Many people with a dissociative disorder first receive medical attention for their condition in an emergency room. Symptoms of a psychiatric crisis requiring urgent medical care include traumatic flashbacks that are overwhelming or associated with unsafe behavior, such as a suicide attempt.
If you or a loved one has less urgent symptoms that may indicate a dissociative disorder, call your primary care doctor. As a first step, your doctor may ask you to come in for a thorough exam to rule out possible physical causes of your symptoms. However, in some cases you may be referred immediately to a psychiatrist.
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
Before your appointment, make a list of:
- Any symptoms you're experiencing, including any recent behavior that caused confusion or concern for you or your loved ones.
- Key personal information, including any major stresses or recent life changes. Also note events from your past, including your childhood, that caused physical or emotional trauma. If you can't recall some periods of your life, note the time frame and anything you can remember about the period leading up to your amnesia.
- Your medical information, including other physical or mental health conditions you have. Make a note of the names of any medications or supplements you're taking and the dosages.
Take a trusted family member or friend along, if possible, to help you remember the information the doctor tells you. Someone who has known you for a long time may be able to talk with the doctor about periods or events that you don't remember.
Make a list of questions to ask your doctor so you can make the most of your appointment. For dissociative disorders, some basic questions to ask include:
- What is likely causing my symptoms or condition?
- What are other possible causes?
- How will you determine my diagnosis?
- Is my condition likely temporary or long term (chronic)?
- What treatments do you recommend for this disorder?
- How much can I expect my symptoms to improve with treatment?
- How will you monitor my progress?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Should I see a specialist? If so, will my insurance cover seeing a specialist?
- Are there any brochures or other printed material that I can take? What websites do you recommend?
Don't hesitate to ask questions during your appointment anytime that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
- What are your symptoms?
- When did you or your loved ones first notice your symptoms?
- Are there periods of time in your life that you don't remember?
- Have you ever found yourself some distance away from your home or work, and not known how you got there?
- Do you ever feel like you're outside of your body, observing yourself?
- Do you feel as though there is more than one person, or maybe many people, living inside your head?
- What other symptoms or behaviors are causing you or your loved ones distress?
- How often do you feel anxious or depressed?
- Have your symptoms caused problems in your work or your personal relationships?
- Have you ever thought about harming yourself or others?
- Do you drink alcohol or use illegal drugs? How often?
- Do you now or have you ever served in the military?
- Have you ever been touched against your will?
- Were you physically abused or neglected as a child?
- Was anyone in your family abused during your childhood?
- Are you currently being treated for any other medical conditions, including mental illness?
In an emergency
If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.
March 26, 2014
- Dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Oct. 28, 2013.
- Highlights of changes from DSM-IV-TR to DSM-5. American Psychiatric Association. http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf. Accessed Oct. 8, 2013.
- Dissociative disorders. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?Section=By_Illness&Template=/ContentManagement/ContentDisplay.cfm&ContentID=26975. Accessed Oct. 28, 2013.
- Dissociative disorders. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/sec15/ch197/ch197a.html. Accessed Oct. 28, 2013.
- What is a dissociative disorder? Sidran Institute. http://www.sidran.org/sub.cfm?contentID=75§ionid=4. Accessed Oct. 28, 2013.
- Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 4, 2013.
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