Dissociative Disorders

This article provides an overview of dissociative disorders, including the specific types, common symptoms, causes, and treatment, along with tips for living with these disorders.

Key Takeaways:

• Individuals with dissociative disorders experience disruptions in memory, perception, emotion, identity, thoughts, and behaviors. This makes it very difficult to function normally and often leads to additional psychological problems.
• The vast majority of people with dissociative disorders have a history of trauma, especially early in life.
• These disorders can often improve through psychotherapy (talk therapy), which focuses on processing trauma, managing stress, and regaining a strong sense of self.

Understanding Dissociative Disorders

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines dissociative disorders as a group of mental disorders that involve a disconnection from reality, with disruptions in memory, thoughts, feelings, perception, behavior, and related functions.

Dissociative disorders lead to an involuntary escape from reality, in which individuals feel unable to control their thoughts, behaviors, and general functioning. In turn, this may lead to significant interference with the ability to function, interact with others, and carry out daily tasks, while impacting psychological well-being. ^[1]

Types of Dissociative Disorders

The DSM-5 lists five types of dissociative disorders: ^[1]

• Dissociative identity disorder
• Dissociative amnesia
• Depersonalization/derealization disorder
• Other specified dissociative disorder
• Unspecified dissociative disorder

Individuals with dissociative identity disorder (DID) experience two or more distinct personality states. Other features include a disrupted sense of self, problems with recall and memory, and altered behavior, thoughts, and general functioning.

Dissociative amnesia is the inability to recall important information about one’s life. Typically, this is information related to specific traumatic or stressful events, although it may be related to one’s overall life and identity, too.

Depersonalization/derealization disorder (DPDR) involves feelings of detachment from one’s self (depersonalization), including thoughts, feelings, and sensations, and/or feelings of detachment from one’s environment or surroundings (derealization).

Other specified dissociative disorder and unspecified dissociative disorders are used when someone has clinically significant symptoms of dissociation, but does not meet the full criteria for the above disorders.

How Common are Dissociative Disorders?

Up to 75% of people may experience symptoms of dissociation at some point in their life, but the prevalence of chronic dissociative disorders ranges from 1 to 5% of the population. Research shows that women are more likely than men to develop a dissociative disorder. ^[3]

Rates of dissociative disorders are also significantly higher in certain populations, including roughly 10% in psychiatric patients, between 15 to 40% of individuals with substance dependence, and up to 55% of women in sex work. ^[3]

Symptoms

Symptoms of dissociative disorders vary depending on the specific disorder, although they share common features, including disturbance in one’s sense of self and reality. Listed below are common symptoms for the three primary dissociative disorders: ^{[1] [2]}

Dissociative Identity Disorder (DID) Symptoms

• Impaired sense of self
• Inability to control your actions or behaviors
• Disrupted sense of identity
• A feeling of switching states/identities
• Trouble recalling everyday events
• Difficulty remembering personal information
• Feeling as if one is not in control of their body or mind

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• Visual, auditory, and other hallucinations

Dissociative Amnesia Symptoms

• Inability to remember information about yourself
• Trouble recalling information about events in your life
• Especially during a specific time period

Depersonalization/derealization (DPDR) symptoms

• Feeling outside of yourself

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• Distorted sense of time
• Emotional numbness
• Visual distortions, such as blurriness or heightened acuity
• Feeling detached from sensations, such as touch, hunger, thirst
• Feeling like you’re in a dream
• A feeling of unfamiliarity with your environment

Causes of Dissociative Disorders

Dissociative disorders are often caused, at least in part, by traumatic or stressful events, such as physical, sexual, and emotional abuse, natural disasters, and combat. Experiencing trauma during childhood can increase the risk of developing a dissociative disorder.. For example, roughly 90% of individuals with DID have experienced child abuse and/or neglect. ^{[1] [4]}

These traumatic events can lead to dissociation as a way to lessen the stress and overall negative impact, thus acting as a sort of mental escape. However, continuing to use or experience this over time can lead to significant separation from reality, memory impairment, and other issues.

Certain factors that may also increase the risk of dissociative disorders, particularly when occurring alongside trauma, include social isolation, high vulnerability, and greater predisposition to negative psychological symptoms. ^[5]

Risks of Dissociative Disorders

Individuals with dissociative disorders have an increased risk of developing other mental health conditions, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorders, and borderline personality disorder (BPD). They are also at an elevated risk of suicidality. ^{[1] [4] [5]} Dissociation can also make it very difficult to form and maintain relationships and function in everyday life.

Diagnosing Dissociative Disorders

Diagnosing dissociative disorders requires multiple steps, including a detailed medical and personal history, initial physical exam, and a comprehensive mental assessment. These are all in place to ensure the most accurate diagnosis.

If you are wondering if you may have a dissociative disorder, the first step is to meet with your primary care doctor. They will go over your medical and personal history, and will conduct a physical exam to rule out other possible causes, such as head trauma, brain lesions, sleep difficulties, or substance use. Neurological exams are often required, involving electroencephalograms (EEG), lumbar punctures, and/or brain imaging. ^{[2] [5]}

If a dissociative disorder is still a possibility, your doctor will likely refer you to a licensed mental health professional for further testing. This involves a comprehensive assessment of mental abilities and psychological health. If you started with a licensed mental health provider, they would also likely refer you to your primary care doctor to rule out potential medical causes.

Dissociative Disorder Assessments

Assessing dissociative disorder requires a long-term approach, particularly to avoid a misdiagnosis. Psychiatrists or experienced psychologists conduct longitudinal assessments over time. This is combined with a detailed personal history, which is gathered not only from the individual but also from family and other close individuals as well. ^[5]

Specific assessments that may be used to help in the diagnostic process include: ^[5]

• Dissociative Experiences Scale: This scale has 28 questions that detail a number of dissociation-related experiences, such as imagination, depersonalization, derealization, and amnesia.
• Dissociation Questionnaire: This questionnaire has 63 questions measuring key dissociation traits, including identity confusion, loss of control over behavior, thoughts, emotions, and amnesia.
• Difficulties in Emotion Regulation Scale: This is a 36-item scale that measures difficulties relating to emotional regulation, such as goal-directed behavior, impulse control, and emotional awareness.

After the full evaluation, the psychiatrist or other qualified mental health professional will compare information and symptoms to the criteria in the DSM-5. Within this, they will also ensure that the symptoms aren’t better explained by other mental disorders, such as schizophrenia, major depressive disorder, or PTSD.

Treatment Options for Dissociative Disorders

Treatment for dissociative disorders depends on the exact disorder and overall symptoms. Primary treatment typically involves some form of psychotherapy, and medication may be used for comorbid symptoms.

Psychotherapy

There are several potentially beneficial psychotherapies (or talk therapies) for dissociative disorders, including psychodynamic therapy, cognitive-behavioral therapy (CBT), and dialectical behavioral therapy (DBT).

Psychodynamic therapy focuses on helping the patient process and work through trauma. Patients are specifically confronted with traumatic memories and use techniques to tolerate, process, and integrate the trauma into their lives. From there, this therapy uses techniques to improve their sense of identity and the way they relate to the world, so that they are less affected by trauma and able to function better overall. ^[5]

DBT is particularly used for people experiencing intense emotions. This therapy helps individuals to develop emotion-regulation and distress tolerance skills, improve relationships, and cultivate mindfulness and other strategies to manage stress. ^[5]

CBT focuses on maladaptive thoughts and behaviors that are contributing to dysfunction. In this therapy, individuals work on understanding helpful and unhelpful thinking and challenging and replacing their negative thoughts with healthier, more realistic ones, while also gaining skills to manage stress and carry out more adaptive behaviors. ^[5]

Medication

Medications aren’t particularly effective for dissociative disorders, but they can help manage co-occurring symptoms, such as anxiety, depression, and trauma. Medications that may be used include:

• Antidepressants
• Antipsychotics
• Mood stabilizers
• Anti-anxiety medications

Other Treatments

Other treatments may have benefits for dissociative disorders. This includes eye movement desensitization and reprocessing (EMDR) and hypnosis.

EMDR involves focusing on a specific traumatic memory while experiencing bilateral stimulation (most often eye movements from side to side). This is designed to help you process trauma and all of the emotion and stress that came along with it. ^[5] EMDR is often used in conjunction with other types of therapeutic interventions, and not as a standalone approach.

Living with Dissociative Disorder

Living with a dissociative disorder can be very challenging due to the inherent difficulties, such as memory problems and an unstable sense of identity. It may impair relationships, cause significant difficulty with work and daily living tasks, and lead to anger, anxiety, and feelings of helplessness. While these challenges can’t be completely avoided, there are some ways to more easily navigate life with a dissociative disorder, including: ^[6]

• Stay in close contact with all relevant members of your healthcare team
• Schedule frequent check-ins (as recommended by your team)
• Communicate openly about your symptoms and experiences
• Lean on family, friends, and others you trust strongly
• Communicate about your condition (if you feel comfortable)
• Write down their contact information
• Educate yourself and others about your condition
• Be mindful of possible triggers, such as specific times of day, dates, or places
• Keep a journal
• Use organization tools, such as notes
• Healthy lifestyle practices, including adequate sleep, a nutritious diet, and regular exercise
• Use stress management techniques, such as meditation or breathwork

Helping Someone with a Dissociative Disorder

If you know someone with a dissociative disorder, there are ways you can offer support. Tips that may help include: ^[6]

• Learn and understand as much as you can about the disorder
• Practice patience, compassion, and understanding
• Be aware of their triggers or things that cause stress
• Help them find a good therapist
• If they experience different states or identities, be aware of appropriate responses and behaviors with each one
• Keep an eye out for self-harm or suicidal behaviors and contact emergency services if needed
• Ask how you can support them in taking any medication and keeping appointments with their care team

When to Seek Help

Dissociative disorders require ongoing treatment and maintenance. Many people experience temporary instances of dissociation, particularly after stressful or traumatic events. But if these feelings and symptoms continue to last and are negatively interfering with your mental health and ability to function, it’s important to seek professional help as soon as possible.

Author

Jack Cincotta

Jack Cincotta holds a M.S. degree in Psychology. He is also a board-certified holistic health practitioner through AADP and an AFPA-certified holistic health coach and nutritionist.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Geralyn DexterPhD, LMHC

Geralyn Dexter, PhD, LMHC (she/her), is a psychology faculty member, researcher, writer, and licensed therapist with 15 years of experience providing evidence-based care.

Activity History - Medically reviewed on April 16, 2026 and last checked on March 19, 2026