Dissociative Disorders

What are dissociative disorders?

A dissociative disorder is the breakdown of one's perception of his/her surroundings, memory, identity, or consciousness.

There are four main kinds of dissociative disorders:

  • Dissociative amnesia
  • Dissociative fugue
  • Dissociative identity disorder (previously called multiple personality disorder)
  • Depersonalization disorder

What are the main characteristics of each dissociative disorder?

Dissociative amnesia:

A dissociative amnesia may be present when a person is unable to remember important personal information, which is usually associated with a traumatic event in his/her life. The loss of memory creates gaps in this individual's personal history.

Dissociative fugue:

A dissociative fugue may be present when a person impulsively wanders or travels away from home and upon arrival in the new location is unable to remember his/her past. The individual's personal identity is lost because that person is confused about who he/she is. The travel from home generally occurs following a stressful event. The person in the fugue appears to be functioning normally to other people. However, after the fugue experience, the individual may not be able to recall what happened during the fugue state. The condition is usually diagnosed when relatives find their lost family member living in another community with a new identity.

Dissociative identity disorder:

Dissociative identity disorder was formerly called "multiple personality disorder." When a person intermittently experiences two or more identities, he/she may have a dissociative identity disorder. While experiencing a new identity, a separate personality takes control, and the person is unable to remember important and personal information about himself/herself. Each personality has its own personal history and identity and takes on a totally separate name.

Depersonalization disorder:

Feelings of detachment or estrangement from one's self are signs of depersonalization. Although these feelings are difficult to describe, individuals with this disorder will report feeling as if they are living in a dream or watching themselves on a movie screen. They feel separated from themselves or outside their own bodies. People with this disorder feel like they are "going crazy" and they frequently become anxious and depressed.

Are there genetic factors associated with dissociative disorders?

Yes, people with dissociative identity disorder usually have close relatives who have also had similar experiences.

Do dissociative disorders affect males, females, or both?

Females are more frequently affected. More than five times as many women than men have problems with dissociative identity disorder.

At what age do dissociative disorders appear?

Dissociative amnesia is generally a problem in adulthood, but it can be found in children and adolescents.

Dissociative fugue happens mostly during adulthood

Dissociative identity disorder occurs most frequently in adulthood.

Depersonalization disorder usually occurs during late adolescence or adulthood.

How often is a dissociative disorder seen in our society?

Dissociative disorders are uncommon. However, there has been significant interest in dissociative amnesia in the past few years. Much of the interest has been related to forgotten childhood traumas and repressed memories. There is considerable debate regarding the authenticity of repressed memories.

How are dissociative disorders diagnosed?

A mental health professional makes a diagnosis of a dissociative disorder by taking a careful personal history from the client/patient and family members. It is important that the therapist learn the details of the person's life. No laboratory tests are required to make a diagnosis of dissociative disorder nor are there any physical conditions that must be met. However, it is very important not to overlook a physical illness that might mimic or contribute to a psychological disorder. If there is any question that the individual might have a physical problem, the mental health professional should recommend a complete physical examination by a medical doctor. Laboratory tests might be necessary as a part of the physical workup.

How are the various dissociative disorders treated?

The treatment for dissociative amnesia is therapy aimed at helping the client/patient restore lost memories as soon as possible. If a person is not able to recall the memories, hypnosis or a medication called Pentothal (thiopental) can sometimes help to restore the memories. Psychotherapy can help an individual deal with the trauma associated with the recalled memories.

Hypnosis is often used in the treatment of dissociative fugue. Hypnosis can help the client/patient recall his/her true identity and remember the events of the past. Psychotherapy is helpful for the person who has traumatic, past events to resolve.

Treatment for dissociative identity disorder involves long-term psychotherapy that helps the person merge his/her multiple personalities into one. The trauma of the past has to be explored and resolved with proper emotional expression. Hospitalization may be required if behavior becomes bizarre or destructive.

Treatment for depersonalization disorder is very difficult. However, the condition can improve with a thorough therapeutic exploration of the trauma in the individual's past and the expression of the emotions associated with that trauma.

What happens to people with dissociative disorders?

Dissociative amnesia: The length of an event of dissociative amnesia may be as short as a few minutes or as long as several years. If the episode is associated with a traumatic event, the amnesia may clear when the individual is removed from the traumatic situation.

Dissociative fugue: Once dissociative fugue is discovered and treated, many people recover quickly. The problem may never occur again.

Dissociative identity disorder: The course of dissociative identity disorder tends to recur over several years. It may become less of a problem, however, after mid-life.

Depersonalization disorder: An episode of depersonalization disorder can be as brief as a few seconds or continue for several years.

What can people do if they need help?

If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.

Author: John L. Miller, MD

Page last modified or reviewed by athealth.com on February 3, 2014