6 Ways to Help Someone With a Dissociative Disorder

Compassion, patience, and an open and honest dialogue between you and your loved one can help them cope.

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Many people talk about “dissociating” when they get overwhelmed, but experiencing chronic dissociation to the point of a dissociative disorder is relatively uncommon. According to the National Alliance on Mental Health, in their lifetime, up to 75% of people will experience an episode of depersonalization or derealization—the feeling of being detached from one’s thoughts and body or surroundings, respectively. However, only 2% of people meet the full criteria for chronic dissociative episodes, which are the hallmarks of dissociative disorders. 

Because the mental health condition is pretty uncommon and largely misrepresented, it can be tough to know how to support a loved one, family member, or friend diagnosed with a dissociative disorder. This article will offer six tips on how to help someone with a dissociative disorder and provide a brief overview of what the mental health condition actually entails.

How to help someone with a dissociative disorder

Here are several other ways to support your loved one on their journey towards recovery:

1. Educate yourself about dissociative disorders

As mentioned, many people lack a reliable frame of reference for understanding dissociative disorders. One reason is that popular culture representations often portray people with dissociative disorders as violent, maniacal, sexually promiscuous, and untrustworthy. These representations add to the already negative connotation surrounding the conditions and make it hard for people to understand the challenges someone with a dissociative disorder faces daily. 

As a quick overview, dissociative disorders, including dissociative amnesia and dissociative identity disorder (DID), are an involuntary escape from reality that often occurs due to past trauma.  People with these disorders have episodes where they may disconnect from memories, emotions, behaviors, and their own identity to lower the fear and anxiety of traumatic memories. There are several different types of dissociative disorders, and the severity and length of the dissociative episodes can vary depending on the diagnosis and the person.

Researching dissociative disorders from reliable sources can help you better understand the reality of the diagnosis, what your loved one is going through, and how to offer support.

2. Ensure your loved one’s safety

Safety is among the most important considerations when considering ways to support a loved one with a dissociative disorder. In the case of DID, suicide attempts and other self-harm behaviors are common. In fact, more than 70% of outpatient patients with this form of dissociation have reported a suicide attempt, research shows. If a loved one is experiencing suicidal thoughts or is in danger of harming themselves, this is a mental health emergency. Contact The Suicide & Crisis Lifeline 24/7 by calling or texting 988. Some people may also choose to receive immediate support by calling 911 or going to the emergency department. 

People with dissociative disorders can also experience fugue states, a unique type of amnesia where they find themselves in an unexpected place without any memory of how they arrived there. This can be incredibly dangerous and disorienting for the person experiencing the amnesiac event. 

In addition to seeking emergency support for self-harm and suicidal thoughts, one way to handle these safety risks is to create a crisis plan with your loved one that outlines what to do if they find themselves in an unsafe situation. Talk to your loved one about how they would like to manage a crisis if it were to arise and write down these decisions. Consider discussing the following questions:

• How can I better understand your symptoms to anticipate a crisis scenario?
• How can I best help you if a crisis arises?
• Who are the people we should contact in this situation? (Examples include emergency services, mental health clinicians, other family members, etc.)
• What treatment options would you prefer in the case of an emergency?

3. Understand and manage triggers

Episodes of dissociation are sometimes brought on by a “trigger,” defined as a situation that places the person under an unmanageable level of stress or recalls aspects of past traumas. It can be helpful to speak with your loved one about the scenarios that trigger their dissociative events to try and help them manage these situations.

Triggers can vary depending on the person, so it may be helpful to make a list of triggers to help your loved one avoid them if possible. Collaborating with the mental health professionals taking care of your loved one is also important. Encourage your loved one to discuss triggers with their providers and share information about their triggers and dissociative episodes as appropriate. 

You can also try to support your loved one in managing dissociative symptoms that arise after being triggered. One of the best techniques for managing dissociative episodes is using grounding exercises. These exercises aim to bring your loved one back to reality. Your loved one can try to use these grounding techniques when they feel triggered and anticipate the possibility of a dissociative episode, and when appropriate, you can help them engage in their grounding practice. Here are some examples:

Ask them what they see or feel around them

Remind them that they are in a safe space, and reorient them to the present moment, reminding them of things in the world around them now, such as what they can see around them, what day of the week it is, and what time it is. (“Right now, you are in a safe place. See the poster on the wall.” or “Feel your feet on the floor, the floor is cold today.”) Try to focus their attention on something within their immediate surroundings to bring them back to the here and now.

Distract with simple tasks

Try to distract them from their negative emotional state through counting exercises, or by wiggling toes, or clenching and unclenching fists.

Breathe

Guide your loved one in mindful breathing exercises in which they breathe in through their nose and out through their mouth. You can suggest they place their hand on their abdomen and watch their hand go up and down as their abdomen moves with their breath.

Touching a familiar, soothing object can also be grounding.  

5. Connect them with professional help 

Although all the above are examples of what you can do to help someone with a dissociative disorder, it’s important to keep in mind that there is plenty that you should not be doing and is better left to a licensed mental health professional.

If you feel as though someone you love is suffering from dissociative episodes regularly and that these episodes are negatively affecting their life, the best thing to do is to encourage them to seek professional help. With the guidance of a mental health professional and family and friends’ support, the frequency and severity of their symptoms can improve. 

6. Take care of your own mental health and well-being 

According to Mental Health America, there are 60 million Americans who provide unpaid care to a family member, friend, or neighbor with a physical or mental illness. While acting as a caregiver, it is important not to forget that a person not taking care of themselves will have a more difficult time caring for others. 

If you’re helping someone with a dissociative disorder, make sure to take care of your own mental health and well-being. Practice self-care, connect with other loved ones, and seek professional mental health support as needed. Failing to take care of your mental health and well-being as a caregiver can result in “caregiver burnout,” which refers to the physical, emotional, and mental exhaustion resulting from caregiving. 

Here are some ways you can care for yourself while helping someone with a dissociative disorder:

• Find a friend or someone you trust to confide in
• Set realistic goals and realize you cannot do it alone 
• Take advantage of social programs and services 
• Find a therapist to support your own mental health needs
• Stay healthy with a well-rounded diet and regular exercise 
• Join a caregiver support group 

Support for dissociative disorders at Charlie Health 

If a young adult in your life is struggling with dissociative symptoms or a dissociative disorder, Charlie Health is here to help.

Our virtual Intensive Outpatient Program (IOP) offers more than one-weekly therapy for young people struggling with complex mental health conditions and their families—including dissociative identity disorder treatment and treatment for other dissociative conditions. Charlie Health combines group sessions, individual therapy, and family therapy for holistic healing. Our expert clinicians use evidence-based treatment modalities to help people process traumatic memories, complex trauma, and other factors underlying dissociative disorders. 

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