17749 Dissociative Disorders

Overview

Dissociative disorders are mental health conditions where you feel disconnected from your thoughts, feelings, memories, or sense of identity. It is like your mind takes a 'time out' to protect you from overwhelming stress or trauma. The experience is real, but it can be confusing and frightening. With the right help, many people learn to manage their symptoms and feel more grounded.

Dissociative symptoms are quite common, especially after traumatic events. However, a full dissociative disorder is much less common. It is estimated that around 1 to 2 in 100 people experience a dissociative disorder at some point.

Anyone can develop a dissociative disorder, but it is most often diagnosed in people who have experienced severe trauma, abuse, or neglect in childhood. It can affect all genders, ages, and cultures.

Symptoms

Common symptoms

• Memory gaps for certain times, events, or personal information
• Feeling detached from your body, like you are watching yourself from outside
• Feeling like the world is unreal, foggy, or dreamlike
• A blurred or constantly shifting sense of who you are
• Sudden mood swings or changes in abilities
• Trance-like states or blanking out
• Difficulty concentrating or remembering everyday things

Symptoms in children

• Playing in ways that repeat a traumatic event
• Sudden changes in attention or focus
• Trouble remembering things that should be easy (like daily activities)
• Excessive daydreaming that interferes with school or play
• Regression – acting younger than their age

Symptoms in older adults

• Memory problems that may look like dementia, but have different causes
• Feeling confused or lost in familiar places
• Detachment that gets worse after a loss or stressful event
• An increase in existing mental health symptoms, such as anxiety or depression

Causes

Main causes

• Experiencing severe trauma or abuse (emotional, physical, or sexual)
• Living through life-threatening accidents, disasters, or violence
• Enduring repeated stress, neglect, or lack of safety during childhood

Risk factors

• Being a survivor of abuse or violence
• Having a life-threatening early childhood experience
• Lacking secure attachments or support early in life
• Facing intense, prolonged stress without enough help or safety

When to see a doctor

See a doctor urgently if:

• Sudden confusion or severe memory loss that affects your safety
• Feeling unable to control your behaviour or putting yourself in danger
• Thoughts of self-harm or suicide – seek urgent care immediately

Book a routine appointment if:

• If dissociative symptoms last for weeks and interfere with work, school, or relationships
• If you want to understand what is happening and get professional support
• If friends or family are concerned about your memory, mood, or behaviour

Diagnosis

A health professional (usually a GP or psychiatrist) will ask about your experiences, symptoms, and health history. They may do a physical exam to rule out other causes. You might be asked to keep a diary of your symptoms. A diagnosis is based on your symptoms and how they affect your life – not on a scan or blood test.

Tests that may be done

• A physical examination to check your overall health
• Blood tests to rule out medical conditions like thyroid problems or vitamin deficiencies
• A neurological examination to check brain and nerve function
• A detailed mental health assessment, possibly including questionnaires

What to expect at your appointment

The process may feel thorough, and that is normal. Your doctor will want to make sure there is no physical cause for your symptoms. You may be referred to a specialist, such as a psychiatrist or clinical psychologist, for a deeper assessment. It is okay to ask questions and bring a trusted person with you for support.

Treatment

Treatment usually involves talking therapies to help you understand and manage dissociation. The aim is to help you feel safe, connect with your body, and cope with memories or stress. Your care team may also treat any related conditions like anxiety, depression, or post-traumatic stress. Any treatment plan is made together with you, based on your needs and goals.

Self-care at home

• Learn grounding techniques, like naming what you see, hear, and feel around you
• Build a regular routine for eating and sleeping
• Create a personal safety plan with your therapist
• Try slow breathing or gentle body awareness exercises
• Stay connected with people you trust, even when you feel like withdrawing
• Keep a symptoms diary to spot early warning signs

Medical treatments

Talking therapies are the main treatment, including cognitive behavioural therapy (CBT), trauma-focused CBT, and dialectical behaviour therapy (DBT). Some people find eye movement desensitisation and reprocessing (EMDR) helpful for trauma. Medication is not a direct treatment for dissociation itself, but it may be used to treat depression, anxiety, or sleep problems that often accompany dissociative disorders. Any medication is prescribed and managed carefully by a psychiatrist.

When is surgery considered?

Surgery is not used for dissociative disorders.

Living with this condition

Day-to-day life with dissociation can be challenging. You might feel 'out of it' at school, work, or home. Learning to recognise early warning signs and using grounding exercises can help you stay connected. Some people find it useful to carry a small object that reminds them of the present moment. With practice, many people develop skills to manage symptoms before they become overwhelming.

Lifestyle tips

• Get regular physical activity – even a short walk can help
• Try to keep a steady sleep schedule
• Limit alcohol and recreational drugs, as they can make dissociation worse
• Create calm, safe spaces at home where you can relax
• Set small, daily goals to stay connected to your day

Diet and exercise

Eating regular, balanced meals can help stabilise your mood and energy. If you lose track of time, set reminders to eat. Gentle exercise like walking, yoga, or stretching can help you reconnect with your body and reduce anxiety. You do not need to do anything strenuous – the key is consistency and doing what feels safe for you.

Mental health and emotional wellbeing

Dissociative disorders often go hand-in-hand with anxiety, depression, and post-traumatic stress. Feeling 'not yourself' can make you withdraw from others. It is important to remember that dissociation is a coping mechanism that once helped you survive. With therapy, you can learn safer ways to cope. If you ever feel hopeless, reach out for help immediately.

Prevention

You cannot always prevent dissociative disorders, because they are a common reaction to terrible events. But early support after trauma can reduce the chance of symptoms becoming a long-term disorder. If you have experienced trauma, reaching out for help early can make a difference. You can also reduce the impact of stress by building strong support networks and learning healthy coping skills.

Complications

If left untreated

• Ongoing memory gaps that affect work, school, or relationships
• A fragile or unstable sense of identity and low self-worth
• Self-harm or suicidal thoughts
• Using alcohol or drugs as a way to cope
• Difficulty managing basic daily tasks and self-care

Long-term outlook

With the right treatment and support, many people with dissociative disorders recover or learn to manage their symptoms well. Symptoms often improve over time, though the journey is not always a straight line. Many people go on to live full, meaningful, and connected lives. You deserve care, time, and hope.

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