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Symptoms
By Mayo Clinic staffThere are four major dissociative disorders:
- Dissociative amnesia
- Dissociative identity disorder
- Dissociative fugue
- Depersonalization disorder
Signs and symptoms common to all types of dissociative disorders include:
- Memory loss (amnesia) of certain time periods, events and people
- Mental health problems, including depression and anxiety
- A sense of being detached from yourself (depersonalization)
- A perception of the people and things around you as distorted and unreal (derealization)
- A blurred sense of identity
Dissociative disorder symptoms (depending on the type of disorder) may include:
- Dissociative amnesia. Memory loss that's more extensive than normal forgetfulness and can't be explained by a physical or neurological condition is the main symptom of this condition. Sudden-onset amnesia following a traumatic event, such as a car accident, is rare. More commonly, conscious recall of traumatic periods, events or people in your life — especially from childhood — is simply absent from your memory.
- Dissociative identity disorder. This condition, formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress. In dissociative identity disorder, you may feel the presence of one or more other people talking or living inside your head. Each of these identities may have name, personal history and characteristics, including marked differences in manner, voice, gender and even such physical qualities as the need for corrective eyewear. There often is considerable variation in each alternate personality's familiarity with the others. People with dissociative identity disorder typically also have dissociative amnesia.
- Dissociative fugue. People with this condition dissociate by putting real distance between themselves and their identity. For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location. People experiencing dissociative fugue may be very capable of blending in wherever they end up. A fugue episode may last only a few hours or, rarely, as long as many months. Dissociative fugue typically ends as abruptly as it begins. When it lifts, you may feel intensely disoriented, depressed and angry, with no recollection of what happened during the fugue or how you arrived in such unfamiliar circumstances.
- Depersonalization disorder. This disorder is characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie. It may be accompanied by a perceived distortion of the size and shape of your body or of other people and objects around you. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may come and go over many years.
When to see a doctor
If you or someone you love has significant, unexplained memory loss or experiences a dramatic change in behavior when under stress, talk to a doctor. A chronic sense that your identity or the world around you is blurry or unreal also may be caused by a dissociative disorder. Effective treatment is available for these conditions. Seek medical help.
If you or your child experiences abuse or another traumatic situation, talk to a doctor as soon as possible. Early intervention and counseling may help prevent the formation of dissociative disorders.
- Dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 20, 2009.
- Maldonado JR, et al. Dissociative disorders. In: Hales RE, et al., eds. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Publishing; 2008:665.
- Dissociation and dissociative disorders. National Mental Health Association. http://www.nmha.org/index.cfm?objectId=C7DF8D4E-1372-4D20-C86C22067E838DF0&CFID=306278&CFTOKEN=696f1d08c4d6ecd2-823F75DC-1372-4D20-C8B94665B1F8DBE7. Accessed Jan. 20, 2009.
- Frequently asked questions: Dissociation and dissociative disorders. International Society for the Study of Trauma and Dissociation. http://www.isst-d.org/education/faq-dissociation.htm. Accessed Jan. 20, 2009.
- Turkus JA, et al. Therapeutic interventions in the treatment of dissociative disorders. Psychiatric Clinics of North America. 2006;29:245.
- Chu JA, et al. Guidelines for treating dissociative identity disorder in adults. Journal of Trauma & Dissociation. 2005;6:69.
- Silberg J, et al. Guidelines for treating dissociative identity disorder in children and adolescents. Journal of Trauma & Dissociation. 2004;5:119.
- Berkowitz CD. Child maltreatment. In: Marx JA, et al., eds. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006:968.
- Sar V, et al. Dissociative disorders in the psychiatric emergency ward. General Hospital Psychiatry. 2007;29:45.
