I’d like to start this post with a disclaimer: I am not a medically trained professional. I have never studied medicine or psychiatry. I have studied child and adolescent mental health but not in connection to medications or the biological effects of conditions and treatments. All my thoughts and theories are exactly that; thoughts and theories and speculation based on my own personal experience and the experiences of others I’ve spoken to.
That being said, I would like to pose some questions and invite some discussion on the effects medication has on a dissociative person. To my knowledge there has been no study or research on this topic at all and psychiatrists tend to be quick to prescribe anti-anxiety tablets to distressed patients. I’m going to focus this on three types of medication which I have had experience with – anti-anxiety/psychotics, sedatives and painkillers/anaesthetics. Each of these groups of medication have side-effects in common; they numb the emotional/physical senses and force a feeling of calm or sleepiness, they can bring on a feeling of being spaced out or slightly drunk, the aim of course being that the patient doesn’t feel upset or in pain. This is, however, a very dangerous position to put a patient who has a dissociative disorder in. The reason is simple; that numb spaced out drunk feeling is what being dissociated (can) feel like. Anyone who has had an operation and been under general anaesthetic will know how it feels when you wake to be not fully connected to your body or your surroundings, not quite sure of where you are or what has happened, how long have you been asleep and is everything OK? For a dissociative person that is how our minds make us feel naturally, so add to that the effects of a general anaesthetic or strong pain-killer and you can see how it will logically end. I have had minor surgical procedures which required me being put to sleep, upon waking afterwards it took me far longer to recover from the anaesthetic than the doctors thought it would. I believe this was because my mind embraced the “spaced out” feeling of the drug too easily and freely, adding it to my natural dissociative state and not even trying to “come round” like none-dissociative patients do. My mind wasn’t trying to reconnect with my body or make sense of where I was, my mind was happy to float and be numb, and it doesn’t need drugs to do that.
Now the example of the effects of painkillers and anaesthetic is one of side-effects which we need to be aware of, but since the reason for taking that medication is usually a physical problem, a surgical procedure for example, we can’t avoid taking them when they’re needed. We, ourselves and our doctors, simply need to be aware of the mental effects and have extra help on hand. Other medications however, are prescribed to treat our mental health but in my experience only do harm when it comes to dissociation.
I once went to the local crisis team in a very distressed state, I kept “losing myself” and couldn’t keep focus on anything I was doing, I was paranoid of being attacked and couldn’t keep my memories straight, thinking that the past was now and vice versa. When I told the nurse that I had been diagnosed with DID she didn’t believe me (complaints were later filed and ignored) and when she consulted the doctor he prescribed anti-anxiety tablets. Those made me far worse and within a week I had stopped taking them, unable to cope. I’ve had similar experiences with anti psychotics and sleeping tablets. They all seem to trigger my dissociative symptoms and make it nearly impossible to keep grounded and cope with day-to-day life.
One medication I have had success with is antidepressants, which tend to level out emotions and hormones rather than sedate, but that’s just me personally.
Therapy, particularly psychotherapy which goes deep into your past and almost dissects your triggers to allow you to process everything slowly, has shown itself to be an effective treatment for dissociative disorders. It doesn’t cure the condition, I doubt that anything ever could, but it can in time help to control the symptoms and lay to rest the memories behind it. Most people I’ve spoken with have found therapy to be helpful, even essential, to their ability to cope with day-to-day life. But medication? Until some real scientific studies have taken place, until doctors and nurses have a clear understanding of what dissociation is and how it affects the individual, how can medication be safely given as a form of treatment? If you suffer migraines you don’t take medication that causes headaches, if you suffer eczema you avoid things that irritate or dry your skin. Different medicines affect each of us differently but their common properties make them generally reliable for the majority of people – if they’re prescribed for the appropriate problem. Medicines affect our minds as well as our bodies, our hormone levels and emotions are altered and controlled through medicine the same way our cholesterol is controlled or our blood cell count altered.
If no one knows or understands how the hormones and emotions and mental facilities of a dissociative patient work in the first place, then how can they possibly prescribe medication safely and confidently to treat the condition?