Understanding Dissociative Disorders by Marlene E. Hunter

Author:Marlene E. Hunter [Marlene E. Hunter]
Language: eng
Format: epub
ISBN: 9781845905804
Publisher: Crown House Publishing
Published: 2012-01-15T00:00:00+00:00

Chapter Nine

Comorbid States Associated

with Dissociation

Depression

When we are considering and assessing possible comorbid states in patients who have a dissociative disorder, the question sometimes becomes, “Which diagnosis comes first?”

For example, virtually all people who are markedly dissociative, and are diagnosed with DID, will have a depressed ego state. During the time when that ego state is “out”, the whole aspect of the patient is one of severe depression. At times, a severely depressed ego state will negatively affect the functioning of the whole system, and is one good reason for prescribing antidepressants, especially the SSRIs. Of course, one runs into the rebellion of other ego states who do not want to take the medication, but the answer there is fairly straightforward: “She needs it, she takes it; if you don’t need it, you don’t have to take it but the dose must be given to the body so that she can have it.”

Depression is also commonly found in patients with DDNOS and those who suffer form PTSD. Once again, we must decide which is the primary diagnosis as far as we are concerned—the PTSD or the depression. This decision has a role in the way therapy is organized, and although this is primarily the purview of the therapist, it is the family physician who monitors the whole patient from a physiological-function standpoint. Discussion with the psychotherapist may be very important; at times therapy needs to be put on hold until the depression is brought under control.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.