Dissociative Disorders and Substance Abuse

The experience of dissociation, which refers to unintentional mental distancing from memories, feelings, or sense of self, is extremely common.  Most people have experienced some form of dissociation at some time in their lives, possibly after a traumatic incident or even just while daydreaming.  When dissociation continues for days or weeks, however, it can be difficult to function and maintain normal routines. Chronic dissociation is referred to as a dissociative disorder, a debilitating mental illness that requires long-term psychiatric care.  Substance use disorder is one of the most commonly diagnosed conditions among those with dissociative disorders and can hinder the success of psychiatric treatment. People who receive a dual diagnosis of addiction and dissociative disorder should be treated for both issues simultaneously, as ignoring one will likely counter any progress made in the treatment of the other.

Types of Dissociative Disorders

Dissociative disorders usually occur as a response to a traumatic event or abusive childhood.  Roughly 90% of people diagnosed with a form of dissociation have endured trauma in their past. These experiences create so much emotional pain and mental strife that the victim is unable to cope.  This can cause a psychological separation from the identity that experienced the trauma. The most well-known form of dissociative disorder is dissociative identity disorder, previously known as a split-personality disorder.  This condition has been a source of curiosity and Hollywood romanization over the years because of its extreme presentation. DID is caused by the formation of two or more distinct personalities, reoccurring amnesia regarding personal details and recent memories, and significant difficulty maintaining relationships and professional life.  

Depersonalization/derealization disorder can create feelings of detachment from self or surroundings.  For example, a person may feel as if they are watching themselves from outside their body, or as if their environment and the people around them are not real.  This form of disassociation is extremely disturbing to the individual because they remain aware of reality and the unusual nature of their perception throughout the entire experience.  Depersonalization/derealization disorder is commonly associated with post-traumatic stress disorder or PTSD. PTSD is a mental illness caused by a traumatic experience that causes the individual to avoid people, places, and circumstances that remind them of their trauma.  PTSD often creates symptoms of anxiety and panic when triggering situations present themselves.    

Dissociative amnesia is the third and final type of dissociative disorder, and refers to the inability to recall important details about one’s life.  This condition can range in severity from an inability to remember specific details about a significant event, to forgetting an entire identity. This condition is especially common in those who have experienced traumatic childhood abuse or neglect.  It can also be observed in some victims of violence or trauma that develop PTSD. 

Dissociative Disorder and Substance Abuse

Aside from the many complications that come from chronic disassociation, dissociative disorders increase the risk of several other mental illnesses and symptoms including anxiety, depression, eating disorders, and suicidal thoughts.  All these conditions can cause a great deal of distress and an inability to cope. Without adequate treatment, those experiencing dissociative disorders are likely to turn to drugs or alcohol to numb their emotional pain and manage mental anguish.  Unfortunately, there has been a history of missed diagnoses and miscommunication among patients struggling with substance use disorders and dissociative disorders. In the past, medical professionals experienced in treating substance use disorders would often miss the signs of dissociation among their clients, therefore hindering a full recovery from addiction.  

The first step in successfully treating substance use disorders occurring alongside a dissociative disorder is receiving a professional dual diagnosis.  Mental health experts will then need to work in conjunction with addiction experts to assess the patient. This may involve in-depth therapy techniques, personality tests, and uncovering a history of trauma.  Because substance use can exacerbate the symptoms of dissociation as well as related mental illnesses, it is important for the patient to reevaluated after a period of sobriety. The dissociative disorder may then be treated using psychotherapy in addition to psychiatric medications used to treat symptoms of additional mental illnesses such as anxiety and depression.

Treating dissociative disorders is especially complex for psychiatric care providers, especially if there is a need to differentiate between multiple personalities.  The addition of substance abuse further complicates the issue, and a return to health and wellbeing may feel impossible for the patient. This condition often creates a sense of hopelessness in the afflicted and their loved ones, but it is important to remember that enjoying a normal, functional life is possible with the right treatment and support.  With the added layer of addiction, however, treatment for dissociative disorders is only feasible alongside holistic treatment for substance abuse. It is critical for these individuals to find a care provider capable of identifying and treating co-occurring conditions.


If you or someone you love is struggling with addiction and mental illness, now is the time to reach out for help.  At Burning Tree, you will find knowledgeable and compassionate professionals that structure treatment to fit individual needs, including the identification of co-occurring disorders.  Through accountability and commitment to the 12 steps, each client will develop the tools to create a sober lifestyle and find lasting recovery. We specialize in the treatment of chronic relapsers  and believe with the right support you can experience true and permanent healing. For more information, call us now at 866-287-2877


We are here for you and your family. You don't have to suffer any longer, find recovery today!

We are in-network with 15+ health insurance providers.

This field is for validation purposes and should be left unchanged.