Dissociative Disorders 101: A Basic Overview of Complex Issues

What is dissociation and what are the mental health disorders designated: Dissociative Disorders?

Dissociation is an alteration in a person's consciousness that affects their perceptions or their personal reality. It can affect a person's sense of self and time or thoughts and memories. On a very basic level, everyone dissociates. This can be when a person "zones out" or when someone gets wrapped up in a book or daydreams. That is dissociation, and that kind of dissociation is normal. The disorders discussed in this article are not the product of normal, healthy dissociating. The disorders discussed here are real mental health issues that have a profound impact on the lives of those who live with them.

Dissociative Disorders are recognized and categorized by the American Psychiatric Association, and are listed in the DSM-IV which is a handbook used by Mental Health Professionals in diagnosing psychiatric disorders. Dissociative Disorders consist of four main disorders. A person may suffer from one of these disorders or several. The symptoms of Dissociative Disorders are typically misunderstood by the general public and can be confusing to some Mental Health Professionals as they can be similar to other psychiatric illnesses. For the sufferer, the symptoms can be frightening and unsettling. A person may feel like they are "going crazy" or "losing their minds", but the truth is, these disorders have a reasonable and logical cause. That cause, is typically trauma.

The four main Dissociative Disorders are: Dissociative Amnesia, Dissociative Identity Disorder (formerly known as Multiple Personality Disorder), Dissociative Fugue and Depersonalization Disorder. Let's look at the basic symptoms of each of these disorders.

Dissociative Amnesia does not encompass a person's entire life, rather there are gaps in memory covering certain periods of a person's life. Usually these gaps in memory are caused by trauma and are often found in cases where a person has been physically, sexually or emotional abused in childhood. This is not the occasional forgetfulness that most people experience. Dissociative Amnesia is memory loss outside the norm and it's not caused by any other physical condition. For example: Jane is a 30 year-old woman. She is talking to her friend about the summer vacations she took every year at her grandparent's farm during her childhood. She tells stories about the summer that she was five years-old and the summer she was seven years-old. Her friend laughs and asks her what happened during the summer she was six. Jane stops and realizes that she has no memory of that summer. She can't remember anything except that her Uncle John was there that year. There is a gap in her memory covering that whole summer and she can't remember anything except returning home for the beginning of the school year. This is a very basic example of how Dissociative Amnesia can manifest itself. There are of course other ways. Let's move on to the second Dissociative Disorder: Dissociative Identity Disorder also known as DID.

Dissociative Identity Disorder or DID, is an extreme form of dissociation. Normally an individual has a whole and complete personality made up of different facets and qualities. People use different parts of their personality as needed. For instance, when someone experiences an injustice they may use their anger to affect change. Or, when someone loses a loved one in death, they experience grief and sadness. However, a person with Dissociative Identity Disorder has a "fragmented" personality. This is caused by trauma, usually during childhood. These "fragments" take on separate qualities of the whole personality and are manifested as separate, individual personalities. These separate personalities are called "alters" while the individual who is known to most people publicly is called the "host". These alters can represent facets like: anger, fear, shame and other emotions. These alters may or may not have their own names and mannerisms and some alters may hold memories of trauma that the host is not aware of. DID is a protective coping mechanism that developed from the need to protect the host from overwhelming trauma. Typically that is the reason that Dissociative Disorders occur. There is more information on Dissociative Identity Disorder or DID at the websites listed at the end of this article.

The third disorder in this group is: Dissociative Fugue. You may have seen stories about this disorder on the news. A man disappears one day, his family reports him missing. A few weeks later he is discovered hundreds of miles away, going by a different name with no memory of who he really is or where he came from. While initially he is confused by the situation, eventually his memory returns. When talking about Dissociative Fugue we are not talking about individuals who scam others to escape consequences of a crime they have committed or to escape an unsatisfactory relationship or job. In Dissociative Fugue, a person has dissociated to the point that the alterations in their perceptions and sense of self and reality compel them to leave the physical location where they reside and to go far away, perhaps taking on another identity. These episodes typically last hours or days. Longer episodes aren't common.

The fourth disorder is : Depersonalization Disorder. A person suffering from Depersonalization Disorder feels as if they are not connected to their body. They may feel numb. They may feel like they are looking at the world as though it were a movie. they may feel that they are moving through life but not really experiencing it. The world may seem unreal. Time may seem to move more slowly (this phenomenon is referred to as derealization). There can be physical sensations like a feeling of floating outside the body or other distorted bodily perceptions. These sensations can be frightening and disconcerting. This reaction is also a product of trauma which can include childhood abuse or witnessing traumatic events like war or an accidental death.

What can a person experiencing these symptoms do? Thankfully, Dissociative Disorders are becoming better understood by the mental health community. Because Dissociative Disorders are typically caused by trauma, therapy can be very helpful. Working through the trauma that made these coping mechanisms necessary can help a person to understand where these behaviors came from. When looking for help, it is important to ask questions of a perspective therapist. Not every therapist is familiar with dissociative symptoms or disorders. Many times a person experiencing dissociative symptoms has a history of panic attacks and Post Traumatic Stress Disorder. They may also have co-existing mental illnesses like an anxiety disorder, chronic depression or bipolar disorder. Because of these factors , medication may also be helpful. Medication can be prescribed by a Mental Health Professional like a psychiatrist. The use of illicit drugs can exacerbate the symptoms and is not recommended. It takes courage and bravery to start the process of understanding trauma and the coping mechanisms the trauma caused, but understanding our past and how it has affected our present and our personalities, helps us to understand ourselves. There are also many online communities made up of people dealing with Dissociative Disorders and these people can be excellent sources of information and support. There are websites listed at the bottom of this article with links to blogs by people experienced in dealing with these issues (use caution when joining groups or chat rooms as unfortunately there are people who prey on individuals with mental health issues). There is hope and there is support out there. People suffering from Dissociative Disorders are not alone. Knowing that fact can help someone to start healing.

Sources: American Psychiatric Association DSM-IV
The Mayo Clinic: www.mayoclinic.com
NAMI: http://www.nami.org/Content/ContentGroups/Helpline1/Dissociative_Disorders.htm