Major depression is a psychiatric disorder that typically results in chronic mood disturbances such as sadness, irritable mood, low self esteem, loss of pleasure in life, feelings of guilt, loss of appetite, loss of energy, difficulty concentrating and suicidal thoughts. These symptoms usually persist for more than two weeks and depressive episodes reoccur more than once. The symptoms can be severe and result in difficulty coping with daily activities both at home and at work. If undiagnosed and untreated, major depression can have fatal consequences. The Cleveland Clinic notes that it affects more than 10 million people in the U.S. every year 1. Dissociative symptoms can also be linked to major depression. These symptoms typically result from living in extremely stressful and unpredictable environments, life threatening trauma or childhood abuse in any form: physical, sexual or emotional.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Individuals suffering from severe stressful events in life, usually during childhood, or from intense depression may be unable to recall those events or the people around them at the time and block those memories. Dissociative amnesia or memory loss has no identified cause or brain disease and it is often long-lasting.
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Dissociative fugue is a form of global amnesia in which the individual completely forgets her own identity and past. According to a study published in the Journal of Trauma and Dissociation, this form of dissociation typically lasts for a few hours to a few months and is associated with major depression and confusion, as the person has no memory of all the events that happened during the period 3.
Dissociative identity disorder also occurs in response to severe depression or traumatic events that usually occurred during developmental stages from childhood to adulthood. The child learns to adopt one or more different personalities in order to cope with severe trauma and distress. By adulthood, the personalities may become so strong that the individual can be intermittently controlled by the different characteristics, names and identities he created as a protective mechanism. The individual may have no recollection of events that occurred while he was the other personalities.
- Dissociative identity disorder also occurs in response to severe depression or traumatic events that usually occurred during developmental stages from childhood to adulthood.
- The individual may have no recollection of events that occurred while he was the other personalities.
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- Cleveland Clinic: Depression
- National Institute of Mental Health: Depression
- Journal of Trauma & Dissociation: Dissociation in Major Depressive Disorder: A Pilot Study
- Farina B, Liotti M, Imperatori C. The role of attachment trauma and disintegrative pathogenic processes in the traumatic-dissociative dimension. Front Psychol. 2019;10:933. doi:10.3389/fpsyg.2019.00933
- Stein DJ, Koenen KC, Friedman MJ, et al. Dissociation in posttraumatic stress disorder: Evidence from the World Mental Health Surveys. Biol Psychiatry. 2013;73(4):302-12. doi:10.1016/j.biopsych.2012.08.022
- National Alliance on Mental Illness. Dissociative disorders.
- American Psychiatric Association. What are dissociative disorders?. Updated August 2018.
- Choi KR, Seng JS, Briggs EC, et al. The dissociative subtype of posttraumatic stress disorder (PTSD) among adolescents: Co-occurring PTSD, depersonalization/derealization, and other dissociation symptoms. J Am Acad Child Adolesc Psychiatry. 2017;56(12):1062-1072. doi:10.1016/j.jaac.2017.09.425
- Schalinski I, Teicher MH. Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder. PLoS ONE. 2015;10(5):e0127151. doi:10.1371/journal.pone.0127151
- Sar V. The many faces of dissociation: Opportunities for innovative research in psychiatry. Clin Psychopharmacol Neurosci. 2014.12(3):171-79. doi:10.9758/cpn.2014.12.3.171
- Kalsched D. Trauma, innocence and the core complex of dissociation. J Anal Psychol. 2018;62(4):474-500. doi:10.1111/1468-5922.12333
- Scheeringa MS. PTSD in children younger than the age of 13: Toward developmentally sensitive assessment and management. J Child Adolesc Trauma. 2011;41(3):181-197. doi:10.1080/19361521.2011.597079
- Gillig PM. Dissociative identity disorder: A controversial diagnosis. Psychiatry (Edgmont). 2009;6(3):24-9.
- Krause-Utz A, Elzinga B. Current understanding of the neural mechanisms of dissociation in borderline personality disorder. Curr Behav Neurosci Rep. 2018;5(1):113-123. doi:10.1007/s40473-018-0146-9
- American Psychiatric Association. What Is Posttraumatic Stress Disorder?. Reviewed January 2020.
- Wabnitz P, Gast U, Catani C. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders. Eur J Psychotraumatol. 2013;4. doi:10.3402/ejpt.v4i0.21452
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Press; 2013.
- American Psychological Association. Children and trauma. Updated 2011.
- Loewenstein RJ. Dissociation debates: Everything you know is wrong. Dialogues Clin Neurosci. 2018;20(3):229-242.
- Syros I. Cognitive behavioral therapy for the treatment of PTSD, Eur J Psychotraumatol. 2017;8:4. doi:10.1080/20008198.2017.1351219
Noreen Kassem is a hospital doctor and a medical writer. Her articles have been featured in "Women's Health," "Nutrition News," "Check Up" and "Alive Magazine." Kassem also covers travel, books, fitness, nutrition, cooking and green living.