Disassociative Identity Disorder (DID)

Recently, I have been watching the TV show "United States of Tara," which is a fictional show about a woman living with disassociative identity disorder (DID), once known as multiple personality disorder. The show incited a curiosity to understand DID better. So here is what I learned: Disassociative identity disorder effects between .01-1% of the general population. It is characterized by having at least 2 or more personalities/identities, known as "alters," that have control over the person's behavior and/or thoughts. It is also distinguished by memory variations, depending on the alter, as well as the inability to recall specific personal information that is more far reaching than just forgetfulness. The alters have their own gender, race, age, class etc. and have their own distinct gestures, way of speaking and movement. Sometimes the alters can be animals and/or imaginary people. When one of the personalities takes over the person's behaviors/actions and thoughts, it is known as "switching." Switching can happen over seconds, minutes or days. There are usually 2-4 alters that are present at diagnosis but often between 13-15 appear during treatment. Stressful life events or environmental triggers can cause a person to switch from one identity to the next.
Some other symptoms that may accompany DID are:

• Depression
• Mood swings
• Suicidal tendencies
• Sleep disorders (insomnia, night terrors, and sleep walking)
• Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers")
• Alcohol and drug abuse
• Compulsions and rituals
• Psychotic-like symptoms (including auditory and visual hallucinations)
• Eating disorders 

The cause of DID is not completely understood but believed to have both environmental and biological basis. Majority of the people with DID have had some type of reoccurrent and of life threatening disturbances before the age of nine, including persistent neglect or abuse. Findings have shown that DID is highest among families where parents are often frightening and unpredictable. 

There is no "cure" for DID but long-term treatment can be successful if the person is committed to treatment. Treatment often consists of talk therapy, medication, hypnotherapy and other adjunct therapy. 

Mindfulness Skills for Everyday Use

The state of being mindful refers to being aware of your body, emotions, thoughts and sensations as well as the environment around you and interactions. The thought of being fully aware of all these things at once can seem like a challenge to even the most advanced multi-taskers. However, being present in the moment allows you to just notice these different concepts and only requires some attention. It make take some time in the beginning of learning to be mindful but practice makes new neural pathways! When cueing in on different sensations, feelings and thoughts, it may be helpful to first try this when you are in a quiet space with some time to yourself. For this exercise we will explore our different senses and how they can help us be mindful.

1.) Sit or lay in a comfortable position, if sitting put both feet flat on the ground.

2.) Take one large inhale, then exhale slowly through your nose. This is just to clear your mind and relax you slightly to help you release any tension from the day.

3.) Lets first focus on sound. What sounds do you hear going on around you? What sounds in the next room or outside? What about the sounds of your own body, your breath, your heartbeat, your stomach? What sounds do you hear in your head, is there an inner monologue? Just sit/lay listening  to every noise that comes and just notice the tone, the volume and  how the sounds mix. Take about 2-5 minutes and just focus on sound.

4.) Now lets move on to smell. What do you immediately smell? What does it smell like? Fruity, sour, musty, sweet, mild, fragrant, flowery, smokey, leathery? What kind of adjective can you think of to put to the smell? As i sit in my office all i can think of is "officecy." Just notice how the smell makes your body react. Does it make you cringe, relax, smile, tense up? Take another 2-5 minutes to explore your sense of smell in this moment.

5.) Taste. You probably arent eating at this exact moment but maybe you still have a taste from something you ate, chewed, drank or smoked earlier. What do you taste? Take a mental scan of you tongue, from the far back to the tip. What words can you put to the taste? maybe one part tastes sweet, while another bitter or sour. If you are having a difficult time exploring taste without an object, you may want to try this one while your eating. Take a couple minutes again to explore your sense of taste.

6.) Feel/touch. What does your body feel like right in this moment? Do you notice any tension or an ache in a part of your body? Just take notice of how your body is contacting the outside world. If you are sitting, how does the chair feel under your body or your feet on the ground? What sort of sensations do you feel inside or outside your body? What about the air around you, do you feel a breeze or the pressure from the air surrounding you? Take 2-5 minutes to explore how your body feels.

7.) Lastly, is sight. Take in all of your surroundings. What do you see? What colors, shapes, words, lines and movement comes across your line of vision? Do you notice anything that maybe you didnt see before? Use your eyes to fully experience this moment.

When you find that you need to take a moment out of your day and be fully present, try using one of your senses to pull you into mindfulness. Like stopping to feel a cool breeze across your arms on a warm day or drinking your cup of coffee, savoring the aroma and the taste. These moments of mindfulness may help bring you great joy.

PTSD & Returning Veterans

Dear Let’s Talk About It,

My twin brother, John, is in the Army and has served a1year tour in Iraq and just returned 6 months ago from a year long tour in Afghanistan.  When he got back from Iraq he bounced back to himself quickly but this time he is having problems. He lives in the apartment over mine and I hear him walking around all night, he has gotten into 2 car accidents and is often angry and jumpy for no reason. Last weekend he drank a case of beer in 1 night, alone in his apartment. It isn’t getting better it is only getting worse.  John is the one all the other soldiers call when they are having problems but won’t get help for himself. When I tell him I am worried he says he can handle it and doesn’t want to talk about it because it only makes it worse. My parents say to leave him alone but I am concerned he is in over his head. What should I do?A.

War and/or exposure to combat can be traumatic and take a serious toll on a person’s mental health. According to the National Center for PTSD, Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), are the longest combat operations since Vietnam, meaning that military personnel often spend long or multiple tours in a combat situation. They are at a high risk for death/injury, seeing the death or injury of others and need to be on high alert at all times. Often times when veterans/active duty members return home from war, they take a while to readjust. While in combat they needed to be extremely alert and aware of every detail in their surroundings. However, when they return that asset needed in war does not translate or is no longer needed at home. This can leave returning soldiers to act “jumpy” or “on “edge.” When symptoms like your brother’s persist, it may mean something more. Post-traumatic Stress Disorder (PTSD) can form after a person experiences a traumatic event. A traumatic event is defined as an event that is perceived as life-threatening, involving fear and possible a sense of no control over the situation and persists for more than a month. Although some have a delayed reaction to PTSD and it may form 6 months down the road. Either way, PTSD may enhance issues such as; alcohol/drug abuse, problems with relationships or at work, feelings of hopelessness and depression as well as physical ailments. Some symptoms may include:

• Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
• Bad dreams
• Frightening thoughts.
• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.
• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

As a loved one concerned for your brother the VA suggests;

1.)    Learn as much as you can about PTSD to understand better what your brother is experiencing and what sort of options may help him.

2.)    Offer to go to doctor visits with him or encourage him to talk to his doctor about what he may be experiencing post-combat.

3.)    Let him know that you are there if he wants to talk but that it’s okay too if he doesn’t want to talk.

4.)    Encourage him to contact friends, family and/or his military buddies to help provide love and support. If he does not have a lot of social outlets, he may consider joining a group for veterans.

5.)    Lastly, invite him out for some physical activity as that may help him process the stress hormones and sweat them out.

Eating Disorders Informational Video

Suicide & Suicide Prevention Video

Tips to improve your resilience

Working on your mental well-being is just as important as working on your physical health. If you want to strengthen your resilience, try these tips:

·         Get connected. Build strong, positive relationships with family and friends, who provide support and acceptance. Volunteer, get involved in your community, or join a faith or spiritual community.

·         Find meaning. Develop a sense of purpose for your life. Having something meaningful to focus on can help you share emotions, feel gratitude and experience an enhanced sense of well-being.

·         Start laughing. Finding humor in stressful situations doesn't mean you're in denial. Humor is a helpful coping mechanism. If you can't find any humor in a situation, turn to other sources for a laugh, such as a funny book or movie.

·         Learn from experience. Think back on how you've coped with hardships in the past. Build on skills and strategies that helped you through the rough times, and don't repeat those that didn't help.

·         Remain hopeful. You can't change what's happened in the past, but you can always look toward the future. Find something in each day that signals a change for the better. Expect good results.

·         Take care of yourself. Tend to your own needs and feelings, both physically and emotionally. This includes participating in activities and hobbies you enjoy, exercising regularly, getting plenty of sleep and eating well.

·         Keep a journal. Write about your experiences, thoughts and feelings. Journaling can help you experience strong emotions you may otherwise be afraid to unleash. It also can help you see situations in a new way and help you identify patterns in your behavior and reactions.

·         Accept and anticipate change. Expecting changes to occur makes it easier to adapt to them, tolerate them and even welcome them. With practice, you can learn to be more flexible and not view change with as much anxiety.

·         Work toward a goal. Do something every day that gives you a sense of accomplishment. Even small, everyday goals are important. Having goals helps you look toward the future.

·         Take action. Don't just wish your problems would go away or try to ignore them. Instead, figure out what needs to be done, make a plan and take action.

·         Maintain perspective. Look at your situation in the larger context of your own life and of the world. Keep a long-term perspective and know that your situation can improve if you actively work at it.

Schizophrenia

Dear Let’s Talk About It,

My youngest son Seth is 22 years old has been through a lot of ups and downs in the past year. Two weeks ago he was hospitalized after the police found him wondering the streets talking to himself. The hospital psychiatrist diagnosed him with Schizophrenia. I am in complete shock and am devastated my son is so ill. What kind of future will Seth have living with Schizophrenia? E.C.

It is not an easy occasion when your child is diagnosed with a disorder such as Schizophrenia. It is very understandable to feel shocked and even devastated. However, the more you can learn about Schizophrenia, it symptoms and patterns, the better equipped you will be to help your son as well as handle your own emotions. To give you a brief overview, Schizophrenia is a life-long brain disorder which can interfere with thought patterns, cause difficulty distinguishing reality from fantasy, cause hallucinations, make it difficult to identify emotions and relate to others. The onset of Schizophrenia typically occurs in young adulthood, such as your son’s age of 22. It is uncertain the cause of Schizophrenia but may include genetic and environmental influences during development. Although there is no “cure” for Schizophrenia, it is a treatable and manageable medical condition. There are medications that can help improve symptoms but it is also important to have other supports such as; peer to peer support groups, a psychiatrist and support from family and friends. Also, it is important for you to create a support network for yourself to help you cope with the tough times and connect with other families who have a loved one with Schizophrenia. For local support contact NAMI (National Alliance for the Mentally Ill) of Ulster County at (845)679-9944.