Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity.
We all have had those moments when we seem to be listening to a friend or colleague, and a couple of minutes later we zone back into the conversation only to realize our mind had been elsewhere. While this a fairly common episode where we space out amidst a busy day, there are other signs of dis-association, or dissociation, that could hint at an underlying condition.
According to the Mayo Clinic, "Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life." In simple terms, a person who disassociates due to distraction or out of boredom does not experience it as a disorder. The disorder often arises as a response to overwhelming experiences or trauma. Much like a survivor of a car accident, who doesn't remember moments before or the exact moment of the crash, those who have experienced psychological or emotional trauma, especially those caused by abuse, develop this disorder as a means to keep harmful memories out of awareness.
According to Rethink Mental Illness, these are the main symptoms:
- Amnesia: loss of memory; this could include memories of events, experiences, or people
- Depersonalization: feeling disconnected from your own body
- Derealisation: feeling disconnected from the world around you or feeling people and things are unreal
- Identity confusion: a vague or unclear sense of who you are
- Identity alteration: change in identity, personal details like how old you are
- Loss of feelings or inability to feel emotions appropriate to situations
- Loss of control of your physical sense of self or body moments
- A chronic sense of detachment from yourself or your life as though you are witnessing your life rather than living it
- Significant stress or recurring issues in your relationships, work, or social life
- Unable to cope with stress
- Other mental ailments or symptoms like depression, anxiety, and suicidal thoughts & behaviors
According to the DSM (Diagnostical Statistical Manual), there are three main kinds of dissociative disorder:
1. Dissociative amnesia: In this type, the primary symptom is that of memory loss, which is more severe than everyday forgetfulness and of a kind that has no other medical causes. If you can't remember bits of your childhood, especially if you have had traumatic experiences, you are likely to have disassociative amnesia. The loss of memory can be very specific to the traumatic event like the loss of a parent or watching a crime scene. Or it can be broader and also lead to loss of memory of your own sense of self. It could involve wandering about or getting lost and finding yourself in a new place (dissociative fugue). Such an episode can last a short span of minutes to hours, or even span to months or years.
2. Dissociative identity disorder (DID): This type of dissociation has been portrayed often in the media in pretty dramatic ways. Earlier called multiple personality disorder, people living with this disorder switch between "alternate identities" or "alters." The person might feel like there are two or more distinct people (not just personalities) living within them and a "trigger" could prompt a dormant personality to come forth. Each alter ego or identity may take a different name, gender, age, and has unique physical and psychological traits. While many learn to live with the co-existing alters, life can still be quite a challenge.
3. Depersonalization–derealization disorder: This type is hard to detect as the experience can be subtle and deeply personal, with barely any observable traits. It involves feeling detached from yourself or your life as though you are watching it as a passive observer (depersonalization). Even your feelings, thoughts, actions might appear distant and impersonal. People, especially those who want more emotional connection or intimacy with you, might find it hard to relate with you and assume you don't care. Others might feel aloof or detached from people, events, and things around them (derealization). Their sense of time might be slowed down or paced up, and everything might appear dreamlike and hazy.
Talk therapy and medication can help manage the symptoms. If you have gone through trauma, finding a trusted professional to talk through your trauma (however little you remember) can help you integrate parts of yourself that had to be split or detached in order to survive or retain your sanity and sense of safety.