Dissociative disorders are a complex group of mental health conditions, often deeply intertwined with the experience of trauma. While there are several types of dissociative disorders that present different symptoms and challenges, any condition that falls into this category is generally disruptive to one’s daily functioning and overall wellbeing.
If you’re wondering what dissociative disorders look like and how to know when it’s time to seek professional treatment, this guide is for you. In it, we’ll cover the basis of dissociative disorders, including their causes and the treatment options available to support recovery.
What Are Dissociative Disorders?
Dissociative disorders are mental health conditions that cause someone to feel detached from reality, particularly in terms of one’s own identity or memories. Dissociation can make someone feel disconnected from:
- Their own thoughts
- Relationships with others
- Consciousness
- The world around them
The intensity and disruption caused by these disorders can vary widely, but they all stem from the brain’s instinct to distance oneself from distressing events or emotions that are too intense to process at the moment.
Causes of Dissociative Disorders
Dissociative disorders develop as a result of the brain coping with trauma. Research suggests that trauma causes a shift in which the brain tries to protect you from psychological harm. The amygdala, which processes emotions, and the prefrontal cortex, which handles rational thoughts and decision-making, become imbalanced. This imbalance can lead to an overemphasis on emotional responses and a reduction in rational thought, setting the stage for dissociative experiences as the mind attempts to insulate itself from the full impact of the trauma.
While dissociation can arise from a variety of traumatic experiences, certain events are more commonly linked to the development of dissociative disorders. These include:
- Prolonged abuse, such as physical, emotional, or sexual abuse, particularly during childhood
- Witnessing violence
- Surviving a natural disaster
- Combat exposure
- Being involved in a severe accident
Who’s Affected by Dissociative Disorders?
Dissociative disorders are relatively rare, with roughly 1.5% of the global population having an official diagnosis. However, research has historically shown that dissociative symptoms are common in the general population, and only a small portion are actually diagnosed with chronic symptoms.
Because dissociative disorders typically arise after traumatic experiences, people with a history of childhood trauma are more likely to develop this condition. A child’s brain isn’t fully developed, and doesn’t possess the emotional skills to cope with trauma. As a result, dissociation becomes deeply ingrained as a survival strategy that carries over into adulthood.
Signs of a Dissociative Disorder
Generally speaking, people experiencing dissociative disorders may feel detached from themselves or their surroundings. The Structured Clinical Interview for Dissociative Disorders, a diagnostic tool for assessing dissociative disorders, suggests that there are five key areas of dissociation:
- Amnesia: Memory loss that may include an inability to recall conversations, events, or periods of time. These gaps could last for just a moment or even span several years.
- Depersonalisation: Feeling disconnected from yourself, as if you’re watching yourself from outside your own body. You may also feel like your thoughts or emotions aren’t your own, or feel that you’re a stranger to yourself.
- Derealization: A disconnection from the world around you, particularly evident in familiar places or around familiar people. You might have episodes in which your surroundings feel dreamlike, and your current environment seems unreal.
- Identity confusion: Ongoing uncertainty or confusion about your sense of self. You may struggle to understand who you are, feel conflicted about different aspects of your identity, or notice that your preferences and beliefs seem inconsistent over time.
- Identity alteration: Acting like a different person, or shifting between distinct identity states that may take control at random times. You might notice there are gaps in your memory for things that happened while another identity state was present.
A person exhibiting the symptoms in these core evaluation areas may require official diagnosis of a dissociative disorder. However, symptoms can vary greatly depending on the type of dissociative disorder someone is experiencing.
5 Main Types of Dissociative Disorders
The DSM-5 lists five primary types of dissociative disorders: dissociative identity disorder (DID), dissociative amnesia, depersonalization/derealization disorder, other specified dissociative disorders, and unspecified dissociative disorders.
Dissociative Identity Disorder (DID)
Also known as multiple personality disorder, dissociative identity disorder (DID) affects roughly 1.5% of the global population. It’s characterized by the presence of two or more distinct personality states or identities. A person experiencing DID may find this identity takes control of their behavior and memory. As a result, they’re unable to recall certain memories or even personal information.
It’s important to note that, while DID affects an individual’s personality, it is not classified as a personality disorder. Dissociative disorders involve a detachment from reality, whereas personality disorders are characterized by negative behavioral patterns. That’s why therapy for histrionic personality disorder (HPD), for example, involves more of a focus on correcting certain behaviors, while dissociative disorder treatment centers on reconnecting with reality.
Symptoms of Dissociative Identity Disorder (DID)
Symptoms of dissociative identity disorder (DID) include:
- Experiencing two or more personality states
- Memory gaps
- Inability to recall personal information
- Sudden changes in preferences, skills, or behaviors
Triggers of Dissociative Identity Disorder (DID)
DID symptoms are often triggered by:
- Exposure to stress or overwhelming situations
- Reminders of past trauma
- Emotional distress
- Substance use
Dissociative Amnesia
Dissociative amnesia is characterized by an inability to recall important personal information, typically of a traumatic or stressful nature, that cannot be explained by ordinary forgetfulness. This condition often affects people between the ages of 20 and 40, and those suffering from it may experience severe memory gaps. Often, they may find themselves unable to remember significant life events, personal details, or even their own identity in extreme cases.
Symptoms of Dissociative Amnesia
The symptoms of dissociative amnesia can manifest in various forms, including:
- Localized amnesia, where memory loss is specific to a certain event or time period
- Generalized amnesia, where a person may lose memory of their entire life and sense of identity
- Selective amnesia, which involves forgetting specific details of an event or period
- Systematized amnesia, which refers to loss of memory for a specific category of information
Triggers of Dissociative Amnesia
The onset of dissociative amnesia is often precipitated by psychological stressors that can overwhelm an individual’s coping mechanisms. Common triggers include traumatic events, such as:
- Experiencing or witnessing abuse
- Military combat
- Natural disasters
- Severe accidents
- Relentless stress, such as enduring chronic emotional abuse or living in a highly unpredictable and unsafe environment
These experiences can cause the mind to compartmentalize or block out memories associated with the trauma as a protective mechanism. The link between trauma and dissociative amnesia highlights the intricate ways in which the mind attempts to shield itself from psychological pain, albeit at the cost of vital personal memories and experiences.
Depersonalization or Derealization Disorder
Depersonalization disorder, or derealization disorder, is a dissociative condition in which someone experiences a recurring sense of detachment from themselves (depersonalization) or their surroundings (derealization). People experiencing these symptoms may feel as though they’re observing themselves from outside their own bodies.
Symptoms of Depersonalization Disorder
Symptoms of depersonalization disorder include:
- Feeling detached from one’s own body, thoughts, or emotions
- A sense that one’s surroundings are unreal
- Emotional numbness or an inability to feel emotions
Triggers of Depersonalization Disorder
Common triggers for depersonalization episodes include:
- High levels of anxiety or stress
- Panic attacks
- Reminders of traumatic events
- Sleep deprivation
Other specified and unspecified dissociative disorders
Some people experience symptoms that generally line up with dissociation and cause significant disruptions to their daily lives, but don’t exactly meet the diagnostic criteria. This could include:
- Symptoms that don’t match a standard disorder
- Mixed symptoms that blend more than one dissociative disorder
- Short-term dissociative distress that goes away after a period of time
Dissociative Disorder Treatment and Management Approaches
Dissociative disorders are highly treatable with the right intervention. Because of this condition’s connection to traumatic experiences, professional therapies and, sometimes, medication management are often required to make a meaningful difference.
Dissociative disorder treatment may blend treatment that’s specific to your diagnosis, grounded in evidence-based therapies, and combined with approaches for co-occurring conditions.
Diagnosis-Specific Treatment
Depending on the type of dissociative disorder you’re diagnosed with, a few different treatment approaches may be effective:
- Dissociative Identity Disorder (DID): Treatment typically focuses on integrating the different identity states, helping them communicate and work together rather than operate separately. This is often a longer-term process built on establishing safety and trust before deeper trauma work begins.
- Dissociative Amnesia: Treatment often centers on gently and gradually recovering lost memories in a safe, supported setting, paired with strategies to manage the distress that surfaces as those memories return.
- Depersonalization or Derealization Disorder: Treatment usually emphasizes grounding techniques and skills that help reconnect a person with their body and surroundings, alongside therapy that addresses the anxiety or stress often driving the episodes.
Psychotherapies
When it comes to treating dissociative disorders, psychotherapy stands at the forefront of therapeutic interventions. Common approaches include:
- Cognitive-behavioral therapy (CBT) is often employed to help patients challenge and change unhelpful thought patterns and behaviors related to their condition.
- Eye Movement Desensitization and Reprocessing (EMDR) has also shown promise, particularly for those whose condition is rooted in trauma, by helping patients process and integrate traumatic memories.
- Psychodynamic therapy delves into the unconscious processes that may be at play, exploring the emotional conflicts that could be contributing to the memory loss.
These psychotherapeutic approaches offer patients a chance to reclaim their memories and, by extension, their sense of self, in a supportive and structured environment. However, a therapy that resonates with one person may not be as effective for another, meaning mental health professionals should be versatile and responsive in their treatment plans.
Dual Diagnosis Treatment
Dissociative disorders frequently occur alongside other mental health conditions, such as depression, anxiety, or post-traumatic stress disorder (PTSD), because of their trauma-based nature. The disorienting nature of a dissociative disorder’s symptoms can also be anxiety-inducing, furthering the distress that exacerbates other conditions. Not to mention, many people turn to drugs or alcohol to numb this distress.
In other words, dissociative disorders commonly coexist with other mental health concerns and addictions. When this is the case, treating the dissociative disorder alone rarely leads to lasting recovery, because untreated substance use and trauma can undermine your progress.
Dual diagnosis treatment addresses all mental health conditions and substance use disorders together to get to the root cause of dissociative symptoms and stop them once and for all. This approach may integrate psychotherapies, medication management, holistic treatment techniques, and other modalities for comprehensive care.
Contact Red Top Wellness Center for Dissociative Disorder Treatment
If you or someone you know is struggling with the effects of trauma and dissociation, the compassionate team at Red Top Wellness Center is here to help. Our experienced mental health professionals specialize in trauma-informed care and are dedicated to providing personalized treatment plans that address your unique needs.
We understand the courage it takes to seek help, and we’re committed to supporting you every step of the way. Call us today at (470) 227-7574 to learn more about our services and how we can assist you on your path to healing.
