Dissociative disorders are a group of mental health conditions that involve disruptions or disconnections in memory, identity, consciousness, or perception. They are typically a response to overwhelming stress or trauma, especially during childhood, and serve as a way for the mind to protect itself. While they can be distressing and confusing, individuals can manage symptoms and live fulfilling lives with the proper support.
There are three main types of dissociative disorders: Dissociative Identity Disorder (DID), Dissociative Amnesia, and Depersonalisation-Derealisation Disorder. Each has features, but all involve detachment from reality or one’s sense of self.
Dissociative Identity Disorder (DID)
Dissociative Identity Disorder, previously known as multiple personality disorder, is perhaps the most well-known and often misunderstood dissociative condition. People with DID have two or more distinct identities or personality states, often referred to as “alters”. These identities may have their own names, voices, behaviours, and even memories. At different times, one identity may take control of a person’s behaviour, leading to noticeable shifts in personality.
Symptoms of DID
- Memory gaps not explained by ordinary forgetfulness
- Feeling like you’re different people at different times
- Changes in voice, behaviour, or preferences depending on which identity is present
- Emotional distress or confusion about identity
These symptoms can interfere with everyday life, affecting work, relationships, and self-esteem. People with DID often also experience anxiety, depression, or post-traumatic stress disorder (PTSD).
Treatment for DID
The primary treatment for DID is psychotherapy, particularly trauma-focused therapies that help individuals understand and integrate the different parts of their identity. The goal is not necessarily to eliminate alters, but to help them work together more cohesively. Medication may be used to manage related symptoms like anxiety or depression, though there is no specific drug treatment for DID itself.
Dissociative Amnesia
Dissociative amnesia involves the inability to recall important personal information, usually after a traumatic or stressful event. This memory loss is more severe than everyday forgetfulness and is often linked to emotionally painful or distressing events.
In rare cases, a person may experience a subtype called dissociative fugue, where they may travel or wander and become confused about their identity or past.
Symptoms of Dissociative Amnesia
- Gaps in memory, particularly relating to trauma
- Sudden loss of personal identity or history
- Difficulty remembering key life events or relationships
This kind of memory loss can sometimes last for hours, days, or even longer. While it’s often temporary, it can be deeply unsettling and disruptive to daily life.
Treatment for Dissociative Amnesia
Psychotherapy is again the main form of treatment. Techniques such as cognitive behavioural therapy (CBT) or EMDR (eye movement desensitisation and reprocessing) can help address the trauma that led to the amnesia. Creating a safe, supportive environment can also help memories return naturally. As with DID, medications are sometimes used to manage associated conditions like depression or anxiety.
Depersonalisation-Derealisation Disorder
This disorder involves persistent or recurring feelings of detachment from oneself or the environment. People often describe it as feeling like they’re watching themselves from outside their body (depersonalisation) or that the world around them feels unreal or dreamlike (derealisation). While the person is aware that this isn’t reality, the feeling can be distressing and disorienting.
Symptoms of Depersonalisation-Derealisation Disorder
- Feeling disconnected from your body or thoughts
- The world feels “foggy”, dreamlike, or artificial
- Emotional numbness
- A sense of time feeling distorted or slowed down
Although episodes can be brief, they can also last for extended periods, especially during times of high stress or anxiety.
Treatment for Depersonalisation-Derealisation Disorder
Therapy is the most effective approach, especially CBT, which can help challenge unhelpful thoughts and teach grounding techniques. Mindfulness practices and breathing exercises are also beneficial in helping people reconnect with the present moment. Medication may be prescribed to address co-occurring issues such as panic attacks or depression.
Living with a dissociative disorder can be challenging, especially when symptoms are misunderstood or mistaken for something else. People often suffer for years before receiving a proper diagnosis, which is why education and awareness are so important. People can begin to heal and regain control over their lives with the proper support, whether through therapy, support groups, or lifestyle changes.
If you or someone you know is experiencing symptoms of dissociation, it’s important to seek help from a mental health professional. You are not alone; support is available to help you move forward.
