Many people experience a few moments in their lives where they feel disconnected from their thoughts or who they are. Mental health professionals use the term “dissociation” to refer to this feeling of detachment. It’s estimated that as many as 3 in 4 Americans experience mild, temporary moments of dissociation like daydreaming or losing track of their whereabouts while driving. But up to 2% of people have a chronic dissociative disorder. 

From the community: “…Think of a cut diamond: it has various facets, all of which reflect light in their own ways. A person who is a DID has "cut" her personality into different facets. When she is stressed, one of her facets will come forward and will interact with the world. As for how did this happen, it happened when the person was a child and was abused. This began the "splitting" of the personality so the entire self doesn't have to know about the abuse, the knowledge of which resides in one of the facets.The "cure" is talk therapy. The therapist tries to connect with all the facets, to try to learn as much as is possible about the person. If any facet has a personality disorder of its own, the therapist will treat that facet just as any therapist would treat a person with problems. The therapist will try to discover why that particular facet was cut off from the whole. Then, through imagery, the therapist rejoins that facet with the whole. This process can be very lengthy. I was in therapy for about 6 years and during that time I had about 1/2 of all my facets rejoined with the whole.” – Inspire member 

Understanding dissociative disorders

Dissociative disorders are an uncommon but serious type of mental health disorder. When you have a dissociative disorder, you constantly feel detached from the world. You may have a feeling like you’re seeing the world from outside of your body. Some people experience memory loss or amnesia. Someone with a dissociative disorder needs treatment to address the symptoms and get better.

What are the types of dissociative disorders and their symptoms?

There are three main types of dissociative disorders. Symptoms vary depending on the disorder type.

• depersonalization/derealization disorder

• dissociative amnesia 

• dissociative identity disorder

Depersonalization/derealization disorder

Teenagers are more likely to experience depersonalization/derealization disorder. The average age for symptom onset is 16. The disorder rarely occurs after the age of 20. People with this disorder experience persistent, recurrent episodes of:

• Depersonalization: You feel detached from your mind, body, or self. It may feel as if you’re watching events happening to you from outside of your body, like in a movie.

• Derealization: You feel detached from your world or surroundings, as if the people and things around you aren’t real.

Some people experience just depersonalization or derealization, while others alternate between the two episodes. A person is aware when an episode is happening and recognizes that the event is unusual. Even though this may be distressing, the person may appear emotionless.

From the community: “It could be possible, in regards to the dissociative amnesia. The thing is, is that I remember nothing from my childhood. My mom and I are very close and she has told me stories. I don't even remember good things. I have found myself in odd, scary areas before and had no idea how I got there. 4 years ago, I was at a partial day program where I was at group therapy from 9 AM to 3:30 in the afternoon. I apparently ran off and had cops looking for me. Had no idea how long I was gone for and what triggered that. I don't even know if that, too, is considered dissociative amnesia. At age 19 though is when I experienced something awful that some parts, I do remember and then other parts I don't remember at all, so that I'm not entirely sure is amnesia or not.” – Inspire member

Dissociative amnesia

People with dissociative amnesia can’t recall information about a traumatic or stressful time in their lives. They may remember small details, or sometimes nothing at all. Adults who survived emotional abuse or neglect during childhood are more prone to dissociative amnesia, but this sort of memory loss can affect people of all ages. Many people with dissociative amnesia are aware that they have memory lapses. However, they don’t consider the “amnesia” to be important or significant. 

There are three types of dissociative amnesia:

• Localized: You can’t remember a specific event or period of time. This is the most common type.

• Selective: You can’t remember specifics about an event or period of time.

• Generalized: You have no memory of a past event or period of time.

From the community: “Does getting well for you mean integrating? DID is not related to schizophrenia nor is it a mood disorder. It is a coping mechanism developed a young age when a traumatic, and repetitive event occurs...such as having a relative that sexually abuses you at every visit. A young child can not comprehend what is happening nor does s/he have the vocabulary to express it, so the child splits, and a new identity is formed to handle the abuse.Not all multiple choose to integrate. Some prefer internal awareness and cooperation.” – Inspire member 

Dissociative identity disorder

Dissociative identity disorder most commonly develops after a traumatic event. As many as 9 in 10 people who develop this disorder are survivors of physical or sexual childhood abuse or neglect. Women are more likely to receive a diagnosis of dissociative identity disorder, but the condition affects men too. 

You may be more familiar with the term multiple personality disorder. They’re the same condition, but mental health providers now use the term dissociative identity disorder because it’s more clinically accurate and less stigmatizing.

Someone with dissociative identity disorder switches between two or more distinct personalities or identities. Each identity has its own unique name, mannerisms, memories, and ways of thinking. The identities may even sound different when a person speaks. The shift to a different identity is involuntary and sudden. A person with this disorder may not remember what they said or did when a different identity was present. 

Other signs of dissociative identity disorder include:

• memory gaps or amnesia about daily events, personal information, and past traumas

• problems with relationships, friendships, and functioning in society or at work or school

• feeling like you’re observing your own actions and speech (an out-of-body experience)

• feeling like your body is suddenly a different age (like a small child), gender, or size 

What conditions can occur with dissociative disorders? 

Dissociative disorders may occur along with, or increase your risk of, issues like:

• anxiety

• borderline personality disorder

• depression and suicidal ideation

• post-traumatic stress disorder (PTSD)

• schizophrenia

• self-harm or self-injury

• substance use disorders

From the community:“I was diagnosed over 10 years ago at the age of 38. It's been a long daily struggle since. Sometimes I wish my brain hadn't been split apart. I have over 50 alters. Then the alters have alters. I have a polyfragmented system. I just wanted to say hello.We are fairly stable right now. Therapy, medications, mindfulness and prayers. Those are some of what helps us.” – Inspire member

How are dissociative disorders diagnosed? 

A psychiatrist often diagnoses a dissociative disorder. This medical doctor will review symptoms and refer to disease criteria in the latest American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, called the DSM-5-TR.  

How are dissociative disorders treated? 

Psychotherapy, or talk therapy, is the first line of treatment for dissociative disorders. A mental health professional helps you remember and cope with past traumatic events. You learn strategies that help you take control of dissociative symptoms. Medications like antidepressants can help if you’re experiencing symptoms of depression, self-harm, or suicidal thoughts. 

These types of psychotherapy are helpful when you have a dissociative disorder:

• Cognitive behavioral therapy (CBT): You learn how to recognize and change false beliefs.

• Dialectical behavioral therapy (DBT): You learn how to accept and manage uncomfortable thoughts and feelings.

• Eye movement desensitization and reprocessing (EMDR): You learn how to replace emotionally charged responses with calmer, positive ones.

SOURCES

• What are dissociative disorders? American Psychiatry Association. August 2018.

• Depersonalization/derealization disorder. Cleveland Clinic. October 2020.

• Dissociative disorders. Cleveland Clinic. March 2018.

• Dissociative disorders. National Alliance on Mental Illness.

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.