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Preparing for your appointment
By Mayo Clinic staffMany 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, hallucinations, amnesia or a suicide attempt.
If you or a loved one has less urgent symptoms of a dissociative disorder, you may start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, 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
- Write down any symptoms you're experiencing, including any recent behavior you exhibited that caused confusion or concern for you or your loved ones.
- Write down your 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 there are periods of your life for which you don't have any recall, write down the time frame and anything you can remember about the period leading up to your amnesia.
- Make a list of your medical information, including other physical or mental health conditions with which you've been diagnosed. Also write down the names of any medications or supplements you are taking.
- Take a trusted family member or friend along, if possible. It can be difficult to soak up everything your doctor says, and a loved one can help remember the information. In addition, 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.
- Write down questions to ask your doctor in advance so that you can make the most of your appointment.
For dissociative disorders, some basic questions to ask your doctor include:
- What is likely causing my symptoms or condition?
- Other than the most likely cause, what are possible causes for my symptoms or condition?
- How will you determine my diagnosis?
- Is my condition likely temporary or 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?
- Will I need care for this condition for the rest of my life?
- 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? What will that cost, and will my insurance cover seeing a specialist?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time 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 for which you don't have any recall?
- 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 are outside of your body, observing yourself?
- Do you feel as though there is more than one person, and perhaps many people, living inside your head?
- How often do you feel anxious or depressed?
- What other symptoms or behaviors are causing you or your loved ones distress?
- Have your symptoms caused problems in your career and your personal relationships?
- Have you ever thought about harming yourself or others?
- Do you drink alcohol or use illicit 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?
What you can do in the meantime
If you have fantasies about hurting yourself or someone else, go to an emergency room or call 911 or your local emergency number immediately.
- Dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 20, 2009.
- Maldonado JR, et al. Dissociative disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing; 2008:665.
- Dissociation and dissociative disorders. National Mental Health Association. http://www.nmha.org/index.cfm?objectId=C7DF8D4E-1372-4D20-C86C22067E838DF0&CFID=306278&CFTOKEN=696f1d08c4d6ecd2-823F75DC-1372-4D20-C8B94665B1F8DBE7. Accessed Jan. 20, 2009.
- Frequently asked questions: Dissociation and dissociative disorders. International Society for the Study of Trauma and Dissociation. http://www.isst-d.org/education/faq-dissociation.htm. Accessed Jan. 20, 2009.
- Turkus JA, et al. Therapeutic interventions in the treatment of dissociative disorders. Psychiatric Clinics of North America. 2006;29:245.
- Chu JA, et al. Guidelines for treating dissociative identity disorder in adults. Journal of Trauma & Dissociation. 2005;6:69.
- Silberg J, et al. Guidelines for treating dissociative identity disorder in children and adolescents. Journal of Trauma & Dissociation. 2004;5:119.
- Berkowitz CD. Child maltreatment. In: Marx JA, et al., eds. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006:968.
- Sar V, et al. Dissociative disorders in the psychiatric emergency ward. General Hospital Psychiatry. 2007;29:45.
