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Dissociative Disorders

Dissociative disorders involve problems with memory, identity, emotion, perception, behavior and sense of self. Dissociative symptoms can potentially disrupt every area of mental functioning.

Examples of dissociative symptoms include the experience of detachment or feeling as if one is outside one's body, and loss of memory or amnesia. Dissociative disorders are frequently associated with previous experience of trauma.

There are three types of dissociative disorders:

  • Dissociative identity disorder
  • Dissociative amnesia
  • Depersonalization/derealization disorder

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Expert Q&A: Dissociative Disorders

Dissociative identity disorder involves a lack of connection among a person’s sense of identity, memory and consciousness. People with this disorder do not have more than one personality but rather less than one personality. (The name was changed recently from ‘multiple personality disorder’ to ‘dissociative identity disorder.’) This disorder usually arises in response to physical and sexual abuse in childhood as a means of surviving mistreatment by people who should be nurturing and protecting.

Yes. They are sometimes misdiagnosed as having schizophrenia, because their belief that they have different identities could be interpreted as a delusion. They sometimes experience dissociated identities as auditory hallucinations (hearing voices). Their symptoms do not improve with antipsychotic medication, but the emotions they display get flatter. This can leading to the mistaken belief that they have schizophrenia and to further ineffective increases in medication. Another common misdiagnosis is borderline personality disorder. People with dissociative identity disorder frequently also have depression.

You may notice sudden changes in mood and behavior. People with dissociative identity disorder may forget or deny saying or doing things that family members witnessed. Family members can usually tell when a person “switches.” The transitions can be sudden and startling. The person may go from being fearful, dependent and excessively apologetic to being angry and domineering. He or she may report not remembering something they said or did just minutes earlier.

Be open and accepting in your responses. Do not ‘take sides’ with one or another component of their identity. Rather view them as portions of the person as a whole. We are all different in different situations, but we see this as different sides of ourselves. Try to maintain that perspective with the person with dissociative disorder. Also, help them to protect themselves from any trauma, abuse, or self harm.

They can, but they usually do not. Typically those with dissociative identity disorder experience symptoms for six years or more before being correctly diagnosed and treated.

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Dr. David Spiegel

Dr. David Spiegel

Professor and Associate Chair of Psychiatry & Behavioral Sciences

Director, Center on Stress and Health

Medical Director, Center for Integrative Medicine

Stanford University School of Medicine

Reviewed Oct. 2020

Medical leadership for mind, brain and body.

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