Severe dissociative symptoms involve intense feelings of detachment from oneself (depersonalization), reality (derealization), or memory gaps (amnesia), often stemming from trauma, leading to identity confusion, altered states (like multiple personalities in DID), and disruptions in functioning, causing significant distress and impacting daily life. Key signs include feeling unreal or robotic, observing yourself from outside, memory loss, shifting identities with different names/voices, and distorted perceptions of time or surroundings.
Dissociative disorders are mental health conditions that involve experiencing a loss of connection between thoughts, memories, feelings, surroundings, behavior and identity. These conditions include escape from reality in ways that are not wanted and not healthy. This causes problems in managing everyday life.
You might:
Short-term dissociation
They can happen to us all sometimes. For example, during periods of intense stress or when we're very tired. Some people also find that using drugs like cannabis can cause feelings of derealisation and depersonalisation. Dissociation is also a normal way of coping during traumatic events.
There are several dissociative disorders, including Depersonalisation/Derealisation Disorder, Dissociative Amnesia (with or without Fugue), Dissociative Disorder Not Otherwise Specified (DDNOS), Other Specified Dissociative Disorders (OSDD), Dissociative Identity Disorder (DID) aka Multiple Personality Disorder (MPD) ...
Dissociative identity disorder is often conceptualized as "the most severe form of a childhood-onset post-traumatic stress disorder."
Symptoms and signs of dissociation
It can appear to be the loss of the sense of self or denial of personal history. The person may have difficulty remembering information about themselves or sometimes switch to different voices and names, and display erratic behaviour. They may have substantial gaps in recollection.
Dissociative disorders include dissociative amnesia, depersonalisation disorder and dissociative identity disorder. People who experience a traumatic event will often have some degree of dissociation during the event itself or in the following hours, days or weeks.
Dissociation can feel frightening because it often involves feeling detached from your body, thoughts, or surroundings. This can be sudden and unsettling, making it hard to feel in control. But it's important to remember that support is out there.
The DMN, active when you reflect on yourself or your experiences, becomes dysregulated during dissociation. This disruption may lead to feeling disconnected from your sense of self, as if you're a stranger in your own body—an experience common in dissociative identity disorder (DID).
If you have DID, you might feel or experience the following:
How to Identify a Dissociative State. From an outside perspective, dissociation may look like daydreaming: someone with glazed eyes, inattentive demeanor, or deep in thought. Other times, it might manifest as heightened emotional responses, such as appearing frightened without an apparent threat.
People who have experienced physical and sexual abuse in childhood are at increased risk of dissociative identity disorder. The vast majority of people who develop dissociative disorders have experienced repetitive, overwhelming trauma in childhood.
An outsider witnessing a PTSD flashback might observe a variety of signs. Depending on the severity and nature of the flashback, some common indicators may include: Physical signs: Increased heart rate, sweating, rapid breathing, trembling, glazed eyes, dilated pupils, pale or flushed skin.
In treating patients with DID, there are reports of some success with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamine oxidase inhibitors, beta blockers, clonidine, anticonvulsants, and benzodiazepines in reducing intrusive symptoms, hyperarousal, anxiety, and mood instability.
Dissociation is not a form of psychosis. These are two different conditions that may easily be confused for each other. Someone going through a dissociative episode may be thought to be having a psychotic episode, and in some cases, dissociation may be the initial phase to having a psychotic episode.
Dissociation is often a response to traumatic experiences or overwhelming stress. It can be triggered by events such as abuse, accidents, violence, loss, or childhood neglect. These experiences can cause the mind to disconnect as a way to cope with intense pain or distress.
Dissociative identity disorder (DID), the most severe dissociative disorder, includes both persistent depersonalization/derealization and dissociative amnesia as well as the presence of distinct self-states with unique attributes or experiences.
You may feel outside of your body, as if you're watching yourself. You might also feel detached from your emotions and identity. Some people suddenly realize that they can't remember something. They might wander while dissociating and forget how they arrived at a certain place.
There are three dissociative disorders, including dissociative identity disorder, dissociative amnesia and depersonalization/derealization disorder. These conditions typically develop as a response to trauma. They're treatable — usually with psychotherapy (talk therapy).
When a person experiences dissociation, it may look like: Daydreaming, spacing out, or eyes glazed over. Acting different, or using a different tone of voice or different gestures. Suddenly switching between emotions or reactions to an event, such as appearing frightened and timid, then becoming bombastic and violent.
2. Herschel Walker. Herschel Walker is an ex-NFL superstar who has openly discussed his diagnosis of dissociative identity disorder (DID) in public. Walker talked about his angry rages, memory loss, and emotional numbness as symptoms of DID resulting from childhood trauma and unresolved stress.
The symptoms of complex PTSD are similar to symptoms of PTSD, but may also include:
Key Signs a Client is Dissociating in Therapy. Emotional Numbness: One of the foremost indicators is when clients become emotionally detached. This is not a mere distraction; they might feel as if they're observing themselves from afar. It's as if their feelings have been muted or switched off.
Signs of a PTSD Blackout
Those include: Sending messages or making calls you do not remember. Losing track of time. Feeling an unexpected adrenaline rush (may occur after a blackout is over)