responders, can take preventative measures to cope with the traumatic events they face and reduce the risk of PTSD.

A strong support system can also help decrease your risk of developing PTSD. However, preventative measures don’t guarantee you will never experience it.

What Are Symptoms of Dissociation?

Dissociative disorders can come with a range of symptoms. You may experience all of them or only a few. There are three major types of dissociative disorder that can come with different symptom profiles. The types of dissociation include:

Dissociative Amnesia

Dissociative disorders can sometimes cause memory loss that is markedly different from typical forgetfulness. You may have a gap in your memory when you can’t remember people, places, or events from your past. Your memory gaps may be centered around a particularly traumatic event. They can also center around periods of high stress like a tour of combat or going through a natural disaster. In rarer cases, amnesia can be more intense, causing complete memory loss about yourself or your life. Some people experience a dissociative fugue, in which they are lost in a state of amnesia and confusion. Episodes of dissociative amnesia can come on suddenly and last for an unpredictable amount of time. Dissociative amnesia can last anywhere between minutes or years.

Dissociative Identity Disorder

Dissociative identity disorder (DID) was once called multiple personality disorder. However, the disorder is better described as a single identity that has been “fractured” into multiple pieces rather than several distinct identities. DID is characterized by the feeling that you share a body with multiple identities. DID is often rooted in a traumatic event in which the mind creates other personas to shield a person from painful psychological trauma. People with DID may also have symptoms of a dissociative fugue when other personalities are in control. A lot remains unknown about dissociative identity disorder. Treatment and research are still ongoing.

Depersonalization Derealization Disorder

Depersonalization and derealization are two different symptoms that can occur with dissociative disorders. Depersonalization is a feeling of disconnection from yourself. This is what is often referred to as an out-of-body experience. Someone experiencing derealization may feel they are observing your actions, experiences, feelings, and thoughts as an outside observer. Derealization is a detachment from the world around you in which it feels less real. You may feel like you are in a foggy, dreamlike state. This can also feel like time is slowed or like the world isn’t real.

You can experience depersonalization and derealization at the same time. Symptoms may come and go for years. In many cases, episodes only last for a few minutes, but they can be extremely uncomfortable and distressing. It’s worth noting that the feelings of depersonalization and derealization aren’t delusions. Most people with dissociative disorders know their world is real despite feeling otherwise. This acknowledgment of reality sets these symptoms apart from psychotic symptoms.

What Is PTSD with Dissociative Symptoms?

Post-traumatic stress disorder is sometimes separated into different subtypes. Mental health disorder subtypes are often distinguished based on clusters of symptoms—or symptoms that group together to create unique experiences between people with the same disorder. There are many possible symptom clusters of PTSD, but dissociative symptoms are among the experiences that can sometimes be considered a subtype.

The dissociative subtype of PTSD was included in the fifth edition Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) relatively recently. The DSM-5 is the latest edition of the premier diagnostic tool that’s used to identify mental health disorders.

PTSD with dissociative symptoms refers to PTSD that comes with symptoms that overlap with dissociative disorders. According to the DSM-5, if you meet the diagnostic criteria for PTSD and also show symptoms of derealization or depersonalization, you may have “PTSD with dissociative symptoms.” These symptoms must be persistent or recurring. These symptoms must also not be better attributed to a psychoactive substance. Some drugs can cause what is called ego-death, which is a temporary loss of your sense of self or individuality.

Dissociative symptoms combined with PTSD may center around flashbacks or memories of a traumatic event. PTSD can cause nightmares and flashbacks that have to do with past trauma. In some flashbacks, you may lose your connection with yourself or the world around you. Since dissociation is often a natural response to trauma, flashbacks, and retraumatization that feel real enough may trigger dissociative symptoms.

How Is PTSD with Dissociative Symptoms Treated?

PTSD is a distressing and chronic condition, but it can be treated effectively. Mental health disorders are complex, so your treatment will ultimately depend on your specific needs. Medications and therapies may be useful. Medications include antidepressants like selective serotonin reuptake inhibitors (SSRIs). Sleep aids may also help manage insomnia and sleep disturbances. Behavioral therapies and trauma therapy called eye movement desensitization and reprocessing (EMDR) can also be helpful.

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