Why Do People Experience Dissociation?

Have you ever been driving down the highway and suddenly realized you were daydreaming for the last 10 minutes? No idea what mile marker you’re at or how you managed to operate a car in that state of mind? Maybe that’s just me, but you’ve surely plopped down on the couch with a good book and gotten lost in it for the next few hours before, right? If you’ve done one or both, you’ve experienced mild dissociation: a disconnection in consciousness, identity, memory, actions, and/or one’s environment. These minor experiences with dissociation are pretty common, as about 1/3 of people say they sometimes feel like they’re on the outside looking in at themselves, according to Mental Health America. This isn’t of much concern, but more severe forms of dissociation are; the following dissociative disorders—characterized by a confusion of identity or detachment from the world—can disrupt daily life and require treatment:

• Dissociative identity disorder, formerly known as multiple personality disorder, is characterized by the existence of more than one identity in a single individual. In addition to disruptions in memory, awareness, identity, and/or perception, those who suffer with this disorder can experience hallucinations, depression, and anxiety.
• Dissociative amnesia is characterized by one’s inability to remember important information, which cannot be attributed to another illness or normal forgetfulness. There are five types of dissociative amnesia:
• Localized amnesia, whereas the individual has no memory from a specific period of time
• Selective amnesia, whereas one has partial memory of a specific time period
• Generalized amnesia, in which individuals can’t remember their entire lives, including their identity.
• Continuous amnesia, in which someone has no memory from the past but is aware of what’s going on in the present
• Systematized amnesia, whereas an individual has no recollection of a certain class of information (e.g., about a specific event or person)
• Depersonalization disorder is when individuals feel like their surroundings are changing shape or size, like those around them are robotic or automated, or like they’re outside of their own body. People with depersonalization disorder may also display irritability, distressed facial expressions, and alertness.
• Dissociative disorder not otherwise specified is the fourth and final dissociative disorder whereas signs and symptoms don’t fit under the umbrella of any other dissociative disorder.

Causes and Signs of Dissociation

Dissociation is ultimately a coping skill we use to step outside of ourselves or away from stress and/or traumatic experiences, such as sexual abuse, war, or natural disasters. These are all triggers for dissociation and dissociative disorders—especially in children. Kids have a fairly easy time separating themselves from traumatic events and memories because they’re still learning about who they are and developing an identity. Furthermore, individuals who adapt this coping skill are at risk of developing more severe dissociation in the future, especially if stressors continue or worsen; therefore, it’s important to pay attention to one’s signs and symptoms of dissociation, so they can resolve these feelings sooner than later. While symptoms may vary depending on the degree and type of dissociation, the following are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as signs that may signify this significant disconnection:

• A serious inability to remember significant events, which can’t be attributed to regular forgetfulness
• Confusion and dazed wandering or dissociative fugue
• Feelings of disconnect from the world around them
• Suicidal thoughts and actions
• A sense of detachment from one’s own body or identity
• Significant issues at work or in relationships
• Feelings of having multiple identities

Treatment for Dissociation

When dissociation becomes severe, it is recommended that sufferers seek professional treatment, or more specifically, psychotherapy. This form of therapy will involve discussing one’s experiences with dissociation, the harmful symptoms that have resulted, and new coping techniques that won’t produce such negative effects. Once an individual has started implementing the coping techniques, the therapist will then typically steer the conversation toward the underlying issue or initial traumatic event. Hopefully, the patient will then be able to move on from his or her scarring past.

At the time being, there aren’t any medications approved by the Food and Drug Administration for the treatment of dissociation; however, doctors do prescribe medicine that helps individuals better manage dissociation symptoms. These include antidepressants, antipsychotics, and anti-anxiety medications.

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