A dissociative disorder is a mental health condition that alters a person's sense of reality.
Someone with a dissociative disorder may have memory loss or may feel:
- that their body or the world around them is unreal
- uncertain about who they are
- that they have many different identities
Most people affected by this disorder will have experienced a traumatic event during childhood. They 'dissociate', or switch off from reality, to cope with it (the box on this page explains what 'dissociation' means).
This feeling of being disconnected from yourself or from the world can be extremely distressing, significantly affecting work and personal life.
It can affect people at any age and is nothing to do with a head injury or underlying health condition – it's the result of the brain adapting to a difficult early life.
If you have been diagnosed with a dissociative disorder, or a friend or family member has, read on. This page explains three main types of dissociative disorders:
It then explains what we know about the cause of dissociative disorders, other conditions commonly associated with dissociative disorders, and how dissociative disorders are treated.
What is dissociative amnesia?
Someone with dissociative amnesia will repeatedly have periods where they cannot remember information about themselves or about events in their past life. They may also forget a learnt talent or skill.
These gaps in memory are much more severe than normal forgetfulness, and are not the result of an underlying medical condition.
Some people with dissociative amnesia will find themselves in a strange place without knowing how they got there. They may have travelled there purposefully, or wandered in a confused state.
These blank episodes may last minutes, hours or days – and rarely, months or years.
What is depersonalisation-derealisation disorder?
'Depersonalisation' means feeling detached from yourself, observing yourself and your feelings and thoughts as if they belong to someone else you are watching in a movie. Some of the typical symptoms are:
- out-of-body experiences
- loss of feeling in parts of your body
- distorted views of your body
- unable to recognise your image in a mirror
- a sense of detachment from your emotions
- feeling like you are watching a movie of yourself
- feeling like you are unreal
'Derealisation' means seeing other people and the environment around you as dream-like and unreal. Objects may change in shape, size or colour. Typical symptoms are:
- feeling like a normal environment is unfamiliar
- a sense that what is happening is unreal
- feeling detached from the world
- a perception of objects changing shape, colour, size
- feeling that people you know are strangers
You might experience one or both of these problems if you have been diagnosed with depersonalisation-derealisation disorder, and will probably be aware that these experiences aren't reality.
Episodes of depersonalisation or derealisation may last just a few moments and come and go over many years, or may be ongoing.
What is dissociative identity disorder?
Dissociative identity disorder, or 'multiple personality disorder', is the most extreme of the three types.
If you've been diagnosed with dissociative identity disorder, you may feel uncertain about who you are and struggle to define yourself.
You may feel the presence of other identities, which may each have their own names, voices, personal histories and mannerisms.
Typical symptoms are:
- feeling like a stranger to yourself
- being confused about your sexuality or gender
- feeling like there are different people within you
- referring to yourself as 'we'
- behaving out of character
- writing in different handwriting
What's the cause?
Many people with a dissociative disorder will have experienced a traumatic event in the past.
Often, this traumatic event will have been physical, sexual or emotional abuse suffered during childhood, although some people 'dissociate' after experiencing war, kidnapping or even an invasive medical procedure.
Switching off from reality is a normal defence mechanism that helps the person to cope during a traumatic time – it's a form of denial, as if "this isn't happening to me".
It becomes dysfunctional when the environment is no longer traumatic but the person still acts and lives as if it is, and hasn't dealt with or processed the event.
So, a dissociative disorder is the result of the brain adapting to a difficult early life environment. It is not:
- to do with genes
- the result of another medical condition
- the result of a head injury
- the result of drug or alcohol abuse (although many people with dissociative disorders misuse alcohol or drugs to cope)
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