The Complexity of Dissociative Disorders:

Dissociative disorders involve problems with memory, identity, emotion, perception, behavior and sense of self. Dissociative symptoms can potentially disrupt every area of mental functioning.

Examples of dissociative symptoms include the experience of detachment or feeling as if one is outside one’s body, and loss of memory or amnesia. Dissociative disorders are frequently associated with previous experience of trauma.

There are three types of dissociative disorders:

• Dissociative identity disorder

• Dissociative amnesia

• Depersonalization/derealization disorder

What Dissociation Feels Like

Someone with dissociation might feel a sense of unreality and lose their connection to time, place, and identity. This unusual experience is because dissociation disrupts four areas of personal functioning that usually operate together smoothly, automatically, and with few or no problems.

These areas are:

• Consciousness

• Identity

• Memory

• Self-awareness and awareness of surroundings

Breaks in this system of automatic functions can cause dissociation symptoms. Dissociation can range from feeling a mild sense of detachment (daydreaming) to experiencing a more severe disconnection from reality (feeling as if the world is unreal).

Types of Dissociation

• Dissociative amnesia (with a possible sub-diagnosis of dissociative fugue, which involves confused wandering with amnesia) – an inability to recall important information to the extent that it cannot be explained by normal forgetfulness.

• Dissociative identity disorder – is characterized by two or more identities or personality traits within a single individual.

• Depersonalization/derealisation disorder – major detachment wherein a person feels that objects around him or she are changing in shape or size or that people are automated and inhuman. A person may also feel detached from his or her own body.

• Other dissociative identity disorders not specified – a dissociative disorder that doesn't fall specifically into one of the other three diagnoses.

Related Conditions

In addition to these dissociative disorders, dissociation may also occur as a symptom of another condition. Conditions in which someone may experience dissociation include:

• Acute stress disorder

• Affective disorders, also known as mood disorders

• Anxiety

• Attention-deficit/hyperactivity disorder (ADHD)

• Borderline personality disorder (BPD)

• Depression

• Epilepsy

• Migraines

• Obsessive-compulsive disorder (OCD)

• Phobias

• Post-traumatic stress disorder (PTSD)

• Schizophrenia

• Substance use disorders

Symptoms of Dissociation

If you have a dissociative disorder or a mental health condition involving dissociation, you may sometimes feel "disconnected" from yourself. Examples of dissociation include:

• "Blanking out" or being unable to remember anything for a period of time

• Experiencing a distorted or blurred sense of reality

• Feeling disconnected or detached from your emotions

• Feeling like you're briefly losing touch with events going on around you, similar to daydreaming

• Feeling numb or distant from yourself and your surroundings

• Feeling that the world around you is unreal and distorted

• Having an altered sense of time and place

• Having flashbacks of traumatic events

• Memory loss about specific events, people, information, or timeframes

It is possible to experience dissociation without being aware of it. Sudden mood changes, difficulty remembering personal details about yourself or your life, and feeling disconnected are all symptoms of dissociation.

Treatment

With appropriate treatment, many people are successful in addressing the major symptoms of dissociative identity disorder and improving their ability to function and live a productive, fulfilling life.

Treatment typically involves psychotherapy. Therapy can help people gain control over the dissociative process and symptoms. The goal of therapy is to help integrate the different elements of identity. Therapy may be intense and difficult as it involves remembering and coping with past traumatic experiences. Cognitive behavioral therapy and dialectical behavioral therapy are two commonly used types of therapy. Hypnosis has also been found to be helpful in the treatment of dissociative identity disorder.

There are no medications to directly treat the symptoms of dissociative identity disorder.

Dissociative Disorder Facts and Statistics

Dissociative disorders have been studied, but not to the extent of many other disorders, so dissociative disorder facts are often disputed. That said, some dissociative disorder facts and statistics include:

• An estimated 2.4% of people meet the diagnostic criteria for depersonalization/derealisation disorder, although this estimate is argued by many and, in reality, it may be lower.

• Dissociative identity disorder may be observed in 1-3% of the population.

• Some believe that dissociative disorders should be considered trauma-related disorders.

• Dissociative identity disorder used to be known as multiple personality disorder. The name was changed in 1994.

• According to the Sidran Institute (devoted to education around trauma disorders), most people with a dissociative disorder also have posttraumatic stress disorder.

Related conditions

Both acute stress disorder and posttraumatic stress disorder (PTSD) may involve dissociative symptoms, such as amnesia and depersonalization or derealization.

Related conditions

• Acute stress disorder

• Posttraumatic stress disorder (PTSD)

Both acute stress disorder and PTSD may involve dissociative symptoms, such as amnesia and depersonalization or derealization.