Overview of Dissociative Disorders

Many people occasionally experience minor gaps in their memories, perceptions, identity, and awareness. For example, people may drive somewhere and then realize that they do not remember the drive. They may not remember it because they were absorbed—with personal concerns, a program on the radio, or a conversation with a passenger—or just daydreaming. Such experiences, referred to as normal dissociation, typically do not disrupt everyday activities.

In contrast, people with a type of mental illness called a dissociative disorder may totally forget activities that occurred over minutes, hours, or sometimes much longer. They may sense they are missing a period of time. In addition, they may feel detached (dissociated) from themselves—that is, from their memories, perceptions, identity, thoughts, emotions, body, and behavior. Or they may feel detached from the world around them. Thus, their sense of identity, memory, and/or consciousness is fragmented.

Dissociative disorders involve the following:

• Feeling detached from self and/or the surroundings (depersonalization/derealization disorder)

• Being unable to recall important personal information, usually related to trauma or stress (dissociative amnesia)

• Having a fragmented sense of identity and memory (dissociative identity disorder)

Dissociative disorders are usually triggered by overwhelming stress or trauma. For example, people may have been abused or mistreated during childhood. They may have experienced or witnessed traumatic events, such as accidents or disasters. Or they may be experiencing inner conflict so intolerable that their mind is forced to separate incompatible or unacceptable information and feelings from conscious thought.

Brain research in animals and humans has begun to identify specific brain structures and functions underlying dissociation.

Dissociative disorders are related to trauma- and stressor-related disorders (acute stress disorder and posttraumatic stress disorder). People with stress-related disorders may have dissociative symptoms, such as amnesia, flashbacks, numbing, and depersonalization/derealization. Some people with symptoms of posttraumatic stress disorder (PTSD) also experience depersonalization and/or derealization. Depending on the specific symptoms, this may classified as a dissociative subtype of PTSD, complex PTSD, or another combination of diagnoses.