The term “dissociative disorders” describes a persistent mental state that is marked by feelings of being detached from reality, being outside of one’s own body, or experiencing memory loss (amnesia). About 2% of the U.S. population experiences true dissociative disorders (not just momentary feelings of dissociation).
Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.
Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay. Symptoms — ranging from amnesia to alternate identities — depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious.
Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.
Signs and symptoms depend on the type of dissociative disorders you have, but may include:
There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:
Some people with dissociative disorders present in a crisis with traumatic flashbacks that are overwhelming or associated with unsafe behavior. People with these symptoms should be seen in an emergency room.
If you or a loved one has less urgent symptoms that may indicate a dissociative disorder, call your doctor.
If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.
Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that’s frightening or highly unpredictable. The stress of war or natural disasters also can bring on dissociative disorders.
Personal identity is still forming during childhood. So a child is more able than an adult to step outside of himself or herself and observe trauma as though it’s happening to a different person. A child who learns to dissociate in order to endure a traumatic experience may use this coping mechanism in response to stressful situations throughout life.
People who experience long-term physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.
Children and adults who experience other traumatic events, such as war, natural disasters, kidnapping, torture, or extended, traumatic, early-life medical procedures, also may develop these conditions.
People with dissociative disorders are at increased risk of complications and associated disorders, such as:
Children who are physically, emotionally or sexually abused are at increased risk of developing mental health disorders, such as dissociative disorders. If stress or other personal issues are affecting the way you treat your child, seek help.
If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to a mental health professional who can help your child recover and adopt healthy coping skills.
Diagnosis usually involves assessment of symptoms and ruling out any medical condition that could cause the symptoms. Testing and diagnosis often involves a referral to a mental health professional to determine your diagnosis.
Evaluation may include:
For diagnosis of dissociative disorders, the DSM-5 lists these criteria.
For dissociative amnesia:
For dissociative identity disorder:
For depersonalization-derealization disorder:
Dissociative disorders treatment may vary based on the type of disorder you have, but generally include psychotherapy and medication.
Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional. Look for a therapist with advanced training or experience in working with people who have experienced trauma.
Your therapist will work to help you understand the cause of your condition and to form new ways of coping with stressful circumstances. Over time, your therapist may help you talk more about the trauma you experienced, but generally only when you have the coping skills and relationship with your therapist to safely have these conversations.
Although there are no medications that specifically treat dissociative disorders, your doctor may prescribe antidepressants, anti-anxiety medications or antipsychotic drugs to help control the mental health symptoms associated with dissociative disorders.
As a first step, your doctor may ask you to come in for a thorough exam to rule out possible physical causes of your symptoms. However, in some cases you may be referred immediately to a psychiatrist. You may want to take a family member or friend along, if possible, to help you remember information.
Here’s some information to help you prepare for your appointment, and what to expect from your doctor.
Before your appointment, make a list of:
Some questions to ask your doctor may include:
Don’t hesitate to ask other questions during your appointment.
Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
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