Dissociation is a prevalent condition that mainly affects those who endured chronic childhood trauma or those who have experienced profound trauma as an adult, such as exposure to war, a natural disaster, or the sudden loss of a loved one.
What is dissociation?
There are various descriptions of dissociation.
However, to put things simply, dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, and sense of identity.
Most experts believe dissociative disorders develop as a reaction to trauma, where such conditions are the brain’s way of keeping disturbing or unbearable memories at bay.
Coping mechanism
You may better understand the condition by considering dissociation as a coping mechanism.
People with dissociative disorders try to escape reality in unhealthy and involuntary ways, which may cause issues with daily functioning (Dissociative Disorders; Mayo Clinic).
Symptoms of dissociation
There are various symptoms of dissociation and dissociative disorders – symptoms can range from a person developing alternate identities to amnesia.
Signs and symptoms of a dissociative disorder depend on the type of disorder you have.
Speaking to a professional
If you think you have any dissociative disorder symptoms, you must speak to your doctor or mental health professional as soon as possible.
Getting treatment for dissociative disorders early on can prevent your condition from worsening and make you feel better sooner.
Symptoms
Symptoms of dissociative disorders can vary and may depend on the type and severity of the disorder you have.
Typically, symptoms of dissociative disorders include:
- Unexpected and sudden mood shifts. For example, you may feel angry or sad for no reason.
- Feeling disconnected from yourself.
- Anxiety or depression (or both)
- Problems dealing with intense emotions
- Memory problems that are not related to other medical conditions or physical injuries
- Another symptom of dissociation involves derealisation, which feels like the world is ”not real” or distorted.
- Confusion in identity – for example, you may behave in a way that you usually wouldn’t or say and do things that you ordinarily find offensive or unacceptable.
- Issues with concentration (and other cognitive-related problems)
What are the main types of dissociative disorders?
According to mental health experts, there are four primary dissociative disorders.
They include:
- Dissociative fugue
- Dissociative amnesia
- Depersonalization disorder
- Dissociative identity disorder
Here we will examine each of the dissociative disorders in more detail.
1. Dissociative fugue
A fugue state, also known as dissociative fugue, is when a person experiences a sudden (unexpected) loss of identity and may impulsively travel far away from home.
A person in a fugue state may be unable to recall some or all past events.
Formerly called psychogenic fugue, a dissociative fugue is a psychological state in which a person loses awareness of their identity or other crucial autobiographical information (Psychology Today; Dissociative Fugue, Psychogenic Fugue).
Unexpected travel
A person experiencing dissociative amnesia often engages in some form of unexpected travel (Psychology Today; Dissociative Disorders, Psychogenic Fugue).
Bewildered wandering
Those who experience dissociative fugue may travel long distances. For example, people may find themselves at work, in a park or on the beach without recollecting how they got there.
The DSM -5 refers to dissociative fugue as a state of ”bewildered wandering” (Psychology Today; Dissociative Disorders, Psychogenic Fugue).
2. Dissociative amnesia
A person with dissociative amnesia cannot remember the details of a stressful or traumatic event.
However, people with dissociative amnesia are aware they are experiencing memory loss.
Dissociative amnesia can last a few days to a few years and may be linked to other mental health conditions, such as anxiety disorders.
Four types of dissociative amnesia
Researchers have identified four types of dissociative amnesia, they include:
- Selective amnesia – where a person has incomplete or foggy memories of a traumatic event
- Generalized amnesia – is when a person has difficulty remembering the details of their life.
- Localized amnesia – involves a person having no memory of a traumatic event for a certain period. For example, if someone is the victim of an assault, they may be incapable of recalling the details of such an event for a few days.
- Systematized amnesia – is when a person has a specific type of memory loss. For instance, they may not recognize or recall a particular family member or another close relative.
3. Depersonalisation disorder
Depersonalization disorder is when people feel detached from their thoughts, feelings, and life.
People with depersonalization disorder report feeling emotionally disconnected and distant toward themselves as if watching their lives play out on a movie or showreel.
Other symptoms of depersonalization include feeling out of control or ”zoned out”.
Time moves differently for people with depersonalization disorder and often feels slower than usual.
In severe cases of depersonalization disorder, a person may not recognize themselves in the mirror – they may also view their body differently. For example, they may perceive their body to be a different shape or size than usual.
4. Dissociative identity disorder
Previously called multiple personality disorder, dissociative identity disorder (DID) is perhaps one of the most controversial dissociative disorders and is highly debated within some mental health communities.
Broadly, DID involves the coexistence of two or more personality states within the same person (BetterHealth Channel).
The person with dissociative identity disorder is usually unaware of the shift in personality states and instead experiences them as episodes of memory loss.
The various personality states may have different styles, tones of voice, body language, memories and outlooks on life.
During severe stress, the person may shift between various personality states.
Risk factors
According to the research literature, various factors can put someone at risk of developing a dissociative disorder.
For instance, those who have experienced physical, sexual or emotional abuse are at significant risk of developing dissociative disorders (Mayo Clinic: Dissociative Disorders).
Moreover, children and adults who endure other traumatic events such as natural disasters, kidnapping, prolonged, early, traumatic medical procedures, war exposure, and torture are also at risk of developing dissociative conditions (Mayo Clinic: Dissociative Disorders).
Complications
There are various complications associated with dissociative disorders.
Individuals experiencing any type of dissociative disorder may endure specific complications as a result of their condition, such as:
- Depression and anxiety disorders
- Self-harm
- Alcoholism and drug use disorders
- Post-traumatic stress disorder
- Profound difficulties in relationships and at work
- Sleep disorders, including sleepwalking, nightmares and insomnia
- Personality disorders
- Suicidal thoughts and behaviour
Why people develop dissociative disorders
Much of the literature suggests dissociative disorders develop as a coping mechanism in response to trauma.
Young children specifically are at risk of developing dissociative disorders.
Children who dissociate
For example, a child is more capable than an adult of stepping outside of themselves and observing trauma as if it’s happening to someone else.
Children are more capable of dissociating themselves from a shocking event due to specific brain plasticity. Still, this early learning can be detrimental since children may use such a coping mechanism in response to other stressors throughout their lifespan.
Treatment
Studies show that treatment options for dissociative disorders have not yet been extensively studied.
Treatment options for dissociative disorders are centred around case studies, not scientific research.
However, there are treatment options available for those with dissociative disorders, including:
- Psychotherapy – sometimes referred to as ”talk therapy”, is usually a long-term treatment. Such therapy may include psychoanalysis and cognitive therapy.
- Stress management techniques – due to stress triggering specific symptoms
- A safe space – research shows that providing trauma survivors with a safe space to talk about their experiences may trigger memory recall in some people with a dissociative disorder.
- Treatment for concurrent disorders – people with dissociative disorders often have other mental health conditions such as anxiety, depression or substance use disorders. Treatment may include a mixture of prescribed medications and therapy.
Getting in touch
If you think you have any of the symptoms mentioned in this article or are concerned about your mental health, speak to a Centres for Health and Healing specialist who can help.
We are always on hand to lend a listening ear and understand how challenging it can be to reach out in the first instance.
However, as hard as reaching out can sometimes be, talking about your concerns is often the first step to feeling better and living a more fulfilling, happier life.
Contact a specialist today to begin your journey to wellness.
Helpful resources
- BetterHealth Channel: Dissociation and dissociative disorders
- Mayo Clinic: Dissociative Disorders – symptoms and causes
- Psychology Today: Dissociative Fugue (Psychogenic Fugue)
