Do you feel disconnected from the world around you? Do your emotions drift in and out of your subconscious? Dissociative disorders are marked by detachments from thoughts, feelings, memory, action, and overall sense of identity. As such, they can be extremely difficult to live with.

It’s estimated that 10 to 11% of Americans struggle with these chronic conditions. ¹ That said, if you do have a dissociative disorder, you’re not alone. This article is meant to help spread awareness and understanding about these mental illnesses.

Dissociative Disorders Defined

The definition of dissociation is when you disconnect from the world through your thoughts, feelings, memories, actions, or overall sense of identity. This division may be one of the four classifications of dissociative disorder: ²

1. Dissociative Amnesia
2. Dissociative Fugue
3. Depersonalization disorder
4. Dissociative identity disorder

We invite you to follow along as we take a deeper look into each of these subtypes.

Dissociative Amnesia

Dissociative amnesia is known for its interference with memory. You may be unaware of crucial details about yourself and your place in the world. ³

Dissociative amnesia has four degrees, each affecting a specific segment of the patient’s memory. According to Dr. Spiegel of Stanford University School of Medicine, the four categories of dissociative amnesia are:

1.) Localized Amnesia

Localized amnesia is when you can’t remember a certain event or events of a specific time. These gaps in memory are usually related to trauma or stress. You may experience episodes of localized amnesia that occur once or twice a year.

In an example of localized amnesia, an abused child may not remember the timeframe of his abuse. Or, an inability to draw up details of the abuse.

2.) Selective Amnesia 

Selective amnesia occurs when you forget segments of events during a given period. In other words, you may only remember a painful moment of a traumatic event, but not the event as a whole. ⁴

It’s possible to struggle with selective and localized amnesia as the two often mirror one another. However, selective amnesia is more specific and pronounced – you’ll remember specific circumstances and also forget other crucial details.

3.) Generalized Amnesia 

Generalized amnesia is the most well-known type of disassociative amnesia. Yet, it’s also the rarest. It’s most common in combat veterans, people who have witnessed (or are victims of) physical and sexual assault, and those susceptible to extreme stress. ⁵

You struggle with generalized amnesia when you forget your identity and personal history. You may not remember who you are, where you’re from, where you’ve gone, or what you’ve said. Such forgetfulness can concern great lengths of time and make you unaware of entire situations.

In these cases, it’s common to forget general information about the world. It can also result in losing the ability to do tasks that had once come easily to you.

4.) Systematized Amnesia

Systematized amnesia occurs when you forget particular information of a specific category. For example, you might forget memories of a certain person. Or, you may not remember crucial memories about your entire family.

Dissociative Fugue 

Dissociative fugue may occur alongside dissociative amnesia. According to Britannica, a fugue state is an “unexpected travel away from one’s home with an inability to recall some or all of one’s past. Onset is sudden, usually following severe psychosocial stressors.”

Fugues can last from hours to months or even longer. In a fugue state, you can appear normal or confused. In either case, you’re unlikely to have any memory leading up to and during the fugue. You may find yourself in a new environment, situation, or experience. ⁶

Depersonalization Disorder

Through depersonalization disorder (DPD), also known as derealization disorder, you may find yourself experiencing your day-to-day life outside of your body. It’s also common to question the validity of what you’re experiencing as real. ⁷

Depersonalization experiences are common. Everyone will, at one point or another, have a derealization episode in which they question what’s going on around them. However, depersonalization disorders are more serious and chronic mental illnesses that last for a long time.

Dissociative Identity Disorder

Dissociative identity disorder (DID), previously referred to as multiple personality disorder, is the most well-known dissociative disorder. Although widely depicted in media and literature, the condition is rare – with 1.5% of the general population receiving a diagnosis. ⁸

DID occurs when you have two or more distinct personalities that exist within yourself. These personality states may switch occasionally, but there’s usually one that has “ultimate control” over you. ⁹

Possession States

In extreme cases, you may experience a “possession state.” This is when the more domineering, aggressive personality takes control of you and can result in disturbing, distressing, and obviously unwanted experiences.

In some cultures, this possession state resembles demonic or spiritual possession. This is a sensitive topic and something that psychiatry is still trying to solve.

There have been research cases looking into self-identified spiritual and supernatural possessions. Many have found links to dissociative identity disorders.

For example, one study followed three self-identified cases of supernatural possession from three distinct religious backgrounds. The researchers found each case revealed symptoms of DID. ¹⁰

References

¹ Kate MA, Hopwood T, Jamieson G. The prevalence of Dissociative Disorders and dissociative experiences in college populations: a meta-analysis of 98 studies. J Trauma Dissociation. 2020 Jan-Feb;21(1):16-61. doi: 10.1080/15299732.2019.1647915. Epub 2019 Aug 28. PMID: 31461395.

² Kihlstrom JF. Dissociative disorders. Annu Rev Clin Psychol. 2005;1:227-53. doi: 10.1146/annurev.clinpsy.1.102803.143925. PMID: 17716088.

³ Staniloiu A, Markowitsch HJ. Dissociative amnesia. Lancet Psychiatry. 2014 Aug;1(3):226-41. doi: 10.1016/S2215-0366(14)70279-2. Epub 2014 Jul 2. PMID: 26360734.

⁴ Sirigu A, Grafman J. Selective impairments within episodic memories. Cortex. 1996 Mar;32(1):83-95. doi: 10.1016/s0010-9452(96)80018-9. PMID: 8697754.

⁵ Sengupta SN, Jena S, Saxena S. Generalised dissociative amnesia. Aust N Z J Psychiatry. 1993 Dec;27(4):699-700. doi: 10.3109/00048679309075834. PMID: 8135696.

⁶ Raval CM, Upadhyaya S, Panchal BN. Dissociative fugue: Recurrent episodes in a young adult. Ind Psychiatry J. 2015 Jan-Jun;24(1):88-90. doi: 10.4103/0972-6748.160944. PMID: 26257491; PMCID: PMC4525440.

⁷ Yang J, Millman LSM, David AS, Hunter ECM. The Prevalence of Depersonalization-Derealization Disorder: A Systematic Review. J Trauma Dissociation. 2023 Jan-Feb;24(1):8-41. doi: 10.1080/15299732.2022.2079796. Epub 2022 Jun 14. PMID: 35699456.

⁸ Mitra P, Jain A. Dissociative Identity Disorder. 2023 May 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 33760527.

⁹ Braun BG. Multiple personality disorder: an overview. Am J Occup Ther. 1990 Nov;44(11):971-6. doi: 10.5014/ajot.44.11.971. PMID: 2252069.

¹⁰ Raveen Hanwella, Varuni de Silva, Alam Yoosuf, Sanjeewani Karunaratne, Pushpa de Silva, “Religious Beliefs, Possession States, and Spirits: Three Case Studies from Sri Lanka”, Case Reports in Psychiatry, vol. 2012, Article ID 232740, 3 pages, 2012. https://doi.org/10.1155/2012/232740