There are four major dissociative disorders defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS), published by the American Psychiatric Association:
- Dissociative amnesia
- Dissociative identity disorder
- Dissociative fugue
- Depersonalization disorder
Signs and symptoms common to all types of dissociative disorders include:
- Memory loss (amnesia) of certain time periods, events and people
- Mental health problems, including depression and anxiety
- A sense of being detached from yourself (depersonalization)
- A perception of the people and things around you as distorted and unreal (derealization)
- A blurred sense of identity
Dissociative disorder symptoms (depending on the type of disorder) may include:
- Dissociative amnesia. The main symptom of this condition is memory loss that's more severe than normal forgetfulness and that can't be explained by a medical condition. Amnesia that comes on suddenly following a traumatic event, such as a car accident, is rare. More commonly, you simply can't recall traumatic periods, events or people in your life, especially from childhood.
- Dissociative identity disorder. This condition, formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress. In dissociative identity disorder, you may feel the presence of one or more other people talking or living inside your head. Each of these identities may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for corrective eyewear. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia.
- Dissociative fugue. The main sign of this condition is creating physical distance from your real identity. For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location. People experiencing dissociative fugue may be easily able to blend in wherever they end up. A fugue episode may last only a few hours or, rarely, as long as many months, and then end as abruptly as it began. When it lifts, you may feel intensely out of sorts, with no recollection of what happened during the fugue or how you arrived in your current circumstances.
- Depersonalization disorder. This disorder is characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie. The size and shape of things, such as your own body or other people and things around you may seem distorted. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may come and go over many years.
When to see a doctor
If you or someone you love has significant, unexplained memory loss or experiences a dramatic change in behavior when under stress, talk to a doctor. A chronic sense that your identity or the world around you is blurry or unreal also may be caused by a dissociative disorder. Effective treatment is available for these conditions. Seek medical help.
If you or your child experiences abuse or another traumatic situation, talk to a doctor as soon as possible. Early intervention and counseling may help prevent the formation of dissociative disorders.
Mar. 03, 2011
- Dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Nov. 30, 2010.
- Maldonado JR, et al. Dissociative disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing; 2008:665. Accessed Nov. 30, 2010.
- Simeon D. Dissociative disorders. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec15/ch197/ch197a.html. Accessed Nov. 30, 2010.
- Dissociative identity disorder. Sidran Institute. http://www.sidran.org/sub.cfm?contentID=75§ionid=4. Accessed Nov. 30, 2010.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 7, 2010.