Dissociative disorders are a group of conditions defined by drastic changes in perception, thought, consciousness, identity or memory as they relate to a person’s sense of reality. In other words, a person with a dissociative disorder may feel disconnected from themselves and their environment. It is important to have an understanding of basic dissociative disorders facts, as these conditions affect up to 2% of the general population.
Dissociative disorders encompass several different conditions, including dissociative amnesia, dissociative identity disorder, dissociative fugue and depersonalization-derealization disorder.
One commonality between all dissociative disorders is that they usually develop after a person experiences a traumatic event. High stress levels can also exacerbate episodes of dissociation. Despite how commonplace dissociation experiences are in the world, there are many myths and misconceptions surrounding these disorders.
Myth #1: Dissociative disorders are well understood
Fact: Dissociative disorders are not well understood by the medical community.
As a whole, dissociative disorders can be difficult to diagnose. In the case of dissociative identity disorder, individuals may be misdiagnosed with schizophrenia. Schizophrenia is a disease where individuals experience hallucinations or delusions. In some instances, a person with multiple identities will be considered delusional despite actually having dissociative identity disorder.
Medical professionals may wrongly diagnose several other disorders over dissociative disorders — in part for their connection to experienced trauma. For instance, post-traumatic stress disorder, borderline personality disorder, anxiety, depression, and substance abuse are all related conditions to dissociative disorders that can be caused or exacerbated by traumatic experiences.
The diagnostic criteria of dissociative disorders overlap substantially with many different conditions and include:
- Memory loss of certain time periods or traumatic events (dissociative amnesia, dissociative fugue)
- Feeling disconnected with one’s thoughts, feelings, and physical body
- Suicidal ideation, depression, and anxiety
- Feeling emotionally numb or less in touch with one’s emotions
- No longer identifying with self
Myth #2: People with dissociative disorders are dangerous
Fact: People with dissociative disorders often pose more of a danger to themselves than to others.
Since diagnostic criteria for dissociative disorders include depression, anxiety, and suicidal thoughts, individuals that are diagnosed with dissociative disorders must be monitored for sudden personality changes or uncharacteristic tendencies. Popular media often portrays people with dissociative identity disorder as having violent alters. This type of portrayal is a gross exaggeration, as many times family members are not even aware that a person has switched their “identity.”
Dissociative identity disorder was renamed from multiple personality disorder because rather than having completely separate identities, many individuals with this disorder have only one identity that is split into smaller pieces. According to Dr. David Spiegel of Stanford University, family members of diagnosed individuals can look for the following signs that a relative with dissociative identity disorder has switched identities:
- Sudden mood swings
- Uncharacteristic behaviors
- Forgetfulness about what an individual recently said
- Rapid changes in personality
Additionally, according to the Mayo Clinic, individuals with dissociative disorders may be at higher risk for suicidal behavior, self-harm, and mutilation. However, just because an individual may be at a higher risk for something does not mean this is a hard and fast rule. If a person with a dissociative disorder claims they want to harm themselves or others, medical treatment is absolutely necessary.
Myth #3: Dissociative disorders don’t require treatment
Fact: Treatment is highly recommended for individuals with dissociative disorders.
Depending on the dissociative disorder, specific treatments are recommended. In rare cases, dissociative disorders will only be temporary, like with dissociative amnesia or dissociative fugue. Individuals can regain their lost memories from amnesia or fugue states over time, particularly with cognitive behavioral therapy. However, for the vast majority of people diagnosed with dissociative disorders, treatment is necessary. Because dissociative identity disorder can be hard to diagnose, patients sometimes go for as long as six years before receiving a proper diagnosis.
Once a patient is accurately diagnosed with a dissociative disorder, an individual treatment plan will be created to effectively manage the disorder. Without treatment, people with dissociative disorders often struggle to maintain their everyday needs.
Myth #4: Dissociative disorders are rare
Fact: Dissociation is a common defense mechanism for people who have experienced trauma.
Having a dissociative experience is a relatively common occurrence. Some dissociative disorders statistics show that nearly 50% of United States adults experience at least one depersonalization-derealization episode in their lives, yet only 2% go on to develop a long-term dissociative condition. According to the American Psychiatric Association, dissociation episodes are common when individuals experience trauma. For example, rape victims often report feeling as if they are outside their bodies during an attack. To survive through a terrible event, people often will dissociate from their sense of self.
Depending on the country where the study was conducted, the overall prevalence of dissociative disorders is much higher in psychiatric inpatients and outpatients relative to the population at large. In the United States, the prevalence of dissociative disorders in psychiatric inpatients ranged from 13–20.7%, while in the Netherlands, Germany, and Switzerland, it ranged from 4.3–8.0%. These prevalences suggest that a large proportion of people receiving psychiatric treatment do so for dissociative disorders.
Myth #5: Dissociative and psychotic disorders are similar
Fact: While there can be overlapping symptoms, dissociative and psychotic disorders are different.
By definition, a psychotic disorder such as schizophrenia involves hallucinations, delusions, disorganized thinking or abnormal motor behavior. In contrast, a dissociative disorder does not typically involve hallucinations or delusions. However, it is still possible for individuals with dissociative disorders to experience episodes of psychosis.
Psychosis is considered a symptom of various conditions such as dissociative disorders, schizophrenia, and bipolar disorder. Psychosis can also be brought about by using substances such as alcohol and other drugs, particularly hallucinogenic drugs like psilocybin or LSD.
An individual may be wrongly diagnosed with schizophrenia when they truly have dissociative identity disorder if they describe “voices” or auditory hallucinations. These voices may actually be fragments of a person’s identity, rather than true delusions or hallucinations. In these cases, a patient may be medicated and treated for schizophrenia, but their symptoms will not improve, indicated to medical professionals that they likely have the wrong diagnosis for this patient.
Myth #6: Dissociative disorders can be treated with medication
Fact: Unless a person with a dissociative disorder has a co-occurring mental health condition, medication will not likely be effective.
Unless an individual has a co-occurring mental health condition like bipolar disorder, depression or anxiety, medication is typically not recommended for patients diagnosed with dissociative disorders. Medication only treats certain symptoms rather than the disease as a whole.
However, there are various therapies recommended for individuals with dissociative disorders, including:
- Cognitive behavioral therapy
- Dialectical behavior therapy
- Psychodynamic psychotherapy
- Eye movement desensitization and reprocessing (EMDR).
Dissociative disorders can also be treated with a co-occurring addiction. Help is available at The Recovery Village. If you or a loved one are struggling with addiction and a co-occurring dissociative disorder, contact a representative today to discuss treatment options.
The Mayo Clinic. “Dissociative Disorders.” November 17, 2017. Accessed May 28, 2019. National Alliance on Mental Illness. “Dissociative Disorders.” Accessed May 28, 2019. National Alliance on Mental Illness. “Early Psychosis and Psychosis.” Accessed May 29, 2019. Sar, Vedat. “Epidemiology of Dissociative Disorders: An Overview.” Epidemiology Research International, March 7, 2011. Accessed May 29, 2019. Spiegel, David. “Expert Q & A: Dissociative Disorders.” American Psychiatric Association. Accessed May 28, 2019.
The Mayo Clinic. “Dissociative Disorders.” November 17, 2017. Accessed May 28, 2019.
National Alliance on Mental Illness. “Dissociative Disorders.” Accessed May 28, 2019.
National Alliance on Mental Illness. “Early Psychosis and Psychosis.” Accessed May 29, 2019.
Sar, Vedat. “Epidemiology of Dissociative Disorders: An Overview.” Epidemiology Research International, March 7, 2011. Accessed May 29, 2019.
Spiegel, David. “Expert Q & A: Dissociative Disorders.” American Psychiatric Association. Accessed May 28, 2019.