Types of dissociative disorders

When your experience of dissociation is regular, distressing and affects your everyday life, you may get a diagnosis of dissociative disorder.

Experts have grouped different dissociative symptoms together under different names. This can help them find the best treatment and support for you. You may not fit neatly into one category, which can be confusing when you're trying to make sense of your experiences.

You're not alone though. We're here to help you learn more about dissociative disorders.

When I first discovered the word ‘derealisation’ I felt such a relief that it was a recognised mental health problem.

Dissociative identity disorder (DID)

DID means you have more than one separate identity state.

These states can think, feel and act differently. And different states may take control at different times. You may feel you have one main identity state who manages everyday life. Some people call this a ‘host identity’.

Talking about DID can be complex and people often use different terms:

• Individual identity states are sometimes called parts, alters, selves, others or individuals. In this text we use the term ‘identity state’ to describe an individual part.
• All identity states together are sometimes called a system, team, family, community or unit. In this text, when we say ‘you’ we're talking about all your identity states together.

DID can take a few different forms. For example, your identity states may:

• Each have their own distinct way of experiencing the world
• Be different ages and genders
• Have memories or experiences that conflict with each other
• Take control with no warning
• Not remember what happens when another identity state is in control (this is called amnesia)

DID can be the result of learning to dissociate as a child to cope with trauma.

See our page on understanding dissociation for more on the the causes of dissociation and dissociative disorders.

I have many separate, distinct and unique ‘parts’ of my personality. My ‘parts’ or ‘alters’ collectively add up to the total person that is me. They are each a letter, and I am a sentence.

Partial DID

You might be given a diagnosis of partial DID if one of your identity states is very dominant and in control most of the time.

Not all psychiatrists agree that partial DID is a diagnosis. They may diagnose you instead with other specified dissociative disorder (OSDD) or unspecified dissociative disorder (UDD).

Depersonalisation-derealisation disorder (DPDR)

Depersonalisation and derealisation are types of dissociation. We have more information on these experiences on our understanding dissociation page.

A doctor may diagnose you with DPDR if:

• You regularly experience depersonalisation or derealisation, or both
• These experiences can’t be explained by another diagnosis
• Alcohol or drug use have been ruled out as causes
• It affects your life in a negative way

I suddenly had the sense that I had lost my sense of self; in an instant I felt like my ego was gone.

Dissociative amnesia (DA)

A doctor might give you a diagnosis of dissociative amnesia if:

• You can't remember important information about who you are, like your life history or specific events
• Your experience can't be explained by something else, such as injury or another diagnosis

You may also get a diagnosis of dissociative amnesia with fugue.

A ‘fugue’ or ‘dissociative fugue’ happens when you forget everything about who you are (lose your sense of identity) and travel away from home, work or family. You might take on a new identity during this time. You may not remember the fugue afterwards.

It's so difficult to explain to people that most of your life is just a blur.

Other specified dissociative disorder (OSDD)

A doctor might diagnose OSDD if you have dissociative symptoms that don't fit with any other diagnosis.

For example, if you experience:

• A mix of symptoms from different diagnoses
• A severe but short-term dissociative reaction to something very stressful

The person making your diagnosis should explain why they've given you this diagnosis.

Unspecified dissociative disorder (UDD)

You may get a diagnosis of UDD if you have dissociative symptoms that don't fit into any specific diagnosis. Or because the person diagnosing you doesn't have enough information to make a full diagnosis.

For example, this can happen in an emergency.

How do I get a dissociative disorder diagnosis?

A mental health professional might diagnose you with a specific dissociative disorder if:

• You dissociate regularly
• Your experiences are very distressing and affect your everyday life
• Your symptoms are not explained better by a different diagnosis or life events

If you think you may have a dissociative disorder, ask your GP or psychiatrist to refer you for a full assessment. It might help to take this information with you. Any doctors or therapists you meet with should have specialist training in dissociative disorders.

During the assessment they will ask you questions about your experience of dissociation and how it affects you. They will also check whether something else could be causing it.

For example:

• Certain medications, which may cause dissociation as a side effect
• Drugs or alcohol
• Physical causes of dissociation, like head injuries
• Cultural or religious practices that may explain your experiences
• Another diagnosis, for example of a different mental health problem

Even if you don't get a specific diagnosis, you can still seek help for your symptoms.

To make sure doctors treated me seriously I took printouts about derealisation to appointments.

Difficulties with diagnosis

Dissociative disorders can be difficult to diagnose. There are several reasons why you might not get the right diagnosis straight away:

• Professionals don't get enough training. Mental health professionals don't usually get enough training on dissociative disorders. They might not even be aware of them. So they might not ask you the right questions about your symptoms.
• Assessments may leave out questions about trauma. Professionals won't always ask about trauma or your childhood at an assessment. Understanding more about your life history can help reach a diagnosis. But there isn't always enough time in an assessment.
• Memory loss can make diagnosis harder. If you've experienced trauma, you might have no memory of it. Especially if you have amnesia. So if a doctor asks about your past, you might not be able to remember enough to share. Or you may find it too hard to talk about.
• There is confusion between DID and personality disorders. Some doctors still know DID as ‘multiple personality disorder’. So they might be looking for personality disorder symptoms instead of dissociative ones.
• You might have other mental health problems as well. If your doctor is more familiar with other mental health problems, they may focus on these. For example, long-term trauma is linked with borderline personality disorder (BPD) and complex post-traumatic stress disorder (complex PTSD). Dissociation can be a symptom of these. So your doctor might not realise you have a dissociative disorder as well.

Video: Talking about dissociative disorders

Watch Paul, Anamoli, Hayley and Paul talk about what life is like with different types of dissociation.