CW: This article discusses topics surrounding mental disorders and includes references to suicide and self-harm, which could be distressing to some readers.
Misdiagnoses, misinformation, and stigmas surrounding dissociative disorders have been rampant due to misleading representations in the media. It is time we talked about it
What are dissociative disorders?
Dissociative disorders are a group of mental health conditions which can disrupt a person’s memory, general awareness, self-identity, and perceptions. There are three main types of dissociative disorder, depersonalisation-derealisation disorder (DPDR), dissociative amnesia, and dissociative identity disorder (DID), formally known as multiple personality disorder.
People who experience depersonalisation-derealisation disorder will often feel disconnected from their mind, body, and environment. DPDR consists of two distinct symptoms, depersonalisation and derealisation. Depersonalisation is described as feeling outside yourself, away from your body, observing your actions, feelings, and thoughts from a distance. Whereas derealisation is described as feeling the world around you is unreal, the people close to you seem alien and difficult to process.
People who experience dissociative amnesia often have episodes during which they cannot remember information about themselves or events in their life. They may even forget how to do basic life skills or skills they have personally learned. People with dissociative amnesia often find themselves in strange situations or doing usual things and will have no recollection of why.
Lastly, people who experience dissociative identity disorder live with a system of unique identities, or alters, each with their own name, voice, personality, and perceptions. The individual with DID will shift in and out of these identities causing them to dissociate.
What causes dissociative disorders?
Not much is known about what exactly causes a dissociative disorder, but they are often associated with other mental health conditions, acute stress, trauma, and drug misuse. Mental health conditions often linked to dissociative disorders include PTSD, depression, anxiety and panic attacks, bipolar disorder, eating disorders, OCD, suicidal tendencies, self-harm, and possibly others. Someone affected by one or more of these conditions may experience dissociative behaviour.
“Many people with a dissociative disorder have had a traumatic event during childhood. They may dissociate and avoid dealing with it as a way of coping with it.”
Dissociation is a coping mechanism developed by the mind to protect itself when it gets overwhelmed. Our brain struggles to process topics it finds overwhelming, such as trauma or stress. So, when something cannot be processed, the mind goes into a state of dissociation to avoid the thing making it feel overwhelmed. This can be effective for a while, though the more a person dissociates, the quicker the mind will activate this coping mechanism. This is when dissociation can become an issue.
Why we need to talk about dissociative disorders
I have been facing depersonalisation-derealisation disorder since my mid-teens. It is frequently caused by instance feelings of stress, anxiety, and depression. During my third year of university, my dissociative behaviour became exceptionally serious. I remember sitting in the library and drafting my dissertation. I was gazing out the window and procrastinating writing, when I started to notice the clouds seemed eerily flat. As if someone had taken a brush and simply painted them upon a sky-blue canvas. The surrounding buildings seemed to compress into each other, followed by the trees and the cars. Suddenly, the world outside the window only seemed to exist two-dimensionally. I realised I was experiencing derealisation. I told myself, if I ignored it for long enough it would go away like usual.
One week later, I was still experiencing derealisation. After two weeks, depersonalisation kicked in. Finally, after three weeks of continuous symptoms, I knew I needed to talk to someone. A professional. Someone who should know what they are talking about. I went to see a counsellor. I told him how I had been feeling and about my experience in the library. I remember his puzzled look and concerned tone when he told me it might be psychosis. He asked me if I had a history of hallucinating. This is when I realise, this guy doesn’t know what dissociative disorders are.
Only around 2% of people are diagnosed with a dissociative disorder, despite research showing up to 66% of people will experience dissociative behaviour after a traumatic event. It is estimated that we will all experience some form of dissociation while undergoing acute stress. Yet, because of the small number of diagnoses, dissociative disorders are typically not brought to attention from a medical standpoint. This has led to a series of negative representation in the media. In early 2022, a surge of people started claiming to have dissociative identity disorder on TikTok. Quickly, this became the newest trend, filling the for-you-page with videos containing misinformation, stigma, and false narratives surrounding DID. This trend led to a lot of hate towards the DID community and a series of young people self-diagnosing due to the spread of false symptoms.
“No one should be pressured to present proof of their trauma or medical diagnosis, but still there are individuals on social media spreading misinformation about DID, which only adds to the confusion of those already questioning their mental health.”
It is crucial that mental conditions with a lower diagnosis rate are brought to attention to avoid instances like this. Large amounts of stigma and misunderstanding can cause people to refrain from seeking advice when questioning their mental health. It can cause people to self-diagnose or even be misdiagnosed by a professional. If I had not known about depersonalisation-derealisation disorder before seeing a counsellor, I would have believed it was psychosis. This could have been damaging to my mental health and could have led to a further misdiagnosis from a doctor. This is why education on exceptional mental conditions is so important. It can prevent a misdiagnosis, the spreading of a hurtful stigma, or even give a young person the confidence to ask for help when questioning their own mental health.