Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.
Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay.
Dissociative Disorders Symptoms:
- Memory loss (amnesia) of certain time periods, events, people and personal information
- A sense of being detached from yourself and your emotions
- A perception of the people and things around you as distorted and unreal
- A blurred sense of identity
- Significant stress or problems in your relationships, work or other important areas of your life
- Inability to cope well with emotional or professional stress
- Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviour
Dissociative Disorders Types:
There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:
- Dissociative amnesia. The main symptom is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. Dissociative amnesia can be specific to events in a certain time, such as intense combat, or more rarely, can involve complete loss of memory about yourself. It may sometimes involve travel or confused wandering away from your life (dissociative fugue). An episode of amnesia usually occurs suddenly and may last minutes, hours, or rarely, months or years.
- Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities. You may feel the presence of two or more people talking or living inside your head, and you may feel as though you’re possessed by other identities. Each identity may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for eyeglasses. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.
- Depersonalization-derealization disorder. This involves an ongoing or episodic sense of detachment or being outside yourself, observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization). You may experience depersonalization, derealization or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.
Dissociative Disorders Risk factors:
People who experience long-term physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.
Dissociative Disorders Causes:
- Trauma. You may psychologically disconnect from the present moment if something really bad happens to you. This is called peritraumatic dissociation.
- Certain drugs. You may lose your sense of identity or reality if you drink alcohol or take illicit drugs.
- Meditation. Like daydreaming, you may become less aware of the here and now while you meditate. Some expert meditators say they lose an awareness of their self or body during certain mindfulness meditation practices.
Dissociative Disorders Treatment:
Dissociative disorders treatment may vary based on the type of disorder you have, but generally include psychotherapy and medication.
Psychotherapy
Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counselling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional. This kind of treatment may help you find the cause of your dissociation. But the goal is to help you manage or get rid of your symptoms.
Types of psychotherapy may include:
- Cognitive behavioural therapy. It’s designed to help you see and change negative thoughts and behaviours.
- Hypnotherapy. You may find it easier to explore and process your memories when you are in a relaxed state.
- Phasic trauma treatment. This treatment aims to help you stop suicidal thoughts or self-destructive behaviour first. Then your psychotherapist will slowly help you process any traumatic memories and re-integrate your identities, if necessary.
- Family treatment. You may find it helpful to get support from a spouse, partner, or other loved one.
- Dialectical behavioural therapy. It may help you learn skills to control your emotions and stop harmful behaviour.
- Eye movement desensitization and reprocessing. It uses techniques from cognitive behavioural therapy along with visual exercises to help you work through memories of severely troubling events.
Dissociative Disorders Medication
Although there are no medications that specifically treat dissociative disorders, your doctor may prescribe antidepressants, anti-anxiety medications or antipsychotic drugs to help control the mental health symptoms associated with dissociative disorders.
