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Signs and Symptoms of Dissociation Aren’t Always So Obvious

Signs and Symptoms of Dissociation Aren’t Always So Obvious

Dissociative identity disorder (DID) and other dissociative disorders go hand-in-hand with signs and symptoms of dissociation. You can find these signs of dissociation included in many lists, and in books like the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). But symptoms of dissociation aren’t always so black and white. The reality of dissociation goes beyond the obvious signs and symptoms of dissociation that you read about.  So what is dissociation really like?

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What is Other Specified Dissociative Disorder?

What is Other Specified Dissociative Disorder?

Dissociative identity disorder (DID) is just one of several diagnoses listed in the dissociative disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Many people live with dissociative symptoms, but don’t meet all of the criteria necessary for a diagnosis of DID. When this is the case, a different diagnosis — other specified dissociative disorder (OSDD) — can be more fitting. These diagnoses all have dissociation in common, so what makes them different?

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Why Normalize Dissociation?

Why Normalize Dissociation?

Over the past couple of months I’ve published a series of articles focused on normalizing dissociation. I’ve said repeatedly that I believe just about everyone can achieve a basic understanding of Dissociative Identity Disorder, provided it’s explained to them in a way they can relate to. But that doesn’t mean I think everyone should. In fact, normalizing dissociation isn’t about making other people understand DID. It’s about freeing ourselves from the need for other people to understand it.

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Normalizing Dissociation Part 5: Identity Alteration

Normalizing Dissociation Part 5: Identity Alteration

The two dissociative symptoms that, once described clearly, are the easiest for people to relate to and understand are also the ones that have earned Dissociative Identity Disorder its undeserved reputation as a bizarre aberration. Identity alteration (experiencing the self as multiple) and dissociative amnesia (gaps in memory) are the two manifestations of dissociation that are mythologized the most. But it’s not because they’re too foreign for most people to grasp. On the contrary, in their mildest forms they’re downright normal.

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Normalizing Dissociation Part 4: Identity Confusion

Normalizing Dissociation Part 4: Identity Confusion

One of the things that makes Dissociative Identity Disorder so difficult to recognize is that, contrary to popular belief, DID symptoms are not the stuff of science fiction. They are, in fact, severe amplifications of normal human experiences. I can think of nothing more normal, nothing more intrinsically human than identity confusion. Of the five primary manifestations of dissociation, I believe identity confusion is easily the most common. But it’s also the one few people will acknowledge in any meaningful way. People are pretty dedicated to the idea that we should know who we are without question, and we fervently admire those who appear most convincingly to do exactly that. But despite appearances, no one gets to live a human life without struggling with their sense of self.

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Normalizing Dissociation Part 3: Derealization

Normalizing Dissociation Part 3: Derealization

On Friday I went to the pharmacy to pick up some medication. It was a long wait, and I wasn’t feeling well. Around me I heard people talking, phones ringing, and the various noises of the grocery store that houses the pharmacy. The sounds seemed to come from a distance, and I felt profoundly disconnected from everyone and everything around me, as if I was an observer in a dream that wasn’t mine. It wasn’t a particularly comfortable experience but it certainly wasn’t an unusual one. I have Dissociative Identity Disorder, and I’ve lived with chronic, severe dissociation nearly all my life. The episode I described illustrates the combined forces of depersonalization and derealization, two forms of dissociation that often appear together. And despite the fact that I have DID and my dissociative experiences, taken as a whole, are decidedly abnormal, dissociation itself is something just about everyone experiences from time to time.

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Normalizing Dissociation Part 2: Depersonalization

Normalizing Dissociation Part 2: Depersonalization

Depersonalization is a way of experiencing the self. It’s a form of dissociation that manifests in a variety of ways that all boil down to a sense of detachment or separateness from one’s self. And though depersonalization is a chronic part of living with Dissociative Identity Disorder, it isn’t something only those of us with DID experience. For most people, episodes of depersonalization are transient, infrequent, and typically occur during periods of high stress.

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Normalizing Dissociation Part 1: Dissociative Amnesia

Normalizing Dissociation Part 1: Dissociative Amnesia

Clarifying the distinction between relatively normal dissociation and relatively abnormal dissociation is important for a number of reasons, including: 1) understanding what Dissociative Identity Disorder is becomes easier when you can clearly identify what it is not, 2) describing symptoms like dissociative amnesia to others is less of a challenge when you start from a place they can relate to, and 3) those of us with DID could do with regular reminders that we aren’t aberrant life forms and, in fact, a good portion of our dissociative experiences aren’t as far-fetched to other people as we may believe.

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What Is Dissociation? Part 5: Identity Alteration

What Is Dissociation? Part 5: Identity Alteration

If you’ve ever seen a television crime show featuring a suspect with Dissociative Identity Disorder, you’ve seen a theatrical depiction of identity alteration, the fifth of the five main dissociative symptoms. A bewildered man suspected of murder is brought in for questioning. Eventually his manner, style of speech, and affect change dramatically and he says something like, “Sam didn’t kill her. I did. I’m Joe.” That switch in personality states is identity alteration at it’s most extreme.

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What Is Dissociation? Part 4: Identity Confusion

What Is Dissociation? Part 4: Identity Confusion

I used to make lists of things I liked and didn’t like. If I wanted to marry and have children, that went on the list. If I enjoyed musical theater, that too went on the list. Inevitably a day would come when I couldn’t imagine wanting to marry or liking musicals. I was perplexed as to why they were on the list in the first place. So I’d start a new one. I was trying hard to figure out who I was. As soon as I had a decent handle on the nature of my identity, it would slip through my fingers once again. I kept these lists in an effort to pin down my sense of self in a concrete and lasting way. What I didn’t know is that I have Dissociative Identity Disorder. Identity confusion is a normal, if monumentally frustrating, part of DID.

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