On TMS And Depression: Frequently Asked Questions


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Transcranial magnetic stimulation is a form of treatment that is non-invasive. It works by directing repeated magnetic energy pulses at particular aspects of the brain responsible for mood regulation. These magnetic pulses go through the skull and activate brain cells that can enhance communication between the brain’s various parts. When TMS pulses are brought at steady intervals, it is called repetitive TMS. How this process works is not yet clear, but the activation seems to have permanent effects on how the brain functions, which can alleviate symptoms of depression and improve one’s mood.

Thinking about magnetic pulsations passing through the brain might scare you or make you feel unimaginable, such as shock therapy effects that you see in movies. But the pulses utilized in TMS are essentially the same strength and type as the magnetic pulsations used in MRI scanning machines and are known to be very safe. Additionally, in contrast to electroconvulsive therapy, TMS does not need any form of post-therapy downtime or sedation, and it comes without any side effects in cognition or memory. In fact, most people who have tried TMS claim that they experience lesser side effects compared to their antidepressants.

What TMS Is For

In the United States, TMS therapy has just been permitted for treating major depressive disorder. However, trials have been ongoing for dissociative identity disorder and other conditions that may cause depression and other mental illnesses. While depression is treatable, TMS is usually recommended when regular treatment forms like medications, self-help strategies, and therapy have not been effective. In the case of medicine therapy, the effects are too intense.

In Europe, on the other hand, TMS has been approved for several other diseases, including stroke rehab, posttraumatic stress disorder, anxiety, schizophrenia, chronic pain, nicotine addiction, Parkinson’s disease, and Alzheimer’s disease. Transcranial Magnetic Stimulation has even shown positive outcomes in conditions like fibromyalgia, autism spectrum disorder, tinnitus, Tourette syndrome, and multiple sclerosis.

TMS For Depression

Depression can dramatically impact you, affecting the way you feel, think, and perform in your everyday life. Many people are capable of attaining relief through therapy, medication, or a combination of different treatments. In contrast, for others, hopelessness creeps in as nothing provides them with a sense of relief and relaxation.

If you are one of those who are diagnosed with major depression that has been resistant to all other forms of treatment, then TMS therapy might be the right choice for you. Just as taking antidepressants targets brain stimulation, TMS functions the same way using magnetic pulses.

TMS Effectiveness

Most past and current studies have produced outcomes that support transcranial magnetic stimulation to improve depressive conditions that are resistant to standard treatments. For individuals with major depression that has not improved by taking medications, more than 50% experience relief of their symptoms using TMS. In contrast, one in three individuals experiences complete remission of their symptoms.

Having said that, it does not necessarily imply that TMS is a proven cure for severe depressive conditions and that one’s depression won’t recur. In fact, the positive outcomes from TMS are inclined to last for about just a year following treatment. However, it is vital to keep in mind that depression is the result of the imbalance of chemicals in the brain but is also caused by a mixture of psychological, social, and biological factors. This means that your relationships, coping strategies, and lifestyle changes as well may have added to your depression. Hence, you can utilize the improvements in your motivation and energy from TMS therapy to initiate talk therapy or perhaps with lifestyle modification, such as exercising, finding support, and improving your eating habits.

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Below are some answers to frequently asked questions about depression. 


What is the number 1 cause of depression?

Experts agree that depression is not necessarily a result of having too little or too many brain chemicals. Instead, there are many potential causes of depression, including genetic susceptibility, medications, medical conditions, mood regulation, and stressful life situations.

Is it possible to diagnose yourself with depression?

Self-screening examinations are instruments that will help one evaluate his or her own mental health. These examinations identify signs and symptoms that could present in certain mental disorders. They could also assist in recognizing patterns of substance use or patterns of emotions.

What are the different types of depression?

Below are some of the most popular types of depression:

  • Bipolar disorder
  • Major depressive disorder
  • Premenstrual dysphoric disorder
  • Atypical depression
  • Seasonal affective disorder
  • Persistent depressive disorder
  • Postpartum depression

Is melancholy the same as depression?

Melancholy has a history that dates back to the Hippocratic period. Its modern definition was founded on Kraepelin’s manic-depressive disorder. Depression is a prolonged or profound misery in one’s daily life. However, melancholy has a unique feature of mood that cannot be translated as extreme depression.

What is a melancholy mood?

By definition, a melancholy mood suggests depression of the spirit or mind, leading to misery. It is a feeling of dejection or sadness.

Is melancholy a disorder?

While melancholic depression was previously identified as an independent disorder, the APA no longer recognizes it as a distinct mental disorder. Rather, melancholia is now acknowledged as a specifier for major depressive disorder.

Can melancholy be happy?

The idea of sadness signifies misery and certain desperation, while melancholy implies grief with a purpose, a feeling with which a person can be enveloped like a blanket. To be engulfed in melancholy is to submerge in purposeful unhappiness, the kind that makes a person happier.


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After completing TMS therapy cycles, standard treatments for depression – psychotherapy and medication – may be ordered as continuing treatment. It is unclear if maintaining long-term TMS sessions will further improve one’s depression. This entails continuous treatment when you have been relieved of your symptoms, hoping to prevent depression symptoms from coming back. However, if your symptoms visibly improve with TMS and eventually the symptoms recur, TMS therapy can be done again. This is known as re-induction.





Taking Care Of Your Mental Health While Attending To The Needs Of Your Loved One With DID

Taking Care Of Your Mental Health While Attending To The Needs Of Your Loved One With DID

Mental disorder is a serious matter. Most people think that it’s a rare condition. However, mental illnesses are more common than people think. It impacts adolescents and adults the most.

From psychological functions to physical abilities, the effects brought upon by severe mental derangement may completely disrupt a person’s life. The battle against it can be a long, arduous process.

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Dissociative Identity Disorder: A Mental Illness

Previously known as Multiple Personality Disorder, Dissociative Identity Disorder (DID) is one of the rarest mental illnesses. It is a condition that affects the personality of an individual where the patient loses touch with the present and true self. The emotions, behavior, and memories entirely change as the person develops two or more personality states or identities. 

DID diagnosis’s common signs and symptoms include drastic memory gaps, identity transformation, social and occupational impairment, and feelings of confusion. Other mental health problems such as depression and anxiety may also arise, if not already present.

The majority of those who suffer from this disorder are victims of terrible abuse and other traumatic experiences from their childhood.

There is currently no special medication available for DID patients. They receive the same prescription of mood stabilizers used to treat depression and anxiety. With this information, someone may experience it for a lifetime. It can be a terrifying notion, especially if someone becomes your loved one.

Having A Loved One Suffering From DID

Amidst the frightening thought that being with someone inflicted with DID is hellish, to both the victim and the family and friends, should not feel alarmed. TV shows and movie portrayals of the illness are often overdramatic and are in no way accurate and realistic.

Contrary to what the media shows, people with DID are more often calm but just vastly disoriented with what’s presently happening around them. There is nothing to fear about the dissociative identity disorder. It is much like other mental health problems that require the utmost and extended care, patience, and understanding.

Knowledge is an essential requirement when dealing with people who are undergoing mental disorders. If you are with someone who has DID, it is vital to be well-informed with the illness and not just the one party affected. 

Your support for your loved one with the disorder is as necessary as seeking an exceptional advocate or therapist to talk to in case their other identities claim dominance.

Remember that those with DID often slip in and out of consciousness, including them forgetting your existence momentarily.  So make sure that you can attend to their needs and show support to your significant other diagnosed with this mental condition.

As DID is primarily a coping mechanism of many victims of trauma, abuse, or violence, you must keep them away from any potential triggers. You may have to identify the triggers since it is often unique for each one. It’s necessary to address this with the help of a therapist. Talking about triggers may be difficult, but professional help will assist in creating a safe space for them.

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As mentioned before, it could not be stressed enough how keeping mentally unstable individuals away from harm is a lot of hard work. Supporting them can be mentally, physically, emotionally, and financially draining. Hence, practicing self-care should also be a priority.

Looking After Yourself

Caring for someone struggling with mental health problems in general and not just dissociative identity disorder involves painstaking tasks that may give you the so-called “burnout.” Burnout is a real condition that affects many caregivers, whether a family, a friend, or a hired professional when their situation and responsibilities start to take a heavy toll on them. 

To be in charge of someone who requires twice as much attention and effort, such as dissociative identity disorder, is a laborious demand. The exhaustion you will feel over a few weeks, months, or years, if left unchecked, can cost you instability too. No one talks enough and accounts for the suffering of caregivers in the mental health sector.

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It is just as necessary for you to nurture your well-being. When your loved one gets diagnosed with or is already struggling with DID, you must acknowledge the sickness and not let it take over your relationship. Do not spend an ounce of energy nor time dwelling over how unfair the situation is or how you’d rather suffer; instead, seeing them in pain is already a pain for you as well.

Give yourself time. Acknowledge that you have to do other things aside from caregiving. Also, allow some time to reflect on what is best and what will work for you and your loved one. You can take small, baby steps to figure out things. The healing process of DID patients is a long one. You cannot and must not rush into anything.

Another critical factor is to not give up on what you enjoy doing. Most people drop everything they do, including their personal career and dreams, in a heartbeat for their loved ones.

Most believe that doing it will help them focus more on looking after their family or partner suffering from DID. But it is a major no-no. You must not forget yourself. Keep things that help you reduce stress and inspire you to continue to be hopeful.

Ultimately, when you feel you cannot push through on your own, seek a therapist too.


How To Support A Family Member With DID

Finding out that someone close to you, such as a family member, has dissociative identity disorder can be frightening. However, it is a much harder situation for the person living with the disorder. It can be isolating, especially with the stigma around the topic. With this stigma, many people with DID find it challenging to open up to loved ones and seek professional help.

Where does this disorder root from? It is a mental disorder that is typically a result of trauma that the person has experienced. “Trauma can result in regression through an emotional withdrawal of the self from the material self and the material world,” explains clinical psychologist and author Ann Reitan, Psy.D. 

If you have a family member with DID, it is essential to learn about the condition. By doing so, you’re taking a step towards understanding and supporting them. While it can be challenging in the beginning, making an effort to understand the condition is a step. Here are some ways that you can do to help a family member with DID:

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Understand Their Triggers

A person with DID undergoes personality shifts. The cause of these shifts is a trigger or an external stimulus, causing them to switch into another alter. These triggers usually have a connection to their trauma, which elicit a strong emotional response. It can either be sounds, smell, touch, places, songs, phrases, times of the year, or when among a group of people. 

Since these triggers vary from person-to-person, it is vital to be extra cautious. As a close family member, you may have an idea of what may trigger them. If not, you can cautiously bring it up and ask them directly. Also, try to learn the terminologies they use and avoid, so you know what not to use when talking to them.

Respect Their Boundaries

If a family member with DID is avoiding you, it may be best to respect that boundary. Do note that even a mild touch can trigger a switch. Try to approach them with caution, but if they tell you they’re not comfortable, don’t push it. Usually, they would be the ones to let you know when it is safe to interact with them.

Watch Out And Stay Calm During Switches

The switching between alters in DID typically happens subtly. In these cases, you may notice slight changes in the way they talk, or that they may seem off track. However, in some cases, the switch can be more evident and disorienting. It is as if they are an entirely different person in one moment.  

While this may be a shocking and confusing situation, it will be helpful to stay calm. Panicking can upset them, which may trigger hostility. As much as you can, try to act as if nothing happened, and you’re interacting just as usual. It may also help to talk to them after the switch, whether they remember anything or not. It can help you prepare for the next time it happens.

Keep Them Safe

Again, triggers may result from your loved one’s trauma. It is crucial to keep them safe from chances of this trauma happening again, which can occur in an abusive household. Understanding their trauma is always the first step, as it can help you save them from it early on.

If they’re harming themselves or have thoughts of suicide, let them know that you’re by their side. If they experience flashbacks and amnesia, you need to be extra attentive. These cases leave your loved one even more vulnerable. Try to talk to them about the things you can do to help them.

Never Stop Learning About The Disorder

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Learning and understanding DID, and the condition of your family members open doors to recovery. If they see that you are willing to educate yourself about it, they will be more open to you. By doing so, you’re also working towards breaking down the stigma around DID.

Find A Support Group

Support groups are an excellent way for you to find people with the same experience of caring for someone with DID. Here, you can get advice on what are the proper actions to take for different situations. Or you can vent to them about the challenges you’re facing.

You can also introduce your family member with DID to a support group for people with DID. These groups are a great way for them to open up and find people with shared experiences.

Either way, it gives you a reliable support system so that you don’t feel alone in your situation.

Bring Up The Topic Of Treatment

As with any mental disorders, professional treatment is highly beneficial. With the help of a professional, your loved one can learn how to cope with their triggers. It allows them to manage better and prepare when switching between alters. Also, it is critical to get an accurate diagnosis for DID to create an effective treatment plan.

As someone close to them, you are the person who can encourage them to seek treatment. Bring up the topic to them gradually. While you may find it challenging to pursue them because of stigma, it is not impossible. First, try looking for reliable providers and talk to them about what you can do. If they give in to your suggestion, offer to accompany them on their appointments. 

Take Care Of Yourself Too

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Finally, don’t forget about yourself. It can be emotionally taxing to keep up with triggers and alters of your loved one with DID. One of the best ways to give support to them is to tend to your well-being. Forgive yourself on thoughts that you are lacking and be kind to yourself.

Be Their Support System

As a family member, you are an essential part of the support system of a person with DID. We hope these tips help you make a more educated response to symptoms of dissociative identity disorder.



What Are You Gonna Do If You Are Locked Down With A Person Who Has DID?

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So, okay. We are now in the new normal due to the COVID-19 pandemic. Everything is in lockdown, people are under quarantine, and most everyone is terrified to go out. What’s even more terrifying, for some, is the idea of living with a person who has Dissociative Identity Disorder. The first thing that comes to mind is James McAvoy in the movie “Split.” It portrays how, supposedly, a person with DID is so violent and unstable that he kidnaps and kills people for fun, and just because he could, due to his disorder.

Continue reading »

Dissociative Identity Disorder: Two Key Points To Remember

In the Dissociative Identity Conference 2019, Dr. Oriella Cattapan, a clinical and forensic psychologist and family therapist, dug deep into dissociative identity disorder (DID) and introduced a case study of a 40-year-old woman named Kate. She shared her knowledge about the disorder and how her understanding of it shaped her way of treating her clients.

Understanding people with mental disorders can be quite tricky. It requires the development of an inclusive perspective of a patient’s circumstances and past, just like how she discussed the emergence of DID in the case study of Kate.

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Here are two key points you can learn from Dr. Cattapan about DID:

DID Requires Unfolding Past Life Events

It may not be the initial concern and diagnosis of a person who comes for psychological treatment.

In the case study of Kate, she was initially diagnosed to have depression due to bullying. It took about two years of treatment before it was fully revealed to Dr. Cattapan that certain behaviors manifest in Kate due to a long history of traumatic life events growing up.

People with DID may be completely unaware of their condition. Instead of being aware, people who suffer from DID find coping mechanisms to shut off traumatic or painful experiences from the past. This may lead them to display certain behaviors or identities unconsciously.

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DID Requires Psychological Treatment

Psychotherapy brings about an open but structured conversation about possible traumatic experiences.

Psychological treatment could help in unearthing painful emotions and memories in a respectful and structured manner. As mentioned, psychological treatment for Kate aided in unwrapping her past, filled with overwhelming experiences and emotions. It provided a clearer picture as to why her mental well-being is affected.

Talking about life experiences through individual psychotherapy can form closure and provide healthy intervention in altering mental processes and outlooks about life and their past.

The Takeaway

It takes patience and great understanding to fully grasp mental conditions or human behaviors that may be viewed as “unpleasant.” What is important is to continually provide a healthy space that allows people to see through their thoughts and emotions clearly and to gain a better connection with oneself.

Caring For MPD Patient If You Have COVID-19

It does not bring me any joy to admit that fate has probably dealt the worst cards possible for my mother. She was abandoned at 4, maltreated by her adoptive parents at 10, married to an alcoholic at 21, and abused until her husband died. As if such ordeals were not enough, my mother got diagnosed with multiple personality disorder (MPD).

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As unsurprising as that diagnosis was, it still felt a little challenging for my little sister and me to accept. After our father’s passing, after all, Mom tried to raise us as best as she could. She had three jobs but never missed any school performance. She would come home exhausted, but we never heard her complain. Though Mom was a hero in our eyes, my sister and I knew that our mother needed us more than ever.

At the time, my sister was about to go to college while I was already working from home as a ghostwriter. I told her that I would become Mom’s primary caregiver and help pay her tuition.

Was it easy? No. There were times when my mother would believe that I was somebody else. Sometimes, she would insist that it was the 1980s. Having a social life was out of the question, too, given that Mom was deteriorating so fast. I could not leave her for more than an hour.

Despite our family’s hardships, another problem came around March 2020. I was tuning in to the local radio station when the reporter announced that there were five COVID-19 patients in our neighborhood. They were workers at the grocery store where I always went to get our supplies.

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I knew I was careful not to touch anything with my bare hands at the store, but I could not be sure about not catching the coronavirus. The thought of testing positive kept me up all night. It was not because I worried about my well-being but because it meant being away from my mother for weeks. Still, I had no other choice but to care for her in indirect ways, such as:

Make My Sister Go Home

My first course of action was to ask my sister to come home. I trusted no one except for my sister to care for Mom at that point. It would also prevent my mother from noticing my absence too much, considering she had company.

Self-Isolate In Another Place

I also called in a favor from a friend who I knew had an empty house a few blocks away from ours. Most people would try to complete their 14-day quarantine in their respective homes, but I could not do it. Mom was there, and the coronavirus would not have an issue latching on to her.

Note that during my self-isolation, the hospital called and informed me that I genuinely got COVID-19. While I turned out to be asymptomatic, it did not make me feel better. I was still unable to come home.

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Never Mention The Virus To My Mother

Whenever my mother’s personality was not switched, she would FaceTime me to know how I was doing. My sister told her that I had to go out of town, and she bought it, so I went along with it.

Before you say it, no, I did not want to lie to my only living parent. Despite that, I figured that letting her know of my current health condition would not be ideal for her mental health.

Final Thoughts

I only came back home yesterday, and Mom welcomed me with a warm hug that I knew so well. She had lots of stories about the last few weeks with my sister, and it made me glad to hear that her routine did not change at all. Although I could not look after Mom in person, I got to do it somehow by doing the things mentioned above.

Understanding DID: Common Reasons Why People Develop Dissociative Identity Disorder

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The 2017 Disassociative Identity Disorder Conference discusses the reasons for developing dissociative identity disorder. Dissociative identity disorder (DID), formerly known as multiple personality disorder, is a mental illness that often develops in people who have experienced extreme trauma during their childhood. Affected individuals have alternate personalities that they may not be aware of. These alter have unique personalities and quirks that are different from the person’s usual character. The following are the most common reasons why people develop DID.

About 90% of people with DID have been emotionally, sexually, or physically abused in their childhood. As they have to escape the horrors that they face in their homes, they disassociate themselves to cope with it. In some cases, people bury the memories of abuse that they forget it. Lucky for those who can immerse these traumas in their minds. There are also incidents wherein the alter mirror the conflicting personalities of the abusers.

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In some cases, though, it is not an excessive amount of attention, as in abuse, that causes the development of DID; it is the inattention. Children who felt neglected in their developmental years tend to develop another persona to deal with the lack of emotional connection. It is critical to provide enough attention for kids, especially during the formative years.

Exposure To Natural Calamities, Accidents, Or War
Besides abuse and emotional neglect, exposure to highly unpredictable events also increase the risk of developing DID. Examples of these events are natural calamities, accidents that may or may not involve death, and war. People form an alter to tolerate the stressful conditions that they are facing and to escape the fear and pain that they are feeling.

Although it may be easier to dismiss and judge people with DID, it is better to treat them with kindness. Affected individuals have already experienced prolonged trauma in their childhood, and they need people who will understand and accept them. Knowing why people with DID develop their condition is one of the keys to understanding them and treating them with love.

The dissociative disorder often stems from mental injuries caused by traumatic experiences growing up. It is hard enough to go through distressing occurrences; much more, it is to deal with an illness as a consequence of it. Patients who are suffering need therapy and all the support they can get.

Living With Dissociative Identity Disorder

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Living with another individual can be challenging. What more if you have to live with two in just one body? We may have heard about dissociative identity disorder so many times, and this case is so complicated that most of us choose to ignore or refuse to understand. This is something more than just a condition that can be treated as this has hardly been understood fully. There has been a constant debate about its existence and nature. Continue reading »

Understanding Dissociative Identity Disorder In Children (Is Online Therapy An Option?)

Hilda’s Story 


Hilda, an eight-year-old South American girl from the suburbs, was sent to the grade level guidance counselor for exhibiting bad behavior in the classroom. Aside from being overly talkative, she disturbs her classmates who are doing their school work. She often gets into petty arguments, physical fight episodes with male classmates, sarcastic when talking back to her teachers, and has bullied some kids in lower grade levels. These kids are smaller and weaker. 


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  Continue reading »

Sidran Institute Psychiatrist And Mental Health Experts Talk About Dissociative Disorders

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Dissociative disorder is a mental health illness that affects a person’s memory, identity perception, behavior, emotion, and sense of self. The disorder has a significant effect in almost all areas of a person’s mental function. When one is experiencing self-detachment and memory loss, the person is then suffering from dissociative disorder. Trauma experienced from the past can cause the development of this disorder.

Dissociative Disorder: Identity Disorder, Amnesia, And Depersonalization Disorder

Sidran Institute (Towson, MD) describes dissociation as the disconnection of a person’s memories, feelings, thoughts, and actions. (The institute also helps people further understand everything about the mental health illness.) As mentioned, dissociative disorder is related to past, traumatic and overwhelming experiences. This was then referred to as the Multiple Personality Disorder.

Dissociative Disorder: Signs And Symptoms

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The person suffering from dissociative disorder has more than one personal identity. These identities come in with changed behavior, thinking, and memory. Such symptom is observable by other people around the person with the illness.

Symptoms can then cause problems on a person’s daily association with other people and have a significant effect on his work and personal relationships. It is also NOT a normal phenomenon despite cultural differences. There are cases wherein some countries consider this a standard spiritual practice. But in medical science, this is regarded as a severe mental health problem.

People with the disorder display preferences and attitude that shift back and forth all the time. The person has no control over them. As a result, the patient experiences stress. He will also become obsessed with his body (which feels different to the person at times). Even with their speech way and style, it’s different from one identity to another.

Sidran Institute psychiatrists and mental health professionals state that in time, a person with such disorder has this feeling that he has more than one identity. Each identity has its personality, perception and even memories. These personalities are entirely different from each other. Still, it is important to note that it’s from the same person. The separate identities created are called “alternate personalities,” “identities”, “states of consciousness” and “alters.”

The extent of this disorder can range from minimal to significantly disturbing. People experiencing this illness usually try to address it immediately to reduce the impact and effects of its symptoms.

Fact: “Although brain imaging is being used to help us better understand psychiatric disorders, they are not currently being utilized for diagnostic purposes.” – Colleen Cullen, PsyD

Risk Factors

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People traumatized by sexual and physical abuse, especially in their childhood years, have the most chance of getting this disorder. Those who get raped multiple times, get beaten a lot, and are exposed to traumatic situations are highly at risk of developing the illness. Self-destruction and even suicidal thoughts and attempts are common for people with dissociative disorder, according to Sidran Institute experts.

Dissociative Disorder Treatment

Sidran Institute suggests and recommends various ways to heal from this mental health disorder. With proper care and early medical intervention, people with dissociative disorder have high chances of overcoming the condition. They improve significantly over time which enables them to function normally and even live a productive life if the disorder has not permanently damaged their cognitive performance.

The usual treatment for dissociative disorder is psychotherapy. Therapy helps those with the illness to take control of themselves once the disorder occurs. If possible, psychotherapy may help people limit their symptoms. The specific goal of therapy is to help address the different aspects of the identities. Treatment programs used are cognitive behavioral therapy, dialectical behavioral therapy, and hypnosis.

Experts do not recommend medication to address the disorder directly. But some medicines can be prescribed to treat some symptoms of the said condition. They should be used with caution, though.

According to Judith M. Glassgold, PsyD, “Practitioners can assist clients through therapies.” If you believe you are suffering from a mental health-related issue, make sure to try therapy or counseling as soon as possible.

If you know someone who has a disassociate disorder, make sure to remind him to become mindful in times of feeling anxiety. According to Ron Siegel, PsyD, “Once you’ve got some anxiety going, just breathe, and feel it. Notice how it feels throughout the body.”

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