Dissociative Disorders

Dissociative Identity Disorder (DID), previously referred to as multiple personality disorder, is one of three mental health dissociative disorders listed in the DSM-5 Manual. It is characterized by the presence of at least two distinct and separate personalities within one individual. Although multiple personalities (alters) exist within a single person, only one tends to be manifested at a time; each with its own memories, behaviors, and life preferences. No one single cause had been identified.

The diagnosis of Dissociative Identity Disorder has been controversial for many years, with many mental health professionals alternatively attributing the disorder to misdiagnosis, social contagion, or simply hypnotic suggestion. As a result, only a handful of specialized psychiatrists are responsible for most Dissociative Identity Disorders. Making a diagnosis may be complicated by the ambiguity of its presentation because many symptoms may resemble other physical or mental disorders such as post-traumatic stress disorder, substance abuse, or seizure disorders. 

Dissociative Amnesia Disorder, formerly called psychogenic amnesia, is a mental illness that involves the temporary loss of recall memory caused by disassociation. The interruption in memory may be voluntary or involuntary and is most often a result of psychological trauma. It is characterized by the inability to recall information often associated with a stressful or traumatic event, leaving the person unable to remember important personal information. It involves episodic autobiographical memory loss inconsistent with normal forgetfulness. Episodic memory involves contextual information, such as what happened in the minutes leading up to a traumatic event. The individual may, however, remember semantic autobiographical information such as the date, time and weather conditions of the accident. It may last for a period of seconds or years. There are cases where this disorder resolves on its own.

Dissociative Amnesia Disorder often arises from traumatic Adverse Childhood Experiences or ACEs. It can be difficult to identify in children due to their undeveloped memory and communication skills. A diagnosis may be considered when the individual exhibits:

• An inability to recall traumatic events creates distress.

• The memory dysfunction does not have a physiological cause.
• The memory dysfunction is not dissociative identity disorder.
• The memory loss is not a result of substance abuse or other substance.

Depersonalization Derealization Disorder, also known as Depersonalization-Derealization Syndrome, is one of three mental health dissociative disorders listed in the DSM-5 Manual. The diagnosis is assigned to individuals who persistently experience feelings of detachment, either bodily or cognitively, from themselves or from their environment. Depersonalization Derealization Disorder falls under the dissociative disorders group of conditions, which are characterized by feelings of disconnection from reality. It is often a chronic and distressing condition that causes the sufferer to feel that they are detached from themselves, their feelings, or their reality, in an almost robotic sense. 

Patients may experience depersonalization in relation to themselves, as if they are viewing their lives from the outside. Others might experience derealization, which relates to feeling detached from one’s surroundings and other people, who may appear as if part of a dream. No once single cause has been identified. Likely there are genetic and environmental factors. Dissociation is a natural response to traumatic events that are out of the sufferer’s control. Onset of the condition is usually at around age 16. Patients may experience symptoms of one or both elements for a diagnosis of Depersonalization Derealization Disorder in to be made. Symptoms may be sporadic or chronic.

A diagnosis of Other / Specified may be used for presentations in which symptoms or characteristic of a dissociative disorder predominate and cause significant distress or impairment in social, occupational, or other important areas of functioning but do not meet the full criteria for any of the disorders in the Dissociative Disorders diagnostic class. No one single cause has been identified.

The other specified dissociative disorder category may be used in situations in which the clinician chooses to specify a reason that the presentation does not meet the criteria for any specific dissociative disorder although symptoms are present. This is done by recording “other specified dissociative disorder” followed by the specific reason (e.g., “dissociative trance”).