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Dissociative Disorder Types, Risk Factors and Therapies

By American Addiction Centers Editorial Staff

What Causes a Dissociative Disorder?
Dissociative disorders are usually caused by a traumatic experience such as rape, abuse, or a serious accident. Risks of these disorders include suicide, self-harm, and drug abuse. People who have the disorders may have a hard time keeping a job or maintaining relationships. Therapy can help the person process the trauma and ease the symptoms.

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Risk Factors
Long-term Dangers
Therapies

Almost everyone has experienced some form of dissociation. It’s common to get lost in thought and lose the thread of the conversation. Some readers report feeling momentarily confused when they look up from their engrossing books and realize that they haven’t actually left their homes. Even deep dreams can cause dissociation when the dreamer awakens and can’t quite remember which version of reality is true.

The mind is incredibly powerful, and the stories the mind weaves can be engrossing and distorting.

People who are experiencing a severe trauma sometimes rely on their minds to help them survive. They may step away from reality, just for a moment, in order to protect themselves from the events that are occurring. People who take frequent leaves of absence like this are often diagnosed with a dissociative disorder.

Types of Disorders

There are four main types of dissociative disorders, and most people have only one type at a time. Each version of the disorder has its own set of symptoms, but often, the treatment options for each version are much the same.

People who have dissociative amnesia have difficulty with their memory. A blow to the head or any other sort of physical trauma doesn’t cause this memory loss. Instead, the amnesia is a direct result of the trauma and the mind’s attempts to protect the person. This sort of amnesia is commonly portrayed in movies and soap operas as a complete wiping of the memory that persists for weeks or months, but the truth is that the amnesia can take many forms, and it can vary quite a bit from person to person. For example, a person with dissociative amnesia may:

Not remember the traumatic event itself. The person may remember everything that happened before the event and everything that happened since, but the event itself is forgotten.
Remember only a few, select details about the event. The person might remember the date or the time, and perhaps the clothes he or she was wearing, but the actual event might be hazy.
Forget everything about his or her life. Some people do truly forget who they are and where they live. They may have a nagging suspicion that they are forgetting something, but they may be unable to shake that feeling.
Forget details having to do with one particular member of the family. Children assaulted by a neighbor, for example, might be unable to remember the name or face of that neighbor.

People who have depersonalization disorder may feel as though the entire world is unreal, or as though he or she is living in a dream.

Unlike the normal feeling of dissociation that may come and go, people with depersonalization disorder may experience dissociation much, or all, of the time. These symptoms are so persistent and severe that the person can’t seem to function normally. They may react completely inappropriately in normal situations, as they don’t feel that they are participating in real life. Or, they may simply withdraw from the world altogether, as they’re not quite certain how they should behave in this strange world.

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Dissociative identity disorder (DID) is the most famous of the dissociative disorders. People with this condition may develop entirely new personalities. According to the National Alliance on Mental Illness, people with it can have as many as 100 personalities, but most have about 10. When a traumatic event occurs, the person develops new personalities that can handle the trauma. Sometimes, the differences between the personalities are dramatic. Some personalities may smoke or wear eyeglasses or curse, while other personalities are religious or meek. When one personality disappears and another appears, the new personality may have no memory of what has just occurred. A person might ask “Where am I and who are you?” in the middle of a therapy session, without realizing that he or she has been there the entire time. Some personalities may have pieces of information from the original traumatic event, while other personalities may not remember the event at all. When these people experience a new trauma, they may pull stronger personalities forward to deal with the issue, or they may craft new personalities to deal with the new trauma.Dissociative fugue is the most rare of the dissociative disorders, but it can also be quite dangerous. People with this disorder experience a break with reality and set out on a long journey of several days or even weeks. These people may not quite know who they are or why they are traveling, and they may cross thousands of miles on their journeys. They may not realize that anything is wrong, and they may seem baffled or confused when they are told about loved ones looking for them.People who have these dissociative disorders may sometimes feel as though they are not in control of their own bodies. They may feel an immense amount of sadness at one moment, without understanding where the emotion is coming from, and then they may feel the emotion lift a few moments later for no reason at all. They may feel as though they have someone else living inside their bodies, trying to take over or make them do things they wouldn’t normally do. They may feel like passengers in their bodies, instead of drivers, and they may feel hopeless to change the situation in any meaningful way.

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Prevalence and Risk Factors

Most experts agree that dissociative disorders aren’t hereditary. If an adult has a dissociative disorder, their children aren’t any more likely to develop a problem than are any other children. The nature of the trauma itself, and when the trauma occurs in the person’s life, is the greatest predictor of disease. People often develop dissociative disorders after they experience violence such as rape, assault or a severe accident.

According to an article published by the International Society for the Study of Trauma and Dissociation, about 73 percent of people who experience some form of trauma exhibit signs of a dissociative disorder in the time immediately following the event. For many people, these symptoms will disappear on their own as the person begins to process the event and learn to live with the trauma. Some people, however, develop chronic forms of dissociative disorders and those chronic forms don’t tend to abate with time. It’s unclear why some people develop dissociative disorders and others do not.

A study published in the journal Child Abuse and Neglect made this link even more clear. Of those who told researchers they were victims of sexual abuse, 88.2 percent had a dissociative disorder. It’s clear that childhood trauma is closely related to these disorders.

Researchers agree, however, that children who experience severe forms of abuse may be at particular risk for dissociative disorders. A study published in the Journal of Nervous and Mental Disease found that 18 out of 31 children who experienced abuse developed dissociative disorders. The study’s authors suggest that severe trauma experienced in childhood is just too difficult for the children to process, and they develop these disorders as a protective response. Other experts have suggested that children often revert to dissociative disorders during abuse because children are encouraged to process lessons through play and imagination. Since these are the tools children are accustomed to using in difficult times, it makes sense that they would lean on these tools during an abusive situation.

Long-Term Dangers

While the dissociative disorders may allow the person to survive the abuse in the moment, the disorders can take a severe toll on the health and well-being of the adult. People who cannot remember specific details about the event may not be able to prosecute those who have injured them, and they may not be able to get closure on the event as a result.

People who have multiple personalities may be unable to hold down jobs or participate in society, as they may constantly switch from one personality to another and remain unable to remember what has just happened.

According to the Mayo Clinic, adults with dissociative disorders face a high risk of:

Suicide
Self-mutilation, such as cutting or burning their skin
Drug and alcohol abuse
Eating disorders
Severe headaches

Children may also face these risks, but they may also express their disorders in ways that adults find distressing. For example, children with dissociative disorders may:

Hallucinate
Seem hyper and unable to concentrate
Cry or seem anxious
Become violent

Children with these symptoms may sometimes be misdiagnosed with schizophrenia, and they may face institutionalization and medications as a result. In addition, if children do not get the help they need to resolve their dissociative disorders, they may develop patterns that are extremely hard to break when they are adults.

Therapies

People who have dissociative disorders often benefit from talk therapies. Here, they can reexamine the painful event and learn why their brains chose to protect them from the trauma instead of allowing them to experience it. These therapies may seem frightening or invasive, but they truly do help. If you or someone you know has a dissociative disorder, call us today and learn more about how we can put you in touch with the treatment you need.