What are Dissociative Disorders?
Dissociative identity disorder is a severe form of dissociation, a mental process that produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from a combination of factors that may include trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism — the person literally shuts off or dissociates themselves from a situation or experience that’s too violent, traumatic, or painful to assimilate with their conscious self.
Types of Dissociative Disorders
Dissociative Identity Disorder
Formerly known as multiple personality disorder, dissociative identity disorder (DID) develops as the experience of more than one distinct identity, and the person’s memories, personality, thoughts, and behaviors shift when their identity experience shifts. People may face lapses in their recent memory due to these shifts, as well as lapses in traumatic memories from their past due to protective dissociation. The unpredictability and disorientation make everyday functioning, independence, and a productive work life difficult. Because the experience is so confusing for the individual and those around them, socialization and relationships suffer. Someone with DID may also experience shifts in their perception of time and place, believing that they are living an earlier traumatic incident.
Depersonalization Disorder
When someone develops depersonalization disorder, they tend to feel out of place in their own body, mind, and sense of self. They may feel that their body parts or their reflection in the mirror are unfamiliar, which can be unsettling and bring up feelings of anxiety and fear. With this confusing disconnection between the person and their everyday experiences, they can also feel numb to their thoughts and emotions as if they are running on autopilot.
Derealization Disorder
Derealization disorder is similar to depersonalization, but the individual experiences the dissociation with the environment around them, including people and things. They may feel detached from their experience as if they’re witnessing everything from far away or through a window or movie screen. Things around them may seem two-dimensional, unreal, or hazy.
Depersonalization and derealization can occur separately or they can show up together with an individual feeling disconnected both from themselves and from their external world. These experiences are stressful, even if the individual is detached from and unable to express their emotions.
Dissociative Amnesia Disorder
Dissociative amnesia is characterized by memory challenges and lapses, which most likely developed to protect the individual from the trauma they experienced. A memory gap may be specific to a past traumatic event or a broader length of time. The gap may be more narrowly focused on certain details from an event or timeframe. Or it may be broad, and the individual loses memory of their own life history and the understanding of what makes up their identity.
Signs and Symptoms of Dissociative Disorders
Symptoms of dissociative identity disorder
The existence of two or more distinct identities or “personality states.” Each identity has a particular set of behaviors, attitudes, preferences, memories, and ways of thinking that are observable by others and may even be reported by the affected person. Shifting from one identity to another is involuntary, sudden, and can reverse at a moment’s notice.
- Long-term gaps in memory concerning everyday events, personal information, or traumatic events of the past.
- Problems in social settings, the workplace, or other areas of functioning in daily life. The seriousness of such problems can range from minimal to significant.
Suicide attempts, self-mutilation, and other self-injuring behaviors are common among those with dissociative identity disorder. More than 70% of outpatients with this condition have attempted suicide.
Symptoms of depersonalization/derealization disorder
One or both of the following conditions exist in the same person in a recurring pattern over a long period of time:
- Depersonalization – Feelings of unreality or of being detached from one’s own mind, body or self. It is as if one is an observer of rather than a participant in their own life events.
- Derealization – Feelings of unreality or of being detached from one’s surroundings. People and things may not seem real.
During these episodes the person is aware of their surroundings, and knows that what they are experiencing is not normal. Even if the person shows little emotion during these episodes, they are usually interpreted as being quite upsetting.
Symptoms may start as early as childhood, with 16 years old being the average age of first experience. Fewer than 20% will have their first experience of the disorder after age 20.
Symptoms of dissociative amnesia
Dissociative amnesia means not being able to recall information about one’s past. This is not the same as simply being forgetful, as it is usually related to a traumatic or particularly stressful event or period of time. An episode of amnesia comes on suddenly and can last as little as minutes, or as long as months or years. There is no particular age of onset, and episodes can occur periodically throughout life.
There are three types of amnesia:
- Localized – Cannot remember an event or period of time (most common form of amnesia)
- Selective – Cannot remember certain details of events about a given period of time.
- Generalized – Complete loss of identity of life history (rarest form).
The person may not be aware of their memory loss or have only little awareness. Even when they do realize a loss of memory, the person often downplays the importance of not recalling a particular event or period of time.
Causes of dissociative Disorders
Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual or emotional abuse. Natural disasters and combat can also cause dissociative disorders.
Treatment of Dissociative Disorders
Psychotherapy
Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional. Look for a therapist with advanced training or experience in working with people who have experienced trauma.
Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances. Over time, your therapist may help you talk more about the trauma you experienced, but generally only when you have the coping skills and relationship with your therapist to safely have these conversations.
