Dissociative Disorder Case Studies

Depersonalization is defined in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) as “experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions” (DSM-5, 2013, p. 302). According to Mayo Clinic, a symptom could be that a person feels like

Implement measures to improve cardiac output: perform actions to reduce cardiac workload: place client in a semi- to high Fowler's position, instruct client to avoid activities that create a Valsalva response, implement measures to promote emotional and physical rest, implement measures to improve respiratory status, discourage smoking, provide small meals rather than large ones,

This disorder is something that should not be taken lightly and should be dealt with immediately because there are numerous ways in which a person can cope with it.

The first health care team member should be the doctor, He is the most familiar with the physiological and psychological limitations of Mr.

Medication is another form of treatment. Although they may not help ASPD directly, some medications have shown positive results in treating other common problems associated with the disorder. Such drugs have been shown to reduce major depression, aggression, anxiety disorder, and ADHD. Combating these problems first allows for a better outcome for the individual with ASPD.

Dissociative identity disorder (DID) is a condition where there are two or more distinct identities that are and will become present in an individual. These personalities can and will eventually take control of the individual, many people consider having dissociative identity disorder an experience of being possessed. The individual can and most likely will experience memory loss that is more extensive than ordinary everyday forgetfulness (Dissociative Identity Disorder (Multiple Personality Disorder). Around two percent of people will experience dissociative disorder, women are more likely than men are to be diagnosed with DID. "Almost half of adults in the United States experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes” (Dissociative Disorders).

Provide care and support, monitor and observe. Have had the appropriate training given to deliver this effective practice. Minimise the risk of dangers to the individual and others.

Educating the family about the disease process is vital for the safety of Mr. Johnson within the home and outside of it. After reviewing the different types of assessment taking by Mr. and Mrs. Johnson, it appears that Mr. Johnson is showing signs of depression with losing interest activities and losing touch with family. Calendars, sticky notes, wrist watches, memory book and a schedule are all tools that may benefit the Johnsons. A calendar that is big enough to write in events can help orientate Mr. Johnson allowing a visual cue to help trigger memory. There is no evidence of suggesting he has issues with reading so using sticky notes and applying them on appliances will help in several ways. He can read out steps to complete kitchen tasks

* Turn the patient with slow, gentle movements. Rapid changes in position may increase ICP.

Three points for sensory perception was->were derived by the patient being able to respond to verbal stimuli and able to communicate his buttock discomforts to me. Three points for moisture was derived by observing the patient occasionally drooling on his arms that added moisture and could pose risk for ulcers. Two points for activity was derived by the patient being mostly wheelchair-bound, subsequently limited his ability to walk. Two points for mobility was derived from observing that the patient made occasional slight changes in body position while he was in his wheelchair. Two points for nutrition was derived by observing that his breakfast plate was only half eaten. Since he requires maximum assistance during the bed transfer and often slid down his bed, one pointed was chosen for friction and

The interventions that I observed was the use of contrast bath for the Chronic Regional pain, E-stim, Ultrasound, hot packs for the pain management as well as to decrease the stiffness and swelling. The activity that I observed were ROM arc to increase movement in the bilateral upper extremities, sand box to increase core strength, Theraputty, peg boards, cognition pattern puzzles, visual perception puzzles, arm bike (rollator), bolts and screw for fine motor coordination, mini mental test to intact orientation as well as memory. I observed how therapist were teaching the patients to increase independence while transferring from bed to wheelchair to commode. I observed the use of adaptive devices to make the patient as functional as possible with their daily activities such as long handled shower brush, Reacher, sock aid, leg lifter, adaptive heavy weighted utensils and many

Turing and repositioning will avoid pressure from being exerted on one spot for too long (Miles, Nowicki, and Fulbrook, 2013). The nurse will also implement safety measures to prevent falling such as keeping the bed in the lowest position and hourly rounding (Crawford and Harris, 2016). The last priority nursing intervention for this patient is to get a set of vital signs before and after physical activity and prevent orthostatic hypotension. The patient can prevent orthostatic hypotension by adequate fluid intake, slow position changes and dangling the feet off the side of the bed before standing up (L. Schimke, J. Schimke,

Depersonalization: Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions. (e.g., perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing).

a.Psychotherapy is the most common treatment for dissociative disorders. Talking with a therapist can help a person understand the causes of the condition, and

Treatments include medication, supportive psychotherapy and occasionally ECT. Medications include lithium, anticonvulsant drugs (carbamazepine (Tegretol), valproate (Depakote), gabapentin (Neurontin) and lamotrigine Lamictal), antidepressants (such as bupropion (Wellbutrin)or sertraline (Zoloft)), neuroleptics (e.g. haloperidol) and benzodiazepines (e.g. lorazepam) Treatment choices depend on the