This chapter explores three important areas:
- Dissociative Disorders
- Depression (Major Depressive Disorder)
- Delirium and Dementia-related conditions
These conditions can affect memory, identity, mood, and thinking, and often require specialist assessment and support.
🧠 Module 8 – Dissociative Disorders
What are Dissociative Disorders?
Dissociative Disorders are conditions where a person experiences disruptions in:
- Memory
- Identity
- Awareness
- Perception
They are often linked to trauma, especially in early life.
🔍 Main Types
1. Dissociative Identity Disorder (DID)
Dissociative Identity Disorder
- Two or more distinct identities (“alters”)
- Gaps in memory
- Identities may take control at different times
2. Dissociative Amnesia
Dissociative Amnesia
- Sudden memory loss (often trauma-related)
- Not caused by physical illness
- May include “fugue” (wandering away)
3. Depersonalization/Derealization Disorder
Depersonalization/Derealization Disorder
- Feeling detached from yourself (depersonalization)
- Feeling the world is unreal (derealization)
🧩 Treatment
- Psychotherapy (main treatment)
- CBT and DBT approaches
- Trauma-informed care
📌 Key Point
Dissociation is often a coping response to trauma, and recovery focuses on processing experiences safely.
🌧️ Module 9 – Depression (MDD)
What is Depression?
Major Depressive Disorder is a serious mood disorder involving:
- Persistent low mood
- Loss of interest (anhedonia)
- Reduced ability to function
Symptoms last at least two weeks, often much longer.
🔍 Key Symptoms
- Sadness or emptiness
- Fatigue and low energy
- Sleep problems
- Difficulty concentrating
- Feelings of guilt or worthlessness
- Loss of motivation
- Possible suicidal thoughts
👶 Different Presentations
- Children/teens: Irritability rather than sadness
- Older adults: Memory problems, physical symptoms
🧠 Causes and Research
- Brain chemistry and genetics
- Life stress and trauma
- Emerging research: gut–brain connection and inflammation
🧩 Treatment
- Antidepressant medication (e.g. SSRIs)
- Cognitive Behavioural Therapy (CBT)
- Lifestyle support (sleep, routine, activity)
📌 Key Point
Major Depressive Disorder is treatable, and early support improves outcomes.
🧓 Module 10 – Delirium & Dementia
These conditions affect thinking, memory, and awareness, especially in older adults.
⚡ Delirium
Delirium
🔍 Key features:
- Sudden onset (hours to days)
- Fluctuating confusion
- Reduced awareness and attention
⚠️ Causes:
- Infection (e.g. UTI)
- Dehydration
- Medication effects
- Surgery
🔄 Important:
- Often reversible if treated quickly
🧠 Dementia
Dementia
🔍 Key features:
- Gradual memory loss
- Decline in thinking and reasoning
- Personality or behaviour changes
🧬 Causes:
- Alzheimer’s disease
- Vascular conditions
- Neurodegenerative disorders
🔄 Important:
- Usually not reversible
- Can be managed with support
🔑 Key Differences
| Feature | Depression (MDD) | Delirium | Dementia |
|---|---|---|---|
| Onset | Weeks–months | Hours–days | Months–years |
| Course | Chronic/episodic | Fluctuating | Progressive |
| Awareness | Usually normal | Reduced/confused | Normal early |
| Memory | Affected by mood | Short-term poor | Progressive decline |
| Reversible | Often yes | Often yes | Usually no |
⚠️ Important Clinical Insight
- Delirium can occur on top of dementia
- Early detection is critical
- Tools like cognitive screening tests help identify issues early
🧠 Final Summary (Modules 8–10)
These three areas highlight different aspects of mental and cognitive health:
- Dissociative Disorders → trauma-related disruptions in identity and memory
- Major Depressive Disorder → persistent low mood and loss of function
- Delirium & Dementia → cognitive and neurological decline
💡 Key Takeaways
- Accurate diagnosis is essential (symptoms can overlap)
- Early intervention improves outcomes
- Each condition requires a different treatment approach
- Support should be personalised and holistic
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