Dissociation is the brain's defense mechanism related to stressful or traumatic situations. While everyone experiences dissociation at some point (i.e. when the mind wanders while driving a car), ongoing and more extreme cases may lead to diagnosis of the disorder.
A Dissociative Disorder alters the normal state of mental functioning and limits the awareness of identity, emotions, memory, perception and/or consciousness. Symptoms can present as mild, moderate, or debilitating, and vary based upon the type of the Dissociative Disorder.
Similar symptoms may be present in other disorders, such as Post-Traumatic Stress Disorder, and in certain brain diseases.
Types of Dissociative Disoders:
1) Depersonalization Disorder: feelings of unreality concerning the self and environment, which may cause impairment in functioning. Symptoms may include:
- Derealization - a feeling that objects or people are distorted (i.e. objects or parts of the body seem larger or smaller than usual)
- Depersonalization - a feeling of detachment from your body or a situation; this can feel as if you are watching a situation from above when you are a participant, as if the world around you is in a movie that you are watching, or you may feel robotic as if something else is controlling your body
- Emotional numbing and/or mood disorders such as depression
- Memory interruption or loss
- Identity confusion
Episodes of depersonalization can be very intense and cause anxiety for the sufferer because the sufferer considers the depersonalization unnatural. This can also lead to depression, panic, or worry about going crazy.
The exact cause of the development of the disorder is unknown; however, it is likely that extreme emotional trauma (such as in cases of abuse or war) is a catalyst. Reminders (also called "triggers") of previous trauma can lead to episodes of depersonalization in one with the disorder.
Treatment for Dissociative Disorder:
Many sufferers are not as concerned with the disorder itself, but instead seek treatment for related mood disorders.
Medication can be given to address mood problems, and psychotherapy and/or cognitive therapy are usually recommended to address unresolved trauma. New coping techniques can be taught in cognitive/behavioral therapy.
2) Dissociative Amnesia: partial or total loss of important information, sometimes occurring suddenly after a particularly stressful event or situation.
A person struggling with Dissociative Amnesia may not remember critical information like age, name, address, friends or relatives, but is able to remember how to carry about daily life.
Dissociative Amnesia is not caused by a neurological issue or drug abuse or any of the other dissociative disorders (Dissociative Identity Disorder, Dissociative Fugue, Post Traumatic Stress Disorder, etc).
Types of Dissociative Amnesia:
- Localized amnesia is the inability to remember all the events that happened in a relatively short period of time, often centered around a painful or traumatic event. Localized amnesia is the most common type of dissociation.
- Selective Amnesia is an inability to remember certain details of a situation or incident. An example of selective amnesia: a person may remember a car crash, but not that it killed a loved one.
- Generalized Amnesia is an inability to remember anything about one's past life.
- Systematized Amnesia is the loss of memory for specific types of information. An example of systematized amnesia: a person may be unable to recall anything about a particular person.
- Continuous Amnesia: inability to remember any events between a specific time in the past and the present. The person is alert and oriented but forgets each event after it occurs.
3) Dissociative Fugue (also known as Fugue State) is confusion over personal identity, often resulting in partial (or complete) adoption of a new identity, accompanied by travel away from home. Recovery from Fugue State is often abrupt and complete as gradual bits of information are remembered.
The Fugue State may range from hours to months but fugue periods are generally brief and self-limiting. In addition, Dissociative Fugue is rare.
During the Fugue State, the person will appear normal. Diagnosis is generally made retroactively. When the fugue ends, the person may suffer shame, depression and intense conflict over what has happened.
Symptoms of Dissociative Fugue:
- Sudden, unexpected travel away from home with an inability to recall the past.
- Confusion about personal identity or assuming a new identity.
- Disturbance not due to medical condition or substance abuse.
- Significant distress in social, work, or other areas of functioning.
Treatment for Fugue State:
- Hypnosis may help, but efforts to restore the memory of the events in the fugue state are rarely successful.
- Therapy - to explore reasons for the fugue state and work on conflict management.
4) Dissociative Identity Disorder (also known as Multiple Personality Disorder) is a dramatic condition in which two or more relatively independent personalities appear to exist within a single person.
More information about Dissociative Identity Disorder can be found on the Dissociative Identity Disorder Resource Page.
Related Resource Pages on Band Back Together
Additional Dissociative Disorder Resources:
The International Society for the Study of Trauma and Disassociation (ISSTD) is an international organization for healthcare professionals who treat complex trauma and dissociation disorders.
Coping with Trauma-Related Dissociation: Skills Training for Patients and Therapists (book)
The Potteridge Centre of Dissociation and Trauma is a UK-based organization that provides information for professionals as well as potential clients.
The UK-based website Mind.org.uk offers an electronic booklet that may help in understanding Dissociative Disorders.
The Trauma Information Pages have research articles related to dissociation and trauma, which can be informative for patients and advocates.
An Infinite Mind provides a wealth of resources for trauma-related disorders.
Boston University's Center for Psychiatric Rehabilitation provides a website dedicated to living well with a psychiatric disability in work and school.