Dissociative disorders - diagnosis and treatment (2023)



Diagnosis usually involves evaluating symptoms and ruling out any medical conditions that could be causing the symptoms. Screening and diagnosis often include a referral to a psychologist to determine your diagnosis.

The assessment may include:

  • General Medical examination.Your doctor will examine you, ask detailed questions, and review your symptoms and personal history. Some tests can rule out physical illnesses - such as head injury, certain brain disorders, sleep deprivation or poisoning - that can cause symptoms such as memory loss and feelings of unreality.
  • Psychiatric examination.A psychologist will ask you questions about your thoughts, feelings and behavior and discuss your symptoms. With your permission, information from family members or others may be helpful.
  • Diagnostic criteria in DSM-5.Your psychiatrist can compare your symptoms to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association.

To diagnose dissociative disorders, the DSM-5 lists these criteria.

Dissociative amnesia

For dissociative amnesia:

  • You've had one or more episodes where you can't remember important personal information—usually something traumatic or stressful—or you can't remember your identity or life story. This memory loss is too great to be explained by simple forgetting.
  • Episodes of memory loss do not only occur during another mental disorder, such as post-traumatic stress disorder. Also, your symptoms are not related to alcohol or other drugs and are not caused by a neurological or other medical condition, such as a heart attack. B. amnesia associated with head injury.
  • There may also be a dissociative fugue, in which you purposefully travel or experience disorienting wandering associated with amnesia - the inability to recall your identity or other important personal information.
  • Your symptoms are causing significant stress or problems in your relationships, at work, or in other important areas of your life.

Dissociative identity disorder

For dissociative identity disorder:

(Video) Dissociative disorders - causes, symptoms, diagnosis, treatment, pathology

  • They display, or others observe, two or more different identities or personalities, which in some cultures can be described as unwanted and unintentional possession. Each identity has its own pattern of perception, relationship and thinking about itself and the world.
  • They have recurring memory gaps for everyday events, skills, important personal information, and traumatic events that are too large to be explained by simple forgetting.
  • Your symptoms are not part of a generally accepted cultural or religious practice.
  • Your symptoms are not due to alcohol or other drugs or illness. In children, symptoms are not associated with imaginary playmates or other imaginary games.
  • Your symptoms are causing significant stress or problems in your relationships, at work, or in other important areas of your life.

Depersonalization-derealization disorder

For depersonalization-derealization disorder:

  • You have constant or recurring experiences of detachment from yourself, as if you are an external observer of your thoughts, feelings, actions or body (depersonalization). Either you feel distant or you have a lack of reality in relation to your surroundings, as if you are in a dream or that the world is distorted (derealization).
  • While experiencing an episode of depersonalization or derealization, you know that the experience does not correspond to reality.
  • Your symptoms are not unique to another mental disorder, such as schizophrenia or panic disorder, or another disruptive disorder. Nor can your symptoms be explained by the direct effects of alcohol or other drugs, or by a medical condition such as temporal lobe epilepsy.
  • Your symptoms are causing significant stress or problems in your relationships, at work, or in other important areas of your life.


Treatment for dissociative disorders can vary depending on the type of disorder, but generally includes psychotherapy and medication.


Psychotherapy is the main way of treating dissociative disorders. In this form of therapy, also known as talk therapy, counseling or psychosocial therapy, you talk to a psychologist about your disorder and the problems associated with it. Look for a therapist with advanced training or experience working with people who have experienced trauma.

Your therapist will help you understand the root cause of your condition and develop new ways of dealing with stressful situations. Over time, your therapist can help you talk more about the trauma you've experienced, but generally only if you have the coping skills and rapport with your therapist to have these conversations safely.


Although there are no medications specifically designed to treat dissociative disorder, your doctor may prescribe antidepressants, anti-anxiety medications, or antipsychotics to help control the mental symptoms associated with dissociative disorder.

More information

  • Cognitive behavioral therapy
  • Hypnosis
  • psychotherapy

Request an appointment

Get ready for your appointment

As a first step, your doctor may invite you for a thorough examination to rule out possible physical causes of your symptoms. However, in some cases you may be referred to a psychiatrist immediately. If possible, bring a family member or friend with you to help you remember the information.

(Video) Dissociative Identity Disorder - Causes, Symptoms, and Treatment

Here is some information to help you prepare for your appointment and what to expect from your doctor.

What can you do

Before your appointment, make a list:

  • Any symptoms you feelincluding any recent behavior that has caused confusion or concern for you or your loved ones.
  • basic personal data,including increasing stressors or recent life changes. Also write down events from your past, including your childhood, that caused physical or emotional trauma. If you can't remember certain periods of your life, write down the timeline and everything you can remember about the period before the amnesia.
  • Your medical information,including any other physical or mental illness you have. List any medications, vitamins, herbs, or other dietary supplements you take and their dosage.
  • Questions to ask your doctorto make the most of your time together

Some questions to ask your doctor may include:

  • What is likely the cause of my symptoms or condition?
  • What are other possible causes?
  • How to determine my diagnosis?
  • Is my condition likely to be temporary or long term (years)?
  • What treatments do you recommend for this condition?
  • How long can I expect improvement in symptoms from treatment?
  • How will you track my progress?
  • I have these other health problems. How can I best deal with them together?
  • Should I see a specialist?
  • Are there brochures or other printed materials I can get?
  • Which sites do you recommend?

Feel free to ask additional questions during your appointment.

What you can expect from your doctor

Your doctor will likely ask you a number of questions. Be prepared to answer them so you have time to think about any points you want to focus on. The doctor may ask you:

  • What symptoms are worrying you or your loved ones?
  • When did you or your loved ones first notice symptoms?
  • Are there moments in your life that you don't remember?
  • Have you ever been far from home or work and didn't know how to get there?
  • Do you ever feel like you are out of your body, watching yourself?
  • Do you feel that there is more than one person or maybe several people living in your head?
  • What other symptoms or behaviors are bothering you or your loved one?
  • How often do you feel anxious or depressed?
  • Have your symptoms caused problems at work or in personal relationships?
  • Have you ever thought about hurting yourself or others?
  • Do you drink alcohol or take recreational drugs?
  • Are you currently in the military or have you ever served in the military?
  • Have you ever been touched against your will?
  • Were you physically abused or neglected as a child?
  • Was someone in your family abused as a child?
  • Are you currently being treated for other medical conditions, including mental disorders?

Mayo Clinic staff

Request an appointment

(Video) Dissociative Amnesia: Causes, Symptoms, Diagnosis and Treatment

December 13, 2022


  1. dissociative disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed Arlington, Virginia: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Retrieved October 11, 2016.
  2. dissociative disorders. National Association on Mental Illness.http://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders. Retrieved October 11, 2016 (encyclopedic entry).
  3. dissociative disorders. American Psychiatric Association.https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders. Accessed on October 11, 2016.
  4. dissociative disorders. Professional version of Merck manuals. http://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/overview-of-dissociative-disorders. Accessed on October 11, 2016.
  5. Palmer BA (Gutachten). Mayo Clinic, Rochester, Minnesota. 30. listopada


Related procedures

  • Cognitive behavioral therapy
  • Hypnosis
  • psychotherapy

dissociative disorders

(Video) How We Diagnose Dissociative Disorders


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  • dissociative disorders
(Video) Dissociative disorders - Types, Symptoms, Diagnosis, and Treatment


What is needed for the diagnosis of a dissociative disorder? ›

Symptoms of dissociative identity disorder (criteria for diagnosis) include: The existence of two or more distinct identities (or “personality states”). The distinct identities are accompanied by changes in behavior, memory and thinking. The signs and symptoms may be observed by others or reported by the individual.

What is the standard treatment for dissociative disorder? ›

Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional.

Is dissociative identity disorder easy to diagnose? ›

Dissociative identity disorder (DID) is a rare psychiatric disorder diagnosed in about 1.5% of the global population. This disorder is often misdiagnosed and often requires multiple assessments for an accurate diagnosis. Patients often present with self-injurious behavior and suicide attempts.

What is the treatment goal for dissociative disorder? ›

The goal of therapy is to reduce dissociation and integrate the functioning of the mind.

What are the three steps in the treatment for dissociative identity disorder? ›

The most common course of treatment consists of three stages:
  • Establishing safety, stabilization, and symptom reduction. ...
  • Confronting, working through, and integrating traumatic memories. ...
  • Integration and rehabilitation.
Jan 31, 2018

What is the first step in treating people with dissociative identity disorder? ›

Phase 1. The first step in treatment aims to reinforce the safety of the person with DID with a focus on more serious symptoms like self-harm or suicidal ideation. In treatment, a licensed mental health expert helps the person with DID to replace any harmful coping techniques they use with healthier options.

What is the most serious dissociative disorder? ›

Dissociative amnesia.

The main symptom is memory loss that's more severe than normal forgetfulness and that can't be explained by a medical condition. You can't recall information about yourself or events and people in your life, especially from a traumatic time.

Can a person be successfully treated for dissociative identity disorder? ›

There is no cure for DID. Most people will manage the disorder for the rest of their lives. But a combination of treatments can help reduce symptoms. You can learn to have more control over your behavior.

How do you help someone with dissociative disorder? ›

You can:
  1. Help them find an advocate and support them to meet with different therapists.
  2. Offer extra support and understanding before and after therapy sessions.
  3. Help them make a crisis plan if they think it would be helpful.

How long does it take to diagnose a dissociative disorder? ›

Typically those with dissociative identity disorder experience symptoms for six years or more before being correctly diagnosed and treated.

How to tell if someone is faking dissociative identity disorder? ›

Individuals faking or mimicking DID due to factitious disorder will typically exaggerate symptoms (particularly when observed), lie, blame bad behavior on symptoms and often show little distress regarding their apparent diagnosis.

What happens if you don t treat dissociative identity disorder? ›

Left untreated, DID can last a lifetime. While treatment for DID may take several years, it is effective. Persons with DID may find that they are better able to handle the symptoms in middle adulthood. Stress, substance abuse, and sometimes anger can cause a relapse of symptoms at any time.

What famous person has dissociative identity disorder? ›

Answer: Famous people with dissociative identity disorder include comedienne Roseanne Barr, Adam Duritz, and retired NFL star Herschel Walker. Walker wrote a book about his struggles with DID, along with his suicide attempts, explaining he had a feeling of disconnect from childhood to the professional leagues.

What happens to the brain of a person with DID? ›

People with multiple personality disorder, or DID, will experience gaps in autobiographical memory, including personal details, daily activities, and traumatic events. These symptoms can disrupt cognitive function and psychological wellbeing and can cause problems in every aspect of a person's life.

How long does dissociation last? ›

Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months). It can sometimes last for years, but usually if a person has other dissociative disorders. Many people with a dissociative disorder have had a traumatic event during childhood.

How do you stop a dissociative episode? ›

This page offers some practical suggestions for helping you cope with dissociation, such as:
  1. Keep a journal.
  2. Try visualisation.
  3. Try grounding techniques.
  4. Think about practical strategies.
  5. Make a personal crisis plan.
  6. Talk to people with similar experiences.
  7. Look after your wellbeing.
  8. Dealing with stigma.

Can a therapist diagnose DID? ›

Clinicians who understand DID symptoms can diagnose DID in the clinical interview. There are also paper and pencil tests that can help clinicians diagnose DID and other dissociative disorders. Studies show that DID symptoms improve over time when treated using Phasic Trauma Treatment.

What are the 3 major disorders that fall within the dissociative disorders category? ›

There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, including: Dissociative amnesia. Depersonalisation-derealisation disorder. Dissociative identity disorder.

What triggers a person with DID? ›

There are a variety of triggers that can cause switching between alters, or identities, in people with dissociative identity disorder. These can include stress, memories, strong emotions, senses, alcohol and substance use, special events, or specific situations. In some cases, the triggers are not known.

What is the controversy with dissociative disorder? ›

Dissociative Identity Disorder Controversy: Is a DID Diagnosis Valid? The basis of this DID controversy is that first-person reports of dissociation based on existing diagnostic scales are invalid due to the crafting of said scales. It is argued that the way these scales are designed, increase false positives.

What triggers dissociation? ›

For many people, dissociation is a natural response to trauma that they can't control. It could be a response to a one-off traumatic event or ongoing trauma and abuse. You can read more on our page about the causes of dissociative disorders. Dissociation might be a way to cope with very stressful experiences.

What are the 5 stages of dissociation? ›

There are five main ways in which the dissociation of psychological processes changes the way a person experiences living: depersonalization, derealization, amnesia, identity confusion, and identity alteration.

Can you live a normal life with dissociative disorder? ›

Living a normal life after experiencing a mental health condition, like dissociative identity disorder, is possible. People who learn ways to healthily cope with dissociative disorders can increase their chances of living what they consider to be a normal life.

What medication helps with dissociation? ›

Studies show that a combination of selective serotonin reuptake inhibitors (SSRI), a specific kind of antidepressant medication, and lamotrigine, an anticonvulsant and mood stabilizer, is an effective treatment for dissociative disorders, especially depersonalization-derealization disorder.

Can you trust someone with dissociative identity disorder? ›

People with DID generally have trust issues that nearly incapacitate them in relationships. It's not unusual for protective alters to attempt to sabotage intimate relationships. That's not about you. Learn as much as you can, but remember all systems are different.

Can people with dissociative disorders drive? ›

So remember -- you are absolutely safe when driving with Depersonalization! Yes, feelings of dissociation while driving can seem scary initially, but don't let anxiety stop you from doing any of your day-to-day activities, and that 100% includes driving. Get into your car and drive, even if it's for a short distance.

Can people with DID have healthy relationships? ›

People with dissociative identity disorder can still have successful relationships. Consistent therapy is the only treatment, and can help them and their partners manage the anxiety, depression, and confusion that tend to come with the condition.

How do you talk to someone out of dissociation? ›

Change the topic, what they were doing or focusing on and distract them by engaging them in conversation, asking them questions or showing them something. Keep them moving. Don't let them sit down to wait until they feel better. Immobility breeds dissociation.

What is shutdown dissociation? ›

Shutdown dissociation simulates central nervous system neuropathy. Peripheral neuropathy describes the damage to the peripheral nervous system. Peripheral damage affects one or more dermatomes and thus produces symptoms for specific areas of the body.

What is the best assessment for dissociative identity disorder? ›

Some measures commonly used in psychological testing (e.g., the Rorschach Inkblot Test, Minnesota Multiphasic Personality Inventory–2, Wechsler Adult Intelligence Scale– Revised, Millon Clinical Multiaxial Inventory–III) Can provide understanding of the patient's personality structure and may yield information useful ...

What are the 5 components of dissociative disorders? ›

Five phenomena constitute the primary clinical components of dissociative psychopathology: amnesia, depersonalisation, derealisation, identity confusion, and identity alteration.

How do psychologists diagnose dissociative disorder? ›

Doctors diagnose dissociative disorders based on a review of symptoms and personal history. A doctor may perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality (for example, head injury, brain lesions or tumors, sleep deprivation or intoxication).

Why is dissociative identity disorder hard to diagnose? ›

Why might it be difficult to get diagnosed? You might have symptoms of other mental health problems as well as dissociation. If your doctor is more familiar with these mental health problems, they may only diagnose these problems without realising that you also have a dissociative disorder.

What is the most well known dissociative disorder? ›

Billy Milligan is one of the most famous cases of DID. He was the first person in the United States with this disorder who was found not guilty of his crimes by reason of insanity. During the trial, many psychologists argued about the existence of DID and assumed it was a ploy rather than a valid disorder.

How long does a DID diagnosis take? ›

Making the diagnosis of dissociative identity disorder takes time. It's estimated that individuals with dissociative disorders have spent seven years in the mental health system prior to accurate diagnosis.

Do therapists always tell you your diagnosis? ›

Whether or not your therapist diagnoses mental health conditions depends on different factors, including both of your preferences. Some clients push for an official diagnosis, and others don't.


1. Dissociation and Dissociative Disorder Mnemonics (Memorable Psychiatry Lecture)
(Memorable Psychiatry and Neurology)
2. Dissociative Identity Disorder in the DSM 5 TR | Symptoms and Diagnosis
(Doc Snipes)
3. Identifying Dissociation and Dissociative Disorders with MID-60
4. Abuse and Trauma - Causes of Dissociative Disorders
(The Mental Breakdown)
5. 5 Signs Of Dissociative Disorder
6. Understanding Dissociative Identity Disorder
(Demystifying Medicine McMaster)


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