Someone with a dissociative disorder escapes reality in ways that are involuntary and unhealthy. The person with a dissociative disorder experiences a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.
The symptoms of dissociative disorders — ranging from amnesia to alternate identities — depend in part on the type you have. Symptoms usually develop as a reaction to trauma and help keep difficult memories at bay. Times of stress can temporarily worsen symptoms, making them more obvious. Dissociative disorders cause problems with functioning in everyday life.
Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.
Signs and symptoms of dissociative disorders include:
There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association:
If you or someone you love has any of the signs or symptoms described above, talk to a doctor. Treatment is available.
Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that's frightening or highly unpredictable. The stress of war or natural disasters also can bring on dissociative disorders.
Personal identity is still forming during childhood. So a child is more able than an adult is to step outside of himself or herself and observe trauma as though it's happening to a different person. A child who learns to dissociate in order to endure an extended period of youth may use this coping mechanism in response to stressful situations throughout life.
Doctors diagnose dissociative disorders based on a review of symptoms and your personal history. Your doctor may perform tests to rule out physical conditions — for example, head injury, certain brain diseases, sleep deprivation or intoxication — that can cause symptoms such as memory loss and a sense of unreality. If your doctor rules out physical causes, he or she will likely refer you to a mental health specialist to determine your diagnosis.
To be diagnosed with a dissociative identity disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For a diagnosis of dissociative amnesia, the DSM includes these criteria:
For a diagnosis of dissociative identity disorder, the DSM includes these criteria:
For a diagnosis of depersonalization-derealization disorder, the DSM includes these criteria:
People with a dissociative disorder are at increased risk of complications and associated disorders, such as:
Dissociative disorders are also associated with major difficulties in personal relationships and at work. People with these conditions often aren't able to cope well with emotional or professional stress, and their dissociative reactions — from tuning out to disappearing — may worry loved ones and cause people at work to view them as unreliable.
Children who are physically, emotionally or sexually abused are at increased risk of developing mental health disorders, such as dissociative disorders. If stress or other personal issues are affecting the way you treat your child, seek help.
Talk to a trusted person such as a friend, your doctor or a leader in your faith community. Ask for help locating resources such as parenting support groups and family therapists. Many churches and community education programs offer parenting classes that also may help you learn a healthier parenting style.
If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to mental health providers who can help your child recover and adopt healthy coping skills.
People who experience long-term physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders. Children and adults who experience other traumatic events, such as war, natural disasters, kidnapping, torture or invasive medical procedures, also may develop these conditions.