A set of mental health illnesses known as dissociative disorders are characterized by abnormalities in consciousness, memory, identity, emotion, perception, behavior, and sense of self. Usually, these interruptions are felt as abrupt, unwelcome incursions into one’s mental state. The overall population is affected by dissociative disorder in 2-5% of cases. Severe and recurrent trauma, especially that which occurs in childhood, is typically the cause of dissociative disorders.
An overview of the risk factors that may make someone more likely to acquire dissociative disorders and dissociation following trauma is given in this article, along with information on the etiology of these illnesses. It also provides an overview of common diagnoses, symptoms of various personality disorders, and current evidence-based treatment choices.
What are Dissociative Disorders?
Dissociative disorders are a group of conditions that affect memory and identity. People with dissociative disorders experience disruptions or breakdowns of memory, awareness, identity, and perception. These disruptions may be sudden, gradual, short-term, or long-lasting.
So, what is DID, and what are the other types of disorders? Let’s dive into this.
Types of Dissociative Disorders
There are three main types of dissociative disorders:
- Dissociative Identity Disorder (DID): DID involves alternating between multiple identities or “personality states.” People with DID experience gaps in memory when different identities take control.
- Depersonalization/Derealization Disorder: This involves feeling detached or disconnected from oneself (depersonalization) and/or feeling that one’s surroundings aren’t real (derealization).
- Dissociative Amnesia: This involves memory loss or inability to recall important personal information that can’t be explained by ordinary forgetfulness.
Is Dissociative Identity Disorder Real?
Some people are skeptical about whether dissociative identity disorder is a real and valid diagnosis. However, DID is included in the leading psychiatric manual, the DSM-5, indicating it is generally accepted in the mental health field.
Causes of Dissociative Disorder
Dissociative disorders are mental health disorders that are often triggered by trauma, overwhelming stress, or other difficult life events. Some key causes and risk factors for developing dissociative disorders include:
Trauma and Stress
Experiencing trauma or severe stress, especially in childhood, can increase the risk of developing dissociative disorders. Common traumatic triggers include:
- Childhood abuse (sexual, physical, emotional)
- Combat exposure for soldiers or veterans
- Living through dangerous events like natural disasters, accidents, or sudden loss
- Undergoing invasive medical procedures
These events overwhelm the mind’s ability to cope. To survive, the mind “splits off” difficult memories or feelings. This protects the person in the short term but can lead to dissociative disorders over time.
Attachment and Development
How children attach to caregivers early in life also plays a role. Those with disorganized attachment styles or early life adversity like parental neglect are more prone to dissociative disorders. The lack of safe nurturing prevents kids from developing healthy coping strategies. Later traumas more easily overwhelm their ability to integrate complex memories and emotions.
The most well-known dissociative disorder is DID (formerly called multiple personality disorder). However, several related conditions fall into this category. They all share roots in trauma and involve the mind failing to properly integrate aspects of perception, consciousness, memory, identity, or the environment.
Risk Factors for Developing Dissociative Disorder
People with dissociative disorder, like DID disorder, experience detachment from their thoughts, feelings, memories, and even their identity. There are several factors that raise a person’s risk of developing this complex condition.
| Age and Gender | The dissociative disorder often starts in early adulthood, between the ages of 15-25. Women are diagnosed much more often than men. Some research shows that up to 75-90% of people treated for dissociative disorders are female. However, some experts believe that dissociative disorders in men are underdiagnosed. |
| Other Mental Health Conditions | People who develop dissociative disorder also often have other mental health conditions. The two most common co-occurring disorders are post-traumatic stress disorder (PTSD) and borderline personality disorder. When people have multiple mental health disorders at the same time, it is referred to as comorbidity. The conditions can interact in complex ways that make treatment more challenging. |
| Personality Traits | Certain ingrained personality traits can raise the risk for dissociative disorder. People who are highly suggestible and imaginative seem more prone to having dissociative symptoms. When under stress, they may “check out” from reality as a coping mechanism. Their ability to dissociate easily makes them more at risk. |
| Social and Environmental Factors | Lack of supportive relationships increases the risk for dissociative disorder. People with limited social connections have fewer protective factors to rely on during times of stress. Low socioeconomic status also raises the odds of developing dissociative disorder. The chronic stresses of poverty, trauma, lack of healthcare access, and other challenges can overwhelm people’s coping abilities. |
Symptoms of Dissociation and Dissociative Identity Disorder
Dissociation occurs when a person disconnects from their ideas, emotions, memories, or sense of self. Dissociative disorders come in several forms, and each has its own distinct set of symptoms.
Common signs of dissociation are:
- Feeling detached from your body, thoughts, or emotions
- Not remembering important personal information
- Feeling like the world is unfamiliar or dreamlike
- Having different identities or personalities
Dissociative identity disorder (DID), previously called multiple personality disorder, has specific symptoms like:
- Having two or more distinct personality states
- Feeling like another identity is taking control of your behavior
- Memory loss around everyday events and personal information
- Being told of behaviors you don’t remember doing
The table below compares key symptoms seen in different dissociative disorders:
| Disorder | Symptoms |
| Dissociative amnesia | Inability to recall important personal information or events |
| Dissociative fugue | Confused wandering or sudden travel away from home |
| Depersonalization/derealization | Feeling detached from your body, emotions or like the world is unreal |
| Dissociative Identity Disorder Symptoms | Multiple identities, memory loss, being controlled by other identities |
While many dissociative disorders share common symptoms like memory and identity disruption, the specifics help distinguish each condition. Those with symptoms of dissociation should seek evaluation from a mental health professional. An accurate diagnosis is the first step in managing dissociative disorders with the right kind of treatment.
Diagnosis and Treatment
Dissociative diseases are complicated illnesses that need to be treated by experts. It’s critical to see a specialist in order to receive a precise diagnosis and efficient care. These professionals have received training in trauma-focused therapy and other therapies, as well as in identifying the warning signs of dissociation.
The following therapies can help control the symptoms of dissociative disorder:
Psychotherapy
- Trauma-focused therapy to process traumatic memories
- Dialectical behavior therapy for coping and emotional regulation skills
Medications
- Antidepressants to help with depression and anxiety
- Anti-anxiety medications, as needed
Many people benefit from a combined approach using both psychotherapy and medication for dissociative disorders. The dissociative identity disorder specialist will recommend the best treatment plan based on the individual’s symptoms and needs.
Effective management of dissociative disorders requires collaboration with a specialist and adherence to the prescribed treatment plan. The dissociative identity disorder specialist has the expertise to provide an accurate diagnosis, rule out other conditions, and coordinate care from a team of professionals. Many patients with dissociative disorders can lead stable, healthy lives with the correct treatment plan. Making the initial move to ask for assistance is crucial.
Conclusion
In the end, severe, recurring childhood trauma that surpasses the mind’s capacity for adjustment frequently results in dissociative disorders. Adversity in early life, chaotic attachment patterns, a deficiency of caring support networks, and a propensity for high suggestibility are important risk factors. According to the research, comorbid illnesses, including PTSD and borderline personality disorder, are widespread, and females are diagnosed at a higher rate. In the future, preventative and early intervention initiatives will depend heavily on improved screening procedures to identify at-risk groups. Typically, medication is used in conjunction with trauma-focused treatment administered by a dissociative disorder expert. Even though living with dissociative disorders might be difficult, there is hope for the future when comprehensive, individually designed therapy is received. It is still critical to raise awareness and provide access to high-quality care.