Dr. Sashikala Hande

Dissociation identity disorder (did), previously known as multiple personality disorder (mpd) is a mental disorder characterized by at least two distinct and relatively enduring identities or dissociated personality states that alternately show in a person's behavior, accompanied by memory impairment for important information not explained by ordinary forgetfulness.

Let me explain this in a simple way.

Example 1- lets say there is Mr. X and Mr. Y. Mr. X is very impressed by the personality of Mr. Y. So he starts liking him. He also tries to sepnd more time with him. He may with time start copying him or seek his help. This problem become so severe that after some time, in a flash Mr. X wakes up and become a copy of Mr. Y. However Mr. X cannot forget that he is actually Mr. X and not Mr. Y. Thus, Mr. X has developed a split personality where he and Mr. Y co exist. This may with time lead to further mental health deterioration such as depression, loss of memory, personality changes, mania, psychosis, antisocial behavior and above all a loss of control and insight in ones life.

Example 2- Mr. X may not be impressed with Mr. Y. But here it's the reverse. Mr. Y is impressed by Mr. X and wants to be a part of Mr. X s personality. He forces himself on Mr. X until he becomes a part of Mr. X. Therefore Mr. Y has been successful in forcing himself on Mr. X although Mr. X wanted to distance himself form Mr. Y but could not due to various reasons.

Example 3- this problem does not need to be confined to just 2 people. Any number of people can force themselves on Mr. X depending on his plotters and schemers. Therefore Mr. X loses his mental health and his personality becomes broken into several pieces which have been thrust on him.

Some people tend to do this voluntarily because of the fact that they like Mr. Y possessions but in most cases people are victimized into this as they are struggling to make ends meet in their lives. The result is agony, despair, loss of self control. An annihilating world and an end full of shame and contempt because of loss of control depending on how erroneous Mr. Y and his associated are.

Many marriages have been broken because of their spouses developing mpd. Spouses who were happy with each other, suddenly turn hostile and throw them out of their lives because they are now possessed with Mr. Y s who are interested in other spouses than their own. Many children also loose their parents love and care because their parents are no longer interested in them and they desert them or send them to boarding schools.

This disease is a social evil and a menace to a justful society. But the stress on taking precaution lies with us.

Developmental trauma

People diagnosed with did often report that they have experienced severe physical and sexual abuse, especially during early to mid-childhood, and others report an early loss, serious medical illness or other traumatic event. They also report more historical psychological trauma than those diagnosed with any other mental illness. Severe sexual, physical, or psychological trauma in childhood has been proposed as an explanation for its development; awareness, memories and emotions of harmful actions or events caused by the trauma are removed from consciousness, and alternate personalities or sub-personalities form with differing memories, emotions and behavior.

As of 2011, approximately 250 cases of did in children have been identified,

Problems with diagnosis

People with did are diagnosed with five to seven comorbid disorders on average much higher than other mental illnesses. Due to overlapping symptoms, differential diagnosis includes schizophrenia, normal and rapid-cycling bipolar disorder, epilepsy, borderline personality disorder, and asperger syndrome. Delusions or auditory hallucinations can be mistaken for speech by other personalities. Persistence and consistency of identities and behavior, amnesia, measures of dissociation or hypnotizability and reports from family members or other associates indicating a history of such changes can help distinguish did from other conditions. A diagnosis of did takes precedence over any other dissociation disorders.

Treatment

Common treatment methods include an eclectic mix of psychotherapy techniques, including cognitive behavioral therapy hypnotherapy and medications can be used for comorbid disorders and/or targeted symptom relief. Some behavior therapists initially use behavioral treatments such as only responding to a single identity, and then use more traditional therapy once a consistent response is established. Brief treatment due to managed care may be difficult, as individuals diagnosed with did may have unusual difficulties in trusting a therapist and take a prolonged period to form a comfortable therapeutic alliance. Regular contact (weekly or biweekly) is more common, and treatment generally lasts years not weeks or months. Sleep hygiene has been suggested as a treatment option,

Legal issues

Individuals diagnosed with did may accuse others of abuse but lack objective evidence and base their accusations solely on regular or recovered memories. There are questions regarding the civil and political rights of alters, particularly which alter can legally represent the person, sign a contract or vote. Finally, individuals diagnosed with did who are accused of crimes may deny culpability due to the crime being committed by a different identity state.

For a mother, a miscarriage is the last thing she would want to hear. It can pin her down psychologically, leading to trauma and stress in unfathomable measures. To understand miscarriage better, it is a condition wherein there is a loss of pregnancy within the first 22 weeks of getting pregnant. The primary symptom of a miscarriage is bleeding from the vagina. So if you experience vaginal bleeding during this phase, then consult a doctor for further guidance.

Why do they occur?
There are many reasons as to why a miscarriage may occur and no study has been able to put a finger on any one specific cause. Having said that, miscarriages are mainly caused due to the presence of unusual chromosomes in the baby. Chromosomes are genetic material that directs the growth and development of a baby. Chromosomes present in either excess numbers or less can hinder the development of the baby. If the miscarriage occurs during the second trimester (14th to 26th week), then it can be accrued to a health anomaly in the mother. A miscarriage may also occur because of a weak cervix as a weak cervix will not be able to hold a pregnancy. This condition is called cervical insufficiency and occurs when the woman is in her second trimester.

Is it possible to prevent them?
In most cases, miscarriages cannot be prevented. For women who have suffered multiple miscarriages, multiple medications might be required to help with their subsequent pregnancies. Following a healthy lifestyle is recommended as it can minimize the risk of a miscarriage. One must abstain from smoking and substance abuse and limit consumption of alcohol in order to keep the body in optimal condition. It is advised to maintain optimal weight levels and eat a well-balanced diet.

Post miscarriage
A miscarriage is a very traumatic experience for a mother to be; it can be emotionally debilitating. That is the reason counseling can help in times such as these. Start planning for a baby only once the symptoms have subsided and you have also had a period post the miscarriage. It is important to make sure that you are physically and emotionally ready to have a baby. Remember, a miscarriage doesn’t mean the end of the world. One can enjoy a fully healthy and a successful pregnancy even after a miscarriage.

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