Dissociation is another word for separation or detachment. People with dissociative disorders sometimes have a disconnected sense of self. This condition can affect emotions, memory, perception, behavior, motor control, consciousness, relationships, and body representation.
Dissociation may begin as a coping mechanism — a way of handling stress — often during childhood. However, affected people may dissociate chronically, which can cause difficulty with functioning. (1) Some people’s symptoms are pronounced and impact everyday life, while others have milder and/or episodic experiences.
Between 1% and 5% of the global population has a dissociative disorder. (2) The Diagnostic and Statistical Manual of Mental Disorders lists three dissociative disorders:
- Dissociative amnesia: If someone has dissociative amnesia, they experience memory loss that can’t be explained by regular forgetfulness or another medical condition. It’s usually most pronounced around traumatic experiences, and the type of amnesia varies. (3)
- Dissociative identity disorder: Individuals with this condition experience two or more clear-cut personalities or might feel possessed. 4 While a small percentage of non-possession-form individuals with DID display observable identity shifts, many show subtle symptoms. Those with possession-form DID are likely to display overt, easily observable identity shifts but make up a smaller percentage of cases. (5) People with DID also experience dissociative amnesia as a primary trait.
- Depersonalization-derealization disorder: Depersonalization is when someone experiences detachment from their body, self, or mind. They might feel as if they’re observing themselves and events from a distance. Derealization has been described as experiencing other people and the world as unreal.
What Causes Dissociative Disorders?
Dissociation can be an automatic response that occurs to limit the amount of emotional pain a person feels in response to trauma. (6) , (7) However, this doesn’t fully explain dissociative disorders, which are persistent, impact functioning, cause distress, and can lead to unfavorable outcomes.
A popular theory proposes that attachment style is another key contributing factor in the development of these disorders. 8 Neuroimaging studies have shown infants with a disorganized attachment style who also experience trauma are most at risk for dissociative disorders.
Disorganized attachment is found in children who are unsure of whether they should love or fear their caregivers due to inconsistent, neglectful, or abusive parenting. Dissociation helps them deny the fearful feelings and try to maintain a positive relationship with the caregiver. This can leave an impression on the developing brain, and long-term dissociating can lead to a fragmented sense of self and hamper daily life. (9)
Two individuals might respond differently to a similar distressing or traumatic event. (10) As such, not everyone who’s experienced trauma and has a disorganized attachment style develops a dissociative disorder.
What Are the Symptoms of Dissociative Disorders?
Because there are several types of dissociative disorders, symptoms vary depending on the diagnosis and individual factors. 11 Signs could include: (12)
- Memory loss that doesn’t arise from another medical condition
- Loss of connection with the self
- Emotional numbness and detachment
- Not feeling physical or emotional pain
- Difficulty self-soothing
- Out-of-body experiences
- Altered time perception
- Getting lost in fantasies that feel real
- Changes to perception of reality
- Chronic stress that impacts relationships, work, school, or other daily functions
- Anxiety, depression, and panic attacks
- Mood swings
- Self-injuring or suicidal thoughts
Do I Dissociate? How Are Dissociative Disorders Diagnosed?
Everyone has the potential to dissociate from time to time, and it’s not harmful so long as it’s occasional and doesn’t restrict functioning. Nonetheless, it can be tricky for people with dissociative disorders to understand or recognize their symptoms. Those who feel that forgetfulness, numbed emotions, and disconnection from reality are negatively influencing their life might consider seeking professional guidance.
Dissociative disorders can be mistaken for other mental health conditions, and dissociation can be a standalone symptom of mental illness. Associated diagnoses include: (13) , (14)
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder (BPD)
- Depression
- Anxiety
- Affective disorders
- Eating disorders
- Schizophrenia
- Substance abuse
What Is the Best Treatment for Dissociative Disorders?
Dissociative disorder treatment is all about helping the individual reintegrate the fragmented components of their identity. Think of an infant’s sense of self and how they relate to the world as a picture puzzle. When parents are consistently loving, present, and understanding of their child, the puzzle pieces fall into place, leaving a clear picture of the individual’s identity and how they relate to the world. If caregivers are unable to provide the necessary care or have unrealistic expectations, the child’s identity and perception of their environment might remain fragmented. (15)
With guidance from a licensed therapist, it’s possible to work toward filling in the missing puzzle pieces and reintegrating the self. The type of therapy that works best depends on the person’s unique symptoms, medical history, and whether any co-occurring disorders are present. Common therapies include:
- Cognitive behavioral therapy
- Dialectical behavioral therapy
- Eye movement desensitization and reprocessing (EMDR) (16)
How To Cope With a Dissociative Disorder Diagnosis
The most important thing to remember when it comes to receiving a dissociative disorder diagnosis is that it’s okay to seek help. It can be difficult to be vulnerable and reach out, but there are medical professionals and support groups that exist to offer compassionate care to those who need it.
Some coping strategies include:
- Sticking with a treatment plan, even when symptoms diminish
- Practicing self-care — healthy daily habits are excellent stress-busters
- Joining a support group to share stories and learn about other people’s experiences
- Getting educated about dissociative disorders to learn about triggers, symptoms, and warning signs
Reaching out to loved ones
How To Help Someone With Dissociative Disorders
There’s plenty that family members and friends can do to help a loved one with a dissociative disorder diagnosis. To support them, aim to be:
- Patient, understanding, and accepting
- Calm and soothing, even when they’re having difficulty with their emotions
- Knowledgeable about their condition, specific triggers, and safety needs
- Someone who sets a good example by practicing self-care and seeking professional help if necessary
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Imogen Sharma is a writer and contributor on the Editorial Team at MentalHealth.com, covering addiction, borderline personality disorder, ADHD, and therapy.
Erin L. George, MFT, holds a master's degree in family therapy with a focus on group dynamics in high-risk families. As a court-appointed special advocate for children, she is dedicated to helping families rebuild relationships and improve their mental and behavioral health.