According to the American Psychiatric Association, “a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”.
Dissociative disorders involve a disconnection that manifests as a feeling of detachment between a person’s thoughts, feelings, or sense of identity.
Major Symptoms of Dissociative Disorders
- Detachment from Self: Individuals may feel as if they are observing their actions from a distance, detached from themselves.
- Unpredictable Mood Swings: Sudden and unexpected mood swings that are difficult to predict or control.
- Persistent Depression or Anxiety: Struggling with ongoing feelings of depression or anxiety that interfere with daily life.
- Distorted Perception: The world around them may seem unreal or distorted, making it hard to connect with their surroundings.
- Memory Lapses: Significant memory gaps, such as forgetting important information or events that would typically be remembered.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), identifies four primary types of dissociative disorders:
1. Dissociative Identity Disorder (DID)
Dissociative Identity Disorder (DID), previously known as multiple personality disorder, involves an identity disturbance in which two or more separate personality states or identities control the individual’s behavior. Each identity has its own unique history, traits, likes, and dislikes. These identities can take turns controlling the person’s behavior, often without the individual being aware of it. When one identity is in control, the person might not remember what happened when another identity was in charge, leading to confusion and distress. The different identities may have distinct ways of speaking, thinking, and even physical traits like being left-handed or right-handed.
Symptoms of Dissociative Identity Disorder (DID):
- Out-of-Body Experiences: Feeling like they are watching themselves from the outside, as if they are not in their own bodies.
- Memory Gaps: Sudden gaps in recent memories, especially related to personal experiences.
- Changes in Behavior: Noticeable changes in speech, behavior, and preferences when different identities take control.
- Hearing Voices: Hearing voices inside their head that are not their own, including conversations or comments from other identities.
- Encountering Strangers: Meeting people who are strangers to them but known to one of their other identities.
- Dissociative Fugue: Amnesia for travel, where the individual cannot remember how or why they traveled to a certain location.
Causes of Dissociative Identity Disorder (DID):
- Lack of Nurturing in Childhood: DID can develop from a lack of care and support during childhood, especially in cases of repeated severe physical or sexual abuse.
- Extreme Childhood Trauma: Experiencing extreme and repeated trauma during critical stages of childhood development can lead to DID.
- Painful Medical Experiences: Painful medical or surgical procedures, problems with attachment to caregivers, and unhealthy family dynamics can also contribute to the development of DID.
2. Dissociative Amnesia
Dissociative amnesia is a mental health condition where a person cannot remember important personal information, usually related to traumatic, painful, or stressful experiences. This type of memory loss is different from normal forgetfulness and can manifest in several ways:
- Localized Amnesia: The person cannot remember an entire experience or period of time in their life.
- Selective Amnesia: Trouble remembering certain details about an event or events that happened during a specific time period.
- Generalized Amnesia: The person completely forgets their identity and everything that has happened to them throughout their life.
Symptoms of Dissociative Amnesia:
- Complete Memory Loss: The individual may experience total memory loss.
- Detachment from Self and Others: Feelings of detachment from themselves and others.
- Impairment in Daily Life: Significant impairment in various aspects of life, including work, home, or school.
Causes of Dissociative Amnesia:
- Childhood Abuse: Physical, sexual, or emotional abuse during childhood or adolescence.
- Victim of Rape: Being a victim of rape can trigger dissociative amnesia.
- Natural Disasters: Experiencing devastating natural disasters.
- Sudden Death of a Loved One: The sudden loss of a loved one can lead to dissociative amnesia.
- Witnessing a Crime: Being a victim or witness to a crime.
3. Depersonalization/Derealization Disorder (DPDR)
Depersonalization-Derealization Disorder (DPDR) is a mental health condition where individuals often feel disconnected from themselves and their surroundings, affecting their perception of reality and emotional health.
Depersonalization:
- Definition: Feeling disconnected or estranged from one’s own thoughts, identity, or physical presence.
- Description: Experiencing the sensation of observing one’s actions from a distance, as if they are external spectators to their lives.
Derealization:
- Definition: Feeling disconnected or estranged from people and objects around them, as if their surroundings are unfamiliar or distant.
- Description: Perceiving surroundings and the people in them as unreal or illusory.
Symptoms of Depersonalization/Derealization Disorder:
- Alexithymia: Inability to recognize or describe emotions.
- Physical or Emotional Numbness: Lack of emotional response or physical sensation.
- Loss of Control: Feeling unable to control speech or movement.
- Distorted Perception: Surroundings may appear distorted, blurry, or colorless.
Causes of Depersonalization/Derealization Disorder:
- Childhood Abuse: Emotional or physical abuse may lead to depersonalization or derealization as a coping mechanism.
- Neglect in Childhood: Experiencing neglect during childhood may result in a sense of disconnection from oneself and the environment.
- Exposure to Domestic Violence: Witnessing domestic violence can create a sense of unreality.
- Avoidance of Difficult Situations: Avoiding or denying difficult situations can lead to feelings of detachment and unreality.
- History of Drug Abuse: A history of drug abuse may result in sensations of being detached from reality.
4. Other Specified Dissociative Disorder
This category includes cases where symptoms of a dissociative disorder cause significant distress or problems in daily life but don’t fully match any specific dissociative disorder.
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