Dissociative disorders are usually brought on by overwhelming stress or trauma, such as:

• Accidents and natural disasters
• Military combat
• Crime victimization
• Childhood abuse or neglect.

The dissociation involved is involuntary, and is believed to be the brain’s coping mechanism for dealing with the traumatic situation. But dissociative symptoms can be highly disturbing and disruptive to a person’s life and sense of wellbeing. 

Treatment for dissociative disorder helps patients process trauma and learn healthy ways to cope with the troubling memories. Treatment options vary, depending in part on the type of dissociative disorder.

Types of Dissociative Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines three main types of dissociative disorders, each with their own set of criteria for diagnosis:

Dissociative Identity Disorder, formerly called “multiple personality disorder,” refers to the fragmentation of a single identity into distinct and separate personality states. These identities can vary in age, gender, or race, and each has their own sets of behaviors, affectations, and personal preferences. Switching between them is involuntary and can cause significant stress for the person who suffers from the disorder as well as those around them. Additional symptoms include gaps in recall of everyday events, traumatic events, and important personal information. In order to meet the criteria for dissociative identity disorder, dissociative episodes must occur outside accepted cultural or religious experiences (such as imaginary playmates or “speaking in tongues”), and must not be attributable to substance abuse or medical conditions.  

Dissociative Amnesia involves gaps in autobiographical memory, usually related to trauma or stress. The memory loss might be of specific events or periods of time, and it may be total or selective. Some people with dissociative amnesia experience the loss of identity-related memories, such as their own name or where they’re from. Dissociative amnesia can come on suddenly or manifest hours or days after the traumatic event. Episodes can last anywhere from minutes to weeks, months, or even years. In order to meet the DSM-5 criteria for dissociative amnesia disorder, memory loss must be outside the scope of normal forgetting, cause significant distress or impairment in important areas of functioning, and must not be attributable to any substance or to dissociative identity disorder. 

Depersonalization / Derealization Disorder involves the feeling of being separate from one’s body, thoughts, actions, or one’s surroundings. Although many people feel detachment from self when faced with danger or when taking certain hallucinogenic drugs, these occurrences are usually temporary. People with depersonalization disorder will experience feelings of detachment periodically or continuously. In order to meet the DSM-5 criteria for depersonalization or derealization disorder, the symptoms must not be attributable to a substance, medical condition, or other mental disorder. 

No two treatment plans will look exactly the same, but treatment options for dissociative  disorders may include a combination of medication and psychotherapy. There is no medication that directly treats dissociative disorders, but a psychiatrist may prescribe certain medications to address anxiety, depression, and other commonly occurring symptoms. 

Psychotherapy is the main component of treatment for dissociative disorders. The goal is to help the patient process the painful memories, develop healthy coping skills, and reintegrate fragmented identities into one whole and functional identity. The types of therapies involved with the treatment of dissociative disorders include:

• Cognitive behavioral therapy (CBT) 
• Dialectical behavioral therapy (DBT)
• Eye Movement Desensitization Therapy (EMDR)

Psychotherapy for dissociative disorder can help patients to:

• Maintain a sense of personal safety
• Manage emotions
• Recognize and manage triggers
• Change unhealthy thoughts and behavior patterns
• Learn techniques for staying focused on the present 
• Build a stress tolerance
• Reduce frequency of dissociative episodes
• Enhance basic life functioning
• Communicate needs effectively with friends, family, and colleagues

Some people respond to treatment right away and are able to eliminate their symptoms. Others recover more slowly and reduce the frequency or duration of dissociative episodes rather than eliminating them altogether. Treatment is an important part of learning to manage the symptoms of dissociative disorder and live a healthy, productive life.