Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. Dissociative disorders involve problems with memory, identity, emotion, perception, behavior and sense of self. Dissociative symptoms can potentially disrupt every area of mental functioning.

Examples of dissociative symptoms include the experience of detachment or feeling as if one is outside, one’s body, and loss of memory or amnesia. Dissociative disorders are frequently associated with previous experience of trauma.

Some people, however, develop a dissociative disorder that requires treatment. Dissociative disorders are controversial and complex problems that need specific diagnosis, treatment and support.

Symptoms of Dissociative Disorder:

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

Causes of Dissociative Disorder:

● Dissociative disorders often first develop as a way to deal with a catastrophic event or with long-term stress, abuse, or trauma. This is particularly true if such events take place early in childhood. At this time of life there are limitations on one’s ability to fully understand what is happening, coping mechanisms are not fully developed, and getting support and resources depends on the presence of caring and knowledgeable adults.

● Mentally removing oneself from a traumatic situation — such as an accident, natural disaster, military combat, being a crime victim, or repeated physical, mental or sexual abuse — can be a coping mechanism that helps one escape pain in the short term. It becomes a problem if over the long term it continues to separate the person from reality, and blanks out memories of entire periods of time.

● Acute stress disorder and post-traumatic stress disorder (PTSD) are closely related to dissociative disorders, sharing such symptoms as memory loss, depersonalization, or derealization.

Types of Dissociative Disorder:

1. Dissociative Amnesia - The main symptom is difficulty remembering important information about one’s self. Dissociative amnesia may surround a particular event, such as combat or abuse, or more rarely, information about identity and life history. The onset for an amnesic episode is usually sudden, and an episode can last minutes, hours, days, or, rarely, months or years. There is no average for age onset or percentage, and a person may experience multiple episodes throughout her life.

2. Depersonalization/ Derealization Disorder - This disorder involves ongoing feelings of detachment from actions, feelings, thoughts and sensations as if they are watching a movie (depersonalization). Sometimes other people and things may feel like people and things in the world around them are unreal (derealization). A person may experience depersonalization, derealization or both. Symptoms can last just a matter of moments or return at times over the years. The average onset age is 16, although depersonalization episodes can start anywhere from early to mid-childhood. Less than 20% of people with this disorder start experiencing episodes after the age of 20.

3. Dissociative Identity Disorder - Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of every day events, personal information and trauma. Women are more likely to be diagnosed, as they more frequently present with acute dissociative symptoms. Men are more likely to deny symptoms and trauma histories, and commonly exhibit more violent behavior, rather than amnesia or fugue states. This can lead to elevated false negative diagnosis.

Treatment of Dissociative Disorder:

● Treatment of dissociative disorders usually consists of psychotherapy, with the goal of helping the person integrate different identities, and to gain control over the dissociative process and symptoms. Therapy can be long and difficult, as it involves remembering and learning to deal with past trauma.

● Cognitive (that is, dealing with a patient’s conscious intellectual activity) behavioral therapy has been found to be effective. Hypnosis may be another helpful treatment. A newer therapy called Eye Movement Desensitization and Reprocessing (EMDR) focuses specifically on the role those disturbing memories play in the development of mental disorders.

● No particular medications treat dissociative disorders, although antidepressants may be needed to treat symptoms of depression.