OverviewWhat are dissociative disorders?Dissociative disorders are mental health conditions that involve feelings of being detached from reality, being outside of your own body or experiencing memory loss (amnesia). Show
The word “dissociation” means to be disconnected from others, from the world around you or from yourself. Dissociative disorders typically develop after short-term or long-term trauma. Types of dissociative disordersThe three types of dissociative disorders include:
There’s also a symptom called dissociative fugue. It’s a temporary mental state in which a person has memory loss and ends up in an unexpected place. Because dissociative disorders appear on the trauma spectrum, many people with a dissociative disorder may have co-occurring trauma-related mental health conditions, such as:
Who do dissociative disorders affect?People of all ages and racial, ethnic and socioeconomic backgrounds can develop a dissociative disorder. Women and people assigned female at birth are more likely to have a diagnosis. People who experienced physical and/or sexual abuse in childhood have the greatest risk of developing dissociative identity disorder (DID). About 90% of people who have DID in the United States, Canada and Europe experienced childhood abuse and neglect. How common are dissociative disorders?Dissociative disorders are rare. About 2% of people in the United States have them. Symptoms and CausesWhat are the symptoms of dissociative disorders?The symptoms of dissociative disorders depend on the type. Symptoms usually first develop after a traumatic event. Stressful situations can worsen symptoms and cause issues with daily functioning. Symptoms of dissociative identity disorder (DID)A person with DID has two or more distinct identities. The “core” identity is the person’s usual personality. “Alters” are the person’s alternate personalities. The core is the identity you had before developing DID and alters. Each alter has a particular set of behaviors, attitudes, preferences, memories and ways of thinking. Other people may be able to tell the difference between the alters, as well as the person with DID. Shifting from one alter to another is involuntary and sudden. Another symptom of DID is ongoing gaps in memory about everyday events, personal information and/or past traumatic events. These symptoms can range widely in severity. For some people, the condition minimally interferes with their life. For others, it causes significant issues. Symptoms of dissociative amnesiaIn dissociative amnesia, the main symptom is an episode of amnesia (memory loss) that comes on suddenly. It can last months or years. There are three types of amnesia:
You may not be aware of your memory loss or have only a little awareness. But loved ones usually recognize the memory loss. Symptoms of depersonalization/derealization disorderThe symptoms of depersonalization/derealization disorder include experiencing one or both of the following episodes in a recurring pattern over a lengthy period of time:
During these episodes, you’re aware of your surroundings and know that what you’re experiencing isn’t normal. These symptoms may start as early as childhood. The average age of the first episode is 16. Fewer than 20% of people with this condition will have their first episode after age 20. What causes dissociative disorders?Dissociative disorders often 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 to your ability to fully understand what’s happening. In addition, your coping mechanisms aren’t fully developed and getting support and resources depends on the presence of caring and knowledgeable adults. Mentally removing yourself from a traumatic situation can be a coping mechanism that helps you escape pain in the short term. This coping mechanism can become an issue if it continues to separate you from reality and removes memories of entire periods of time. Traumatic situations may include:
Scientists have recently been studying specific brain structures and functions that are related to dissociation. So far, they’ve found that during dissociation, structures in the memory regions deep in your brain show rhythmic activity but seem disconnected from other regions responsible for thought and planning. Diagnosis and TestsHow are dissociative disorders diagnosed?Healthcare providers diagnose dissociative disorders by assessing your symptoms and personal history. Your provider may order tests to rule out possible medical conditions that can cause similar symptoms (such as memory loss), including:
Once they rule out possible causes, they’ll likely refer you to a mental health specialist, such as a psychologist, to make a diagnosis through clinical interview and observations. Mental health professionals use criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders to diagnose specific dissociative disorders. Management and TreatmentHow are dissociative disorders treated?Treatment of dissociative disorders usually consists of psychotherapy (talk therapy) to help you gain control over the dissociative process and symptoms. Psychotherapy takes place with a trained, licensed mental health professional, such as a psychologist or psychiatrist. It can provide support, education and guidance to you and/or your family to help you function better and increase your well-being. Specific types of psychotherapy commonly used for dissociative disorders include:
Therapy can be difficult, as it involves remembering and learning to deal with past trauma. But it can significantly help your symptoms in the long term. Other therapies that can help include:
No specific medications treat dissociative disorders. But your provider may recommend certain medications, such as antidepressants, to treat co-occurring mental health conditions. Outlook / PrognosisWhat is the prognosis for dissociative disorders?The prognosis (outlook) for dissociative disorders varies. With professional treatment (usually psychotherapy), many people with a dissociative disorder can address the major symptoms of the condition and improve their daily functioning. For some people, the dissociative disorder, especially dissociative identity disorder (DID), severely impacts their life. Suicide attempts and self-harm are common in people with DID. More than 70% of people with DID attempt suicide. If you or a loved one are thinking about suicide, dial 988 on your phone to reach the Suicide and Crisis Lifeline. Someone will be available to help you 24/7. Living WithWhen should I see my healthcare provider?If you’re experiencing symptoms of a dissociative disorder, talk to a healthcare provider or mental health professional. A note from Cleveland Clinic As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to your life. Talk to a healthcare provider if you’re experiencing symptoms of dissociation. Mental health professionals can offer treatment plans that can help you manage your condition. What is localized amnesia?Localized amnesia involves being unable to recall a specific event or events or a specific period of time; these gaps in memory are usually related to trauma or stress. For example, patients may forget the months or years of being abused as a child or the days spent in intense combat.
What is the difference between selective amnesia and localized amnesia?The loss of memory is localized with a specific window of time. For example, a survivor of a car wreck who has no memory of the experience until two days later is experiencing localized amnesia. Selective amnesia happens when a person can recall only small parts of events that took place in a defined period of time.
When an individual has dissociative amnesia?Dissociative amnesia is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses in which there is a breakdown of mental functions that normally operate smoothly, such as memory, consciousness or awareness, and identity and/or perception.
Is described as an inability to recall important personal material that Cannot be accounted for by medical causes?A major symptom of Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder) is dissociative amnesia, the inability to recall important personal information.
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