Dissociative disorders are a range of conditions that can cause physical and psychological problems 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. Symptoms can range from amnesia to alternate identities as it depends in part on the type of dissociative disorder you may have. When you are more stressed it can temporarily worsen symptoms, making them more obvious.
Symptoms
Signs and symptoms depend on the type of dissociative disorders you have, but may include:
- 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 behaviors
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 level of forgetfulness and that cannot 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 much more rarely in months or years.
- Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterised 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. This is usually clinically diagnosed by a psychiatrist and treated in a clinical setting.
- Depersonalisation-derealisation disorder. This involves an ongoing or episodic sense of detachment or being outside yourself, you may feel like you are observing your actions, feelings, thoughts and self from a distance, as though watching a movie (depersonalisation). 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 (derealisation). You may experience depersonalisation, derealisation or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.