What do the dissociative disorders have in common?

There are different types of dissociative disorder. There is more information on each of these below.

It‘s important to remember that you could have the symptoms of dissociation without a dissociative disorder. There is also a lot of disagreement among professionals over dissociative disorders.

What is dissociative amnesia?

If you have dissociative amnesia you might not remember things that have happened to you. This may relate to a stressful or traumatic event, but doesn’t have to.

In severe cases you might struggle to remember:

• who you are,
• what happened to you, or
• how you felt at the time of the trauma.

This isn’t the same as simply forgetting something. It is a memory ‘lapse’. This means you can’t access the memory at that time, but they are also not permanently lost.

With dissociative amnesia you might still engage with other people, such as holding conversations. You might also still remember other things and live a normal life. But you might also have flashbacks, unpleasant thoughts or nightmares about the things you struggle to remember.

You may have dissociative amnesia with dissociative fugue. This is where someone with dissociative amnesia travels or wanders somewhere else, related to the things they can’t remember. You may or may not have travelled on purpose.

What is dissociative identity disorder (DID)?

Dissociative identity disorder (DID) is sometimes called ‘Multiple Personality Disorder. But we have called it DID on this page.

If you have DID you might seem to have 2 or more different identities, called ‘alternate identities. These identities might take control at different times.

You might find that your behaviour changes depending on which identity has control. You might also have some difficulty remembering things that have happened as you switch between identities. Some people with DID are aware of their different identities, while others are not.

There is a lot of disagreement between researchers over the notion of DID.

We think of someone with DID as having different identities. But some researchers think that that these are actually different parts of one identity which aren’t working together properly.

They suggest that DID is caused by experiencing severe trauma over a long time in childhood. By experiencing trauma in childhood, you take on different identities and behaviours to protect yourself. As you grow up these behaviours become more fully formed until it looks like you have different identities. When in fact the different parts of your identity don’t work together properly.

What is other specified dissociative disorder?

With this diagnosis you might regularly have the symptoms of dissociation but not fit into any of the types.

A psychiatrist uses this diagnosis when they think the reason you dissociate is important.

The reasons they give include the following.

• You dissociate regularly and have done for a long time. You might dissociate in separate, regular episodes. Between these episodes you might not notice any changes.
• You have dissociation from coercion. This means someone else forced or persuaded you. For example, if you were brainwashed, or imprisoned for a long time.
• Your dissociation is acute. This means that your episode is short but severe. It might be because of one or more stressful events.
• You are in a dissociative trance. This means you have very little awareness of things happening around you. Or you might not respond to things and people around you because of trauma.

What is unspecified dissociative disorder?

This diagnosis is used where you dissociate but do not fit into a specific dissociative disorder.

Psychiatrists also use this diagnosis when they choose not to specify the reasons why you do not fit into a specific disorder.

Or if they don’t have enough information for a specific diagnosis. For example, after a first assessment in accident and emergency.

What are dissociative seizures?

Dissociative seizures are hard to get diagnosed. They are regularly wrongly diagnosed as epilepsy.

Dissociative disorders can also be known as non-epileptic attack disorder (NEAD).

It can be hard to tell the difference between a dissociative and epileptic seizure. An EEG can read epileptic seizures but can’t read dissociative seizures. An EEG is a test that detects electrical activity in your brain using small, metal discs attached to your scalp.

Dissociative seizures happen for psychological reasons not physical reasons.

What is depersonalisation/ derealisation disorder (DPDR)?

The feelings of depersonalisation and derealisation can be a symptom of other conditions. It has also been found among people with frontal lobe epilepsy and migraines.

But it can also be a disorder by itself. This means it is a ‘primary disorder’. There is some disagreement among professionals whether DPDR should be listed with the other dissociative disorders at all.

DPDR has some differences to other dissociative disorders. In DPDR you might not question your identity or have different identities at all. You may still be able to tell the difference between things around you. And there may be no symptoms of amnesia. Instead, with DPDR you might feel emotionally numb and questions what it feels like to live. We have explained this in more detail below.

You might have these feelings constantly rather than in episodes. It doesn’t have to have been caused by a traumatic or stressful event.

Many people think that this disorder might be more common than previously thought. This might be because of:

• a lack of information about it,
• patients who didn’t report their symptoms, and
• doctors who don’t know enough about it, meaning they underreport the condition.

With DPDR you might have symptoms of depersonalisation or derealisation or both.

Depersonalisation
With depersonalisation you might feel ‘cut off’ from yourself and your body, or like you are living in a dream. You may feel emotionally numb to memories and the things happening around you. It may feel like you are watching yourself live.

The experience of depersonalisation can be very difficult to put into words. You might say things like ‘I feel like I don’t exist anymore’ or ‘It’s as if I’m watching my life from behind glass’.

Derealisation
If you have derealisation you might feel cut off from the world around you. You might feel that things around you don’t feel real. Or they might seem foggy or lifeless.