Have you ever felt like the world you live in isn't real? Or like you're watching yourself from outside your own body? Do you sometimes forget even important things? If you have these experiences regularly, you may have a dissociative disorder . Don't worry, we'll talk about this in a simple way that you can understand.
What are these dissociative disorders?
Simply put, dissociation disorder is a type of mental health problem. It is when you feel disconnected from your reality, your own body, or your memories. The word "dissociation" literally means "separation." It means that you feel disconnected and disconnected from other people, the world around you, or even yourself.
Often these situations arise due to a short-term or long-term severe shock (`trauma`) that has been experienced at some point in life. Think of it like a way to protect the mind. That is, when an unbearable shock occurs, the mind temporarily 'disconnects' to get rid of the pain. But it becomes a problem if this continues.
What are the main types of dissociative disorders?
There are three main types of dissociative disorders. Let's take a look at what they are.
1. Dissociative Identity Disorder (DID)
This is what some people call "multiple personalities." What happens here is that the same person has two or more distinct identities . We call these identities ``alters.' ' Each ``alter'' controls the person's behavior at different times. Think of it as not being the same person at one time, but at another. Each ``alter'' can have its own unique history, traits, likes and dislikes. It's like having multiple people inside one body.
2. Dissociative Amnesia
In this condition , you lose track of important information about your life. This forgetfulness may be limited to a specific event in your life. Or you may forget a large part of your life story, perhaps even who you are.
3. Depersonalization/Derealization Disorder
You can have both experiences in this, or you can have just one.
- Depersonalization: This is when you feel detached from your mind, emotions, and body. It's like you're watching your life from the outside, like you're watching a movie.
- Derealization: This is when you feel like the environment, people, and things around you are not real. Everything may seem like a dream, blurry.
In addition to this, there is a symptom called ``Dissociative Fugue`` . It involves temporary memory loss and being in an unimaginable place without any thoughts.
Because dissociative disorders are a trauma-related condition, many people with these conditions may also have other mental health problems. For example:
- Post-traumatic Stress Disorder (PTSD)
- Borderline Personality Disorder (BPD)
- Substance Use Disorders
- Depression
- Anxiety Disorders
Who is most affected by these conditions?
Dissociative disorders can affect people of any age, race, or socioeconomic status, but are reported to be more prevalent among women .
People who have been physically or sexually abused as children are particularly at risk of developing dissociative identity disorder (DID). In countries like the United States, Canada, and Europe, it has been found that about 90% of people with DID were abused and neglected as children.
How common are dissociative disorders?
These conditions are actually relatively rare. For example, about 2% of the American population has these disorders.
What are the symptoms of dissociative disorders?
These symptoms vary depending on the type of disorder. These symptoms usually begin to appear after a traumatic event. These symptoms can become worse during times of stress and interfere with daily activities.
Symptoms of dissociative identity disorder (`DID`):
A person with `DID` has two or more distinct identities. The `core` identity is the person's normal personality. `Alters` are the person's alternative personalities.
Each `(alter)` has its own unique behaviors, attitudes, desires, memories, and ways of thinking. Others may be able to recognize the differences between these `(alters)`, as well as the differences between the person with `DID`. The transition from one `(alter)` to another occurs unconsciously and suddenly.
Another key symptom of DID is persistent memory lapses about everyday events, personal details, and/or traumatic events from the past . While these symptoms may be mild for some people, they can have a major impact on the lives of others.
Symptoms of Dissociative Amnesia:
The main symptom is sudden episodes of amnesia , which can last for months or even years.
There are three main types of memory loss:
- Localized: Forgetting a specific event or period of time (this is the most common type).
- Selective: Forgetting only certain details of events that occurred during a certain period of time.
- Generalized: You lose all memory of your identity and life story (this is the rarest type).
You may be unaware of your memory loss, or may have only a very slight awareness of it. But those closest to you can usually recognize this memory loss.
Symptoms of Depersonalization/Derealization Disorder:
In this condition, one or both of the following experiences occur in a recurring pattern over a long period of time:
- Depersonalization: A feeling of being detached from your mind, body, or self, and out of touch with reality. As if you are observing your life and events from a distance, not actively participating.
- Derealization: A feeling of being detached from your surroundings and outside of reality. People and things may seem unreal.
During these events, you are aware of your surroundings, and you know that what you are experiencing is not normal.
These symptoms can sometimes begin in childhood. The average age of onset is around 16 years. Less than 20% of people with the condition have their first episode after the age of 20.
What are the causes of dissociative disorders?
Dissociative disorders often occur as a way of coping with an overwhelming event or long-term stress, abuse, or trauma .
This is especially true when these events occur early in life, when children are young. This is because at that time, the child's ability to understand what is happening is limited. Also, the coping mechanisms to deal with a problem are not fully developed. Help and support are only available if there are responsible and knowledgeable adults.
Mentally 'disconnecting' from a traumatic situation can be a short-term defense mechanism that helps you escape the pain. But if this defense mechanism continues to separate you from reality, erasing an entire period of time from your memory, then it becomes a problem.
Examples of traumatic situations:
- Repeated physical, mental, or sexual abuse
- An accident
- A natural disaster
- War conflicts
- Being a victim of a crime
Recently, scientists have been investigating the specific structures and functions of the brain associated with dissociation. What they have found is that during dissociation, the parts of the brain deep within the brain associated with memory show some rhythmic activity, while the connections with other parts responsible for thinking and planning seem to be lost .
How to identify dissociative disorders?
Doctors diagnose dissociative disorders by carefully examining your symptoms and personal history.
Your doctor may order tests to check for other physical conditions that could be causing these symptoms (e.g., memory loss). For example:
- Head injury
- Brain tumors
- Sleep deprivation
- Drug and/or alcohol use
Once you have ruled out any physical causes, you will likely be referred to a mental health specialist, such as a psychiatrist or psychologist, who will make a diagnosis through clinical interviews and observations.
Mental health professionals classify and diagnose dissociative disorders using criteria from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).
How are dissociative disorders treated?
The main treatment for dissociative disorders is psychotherapy, or talk therapy. This helps you manage the dissociative process and symptoms.
Psychotherapy is provided by a trained, licensed mental health professional , such as a psychiatrist or psychologist. It provides you and/or your family with support, education, and guidance to help you cope with everyday life and improve your mental well-being.
Here are some of the most commonly used psychotherapy methods for dissociative disorders:
- Cognitive Behavioral Therapy (CBT): This is a structured, targeted form of psychotherapy. Your therapist helps you look deeply into your thoughts and feelings. Through CBT, you can learn to let go of unhealthy thoughts and behaviors and develop healthier thought patterns and habits.
- Dialectical Behavior Therapy (DBT): DBT is specifically designed for people who experience intense emotions. The main goal is to balance validation of who you are and what your challenges are with the benefits of change. Your therapist will help you learn new skills to improve your ability to regulate your emotions.
The treatment process can be difficult, as it involves remembering past traumatic events and learning to cope with them. However, in the long run, it can provide significant relief from your symptoms .
Other treatments that may help:
- Hypnosis (`Hypnosis` / `Hypnotherapy`): Hypnosis is a state of deep relaxation and focused attention. When you are in a trance, this focused attention allows you to ignore normal distractions and become more open to suggestions that can guide you to make changes to improve your health.
- Eye Movement Desensitization and Reprocessing (EMDR therapy): This involves moving your eyes in specific ways while you process traumatic memories. The goal of EMDR is to help you recover from trauma or other stressful life experiences. Compared to other therapies, EMDR is a relatively new approach.
There is no specific medication for dissociative disorders. However, your doctor may recommend medications, such as antidepressants, to treat other mental health conditions that may be present.
What does the future hold for someone with dissociative disorder?
The prognosis for someone with dissociative disorders can vary from person to person.
With professional treatment (often psychotherapy), many people with dissociative disorder can control their main symptoms and function well in daily life.
But for some people, especially those with dissociative identity disorder (DID), the condition can be life-threatening. Suicide attempts and self-harm are common among people with DID. It is estimated that more than 70% of people with DID attempt suicide.
If you or someone close to you is having suicidal thoughts, please call the National Mental Health Helpline on 1926. Someone is available 24 hours a day to help you.
When should I see a doctor?
If you feel like you have symptoms of a dissociative disorder, talk to a doctor or mental health counselor immediately.
As with any mental health condition, seeking help as soon as symptoms appear can help reduce the disruption to your life. If you have symptoms of dissociation, talk to a doctor. Mental health professionals can provide treatment plans to help you manage your condition.
Take-Home Message from What We've Said
Okay, so let's remind you of some of the most important points from what we've talked about.
- Dissociative disorders are a mental condition that can occur in response to severe trauma .
- The basic symptom is that you feel disconnected from yourself, your memories, or the world you live in .
- Dissociative identity disorder (DID), dissociative amnesia, and depersonalization/reality disorder are the main types.
- These conditions are rare, but there are treatments.
- The main treatment is psychotherapy.
- If you have these symptoms, don't be afraid or embarrassed to seek medical advice. It's very important to get help quickly.
- You are not alone. There are many people struggling with these situations, and there are those who can help you.
Remember, becoming aware of this condition, talking about it, and seeking help are big steps toward regaining control of your life.
` Dissociative Disorders, Mental Health, Trauma, Memory Loss, Psychotherapy, DID, Depersonalization
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