According to the National Alliance on Mental Illness (NAMI), about 75% of people experience one dissociative episode in their lifetime. It occurs so frequently that you or someone you know may have had a dissociative episode. Although brief dissociative episodes are common, only 2% of the population meet the criteria for chronic dissociative disorders.
What is Dissociative Disorder?
The term “dissociation” refers to the feeling of disconnection a person may experience from the world around them. This experience can sometimes even include a feeling of disconnection from themselves. People who dissociate can have difficulty with emotions, memories, and identity.
A dissociative episode often occurs as a response to trauma or an extremely distressing situation. For example, a child suffering from abuse or a soldier in combat may undergo dissociation to manage their emotions and memories. If left untreated, some people who experience dissociative episodes can develop dissociative disorders. In these cases, the dissociative symptoms persist and cause problems in a person’s daily life.
Types of Dissociative Disorders
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) categorizes dissociative disorder into three major types:
Individuals who have dissociative amnesia find recalling information surrounding a traumatic event challenging. In some cases of dissociative amnesia, the individual may not remember their identity or history. The duration of dissociative amnesia can be as short as a few minutes to as long as a few years.
Individuals who have depersonalization disorder feel chronic detachment from their daily lives. They often describe the experience as being disconnected from their actions, thoughts, and the world around them. In some cases, the individual may see the world around them as unreal (derealization). Depersonalization disorder typically occurs in people younger than 20 years old.
Dissociative Identity Disorder
More widely known as multiple personality disorder, dissociative identity disorder (DID) involves experiencing two or more distinct identities. These identities often have unique personalities, names, and mannerisms — all conveyed through the person experiencing the disorder. An individual may be unaware of these separate personalities and undergo gaps in memory when another identity overcomes them.
Symptoms of Dissociative Disorders
The symptoms of dissociative disorders depend on the type of disorder the individual experiences. Anyone experiencing these symptoms should consult with a mental health care professional or physician.
- Gaps in memory of times and events
- Emotional numbness
- Out-of-body experiences
- Feeling detached from the body or the surroundings
- Significant personality and mood changes
Unfortunately, suicide attempts and self-harm are common among people with dissociative disorders. The following signs and symptoms of dissociative disorder require emergency attention:
- Suicidal thoughts or behaviors
- Attempts to harm themselves or others
Causes and Risk Factors for Dissociative Disorders
Dissociative disorders develop most often in children exposed to ongoing long-term trauma, such as sexual, emotional, or physical abuse. The disorder may also manifest in children who reside in an unpredictable or neglectful home environment. The American Psychiatric Association (APA) states that almost 90% of people diagnosed with dissociative disorders, namely DID, experienced child abuse.
Because personal identity develops during the formative years of childhood, a child can dissociate much more easily than adults. Therefore, young people are more prone to developing dissociative disorders. However, the illness can also appear in adults who experience severe trauma.
Trauma can change the way the brain processes information. Neuroimaging can track how the brain processes information through memory and attention. For individuals who have experienced trauma, the brain remains in a state of “fight or flight.” This makes the processing of memories and information more challenging.
There are no medical tests or lab work that can diagnose a dissociative disorder. Instead, a physician or psychologist bases their diagnosis on a review of symptoms and a client's history. Specific screening tools and checklists can assist clinicians in identifying the presence of dissociative disorder.
Before diagnosing a dissociative disorder, a clinician must rule out any physical sources for the signs and symptoms. For example, a head injury or brain tumor can trigger memory lapses. And a thyroid disorder can result in personality changes and mood swings. A thorough physical exam and lab test can detect any medical issues that could be at the root of the symptoms.
There’s no cure for a dissociative disorder, but symptom management is possible. Through treatment, individuals with the disorder can reduce the appearance of symptoms and process traumatic memories appropriately.
The following therapies can help individuals with dissociative disorder to live full and productive lives.
- Medications such as antidepressants or anxiety medications
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
Additional therapies such as hypnosis may help process the trauma at the core of the dissociative disorder. Healing the trauma that causes the disorder can reduce the appearance of symptoms. By addressing trauma, many people successfully address the major symptoms of dissociative identity disorder. It improves their ability to function and live a productive, fulfilling life.