The Difference Between Dissociative Disorder and Schizophrenia

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There’s a popular misconception that people with schizophrenia switch from personality to personality—each with its own name, thoughts, and voices. That's not the case, however.

People who believe that are confusing schizophrenia with a dissociative disorder known as dissociative identity disorder (formerly called multiple personality disorder).

Schizophrenia and dissociative disorders are both serious mental health disorders that involve different symptoms and different treatments.

Characteristics of Schizophrenia

Schizophrenia is likely the more well-known of the two mental illnesses; however, it’s widely misunderstood.

In order to meet the criteria for schizophrenia, an individual must experience two or more of the following symptoms (and at least one of the symptoms must be one of the first three items on the list):

  1. Delusions – Delusions include fixed false beliefs. For example, someone may believe aliens are talking to him through a certain radio program or that someone is spying on him even though there is no such evidence.
  2. Hallucinations – Someone may see things that others don’t see, hear things that no one else hears, or smell things that no one else smells.
  3. Disorganized Speech – This may include things such as using made-up words or phrases that only have meaning to the individual, repeating the same words or statements, using meaningless rhyming words together, or jumping from topic to topic without being able to hold a conversation.
  4. Grossly Disorganized or Catatonic Behavior – Individuals may exhibit bizarre behavior that interferes with their ability to function. Individuals with catatonic behavior may appear unresponsive even though they are awake.
  5. Negative Symptoms – Individuals with schizophrenia may not exhibit certain types of emotional reactions that healthy people do. For example, an individual with schizophrenia might not interact socially or the individual might not show an emotional reaction to either good news or bad news.

Some individuals with schizophrenia exhibit inappropriate affect, such as laughing in the absence of anything funny.

Many people with schizophrenia have cognitive deficits, such as memory problems and slower processing speeds. This can make it difficult to work or complete daily living tasks.

People with schizophrenia may lack insight into their disorder. Individuals who do not think they have a problem are less likely to be compliant with their treatment. That may mean higher relapse rates, increased involuntary admissions to psychiatric hospitals, and poorer psychosocial functioning.

Some individuals with schizophrenia are able to live independently and maintain jobs with the help of treatment. Others require much more intensive support and they may struggle to live on their own due to the difficulties they have caring for themselves.

Characteristics of Dissociative Disorders

There are three main types of dissociative disorders in the DSM-5: depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder. All three are characterized by a disruption in consciousness, memory, identity, emotion, perception, motor control, behavior, and body representation. Here are the differences between the three disorders:  

  • Depersonalization/Derealization Disorder – People with depersonalization disorder feel detached from their actions or feelings like they’re watching a movie. They might also experience derealization, which is feeling like other people and things aren’t real. A person might only experience depersonalization, only derealization, or both.
  • Dissociative Amnesia – Those with dissociative amnesia have trouble remembering information about themselves, whether it’s a lack of memory of a particular traumatic event or, in rare cases, about their identity or past.
  • Dissociative Identity Disorder (DID) – A person with dissociative identity disorder will alternate between two or more distinct personality states or experiences. These might have their own names, voices, and characteristics. These personalities might seem like they’re trying to take control in a person’s head. With DID, a person may have memory gaps of daily events, personal information, and trauma that they have experienced.

Individuals with dissociative disorders may function normally part of the time. Then, their symptoms may create difficulties for them, by making it hard to work, maintain relationships, or continue with education.

Who Is Affected?

Both schizophrenia and dissociative disorders are relatively uncommon. Schizophrenia affects around 1% of Americans. Those with schizophrenia—estimated at more than 21 million people across the globe—typically begin to experience symptoms in their late teens or early 20s for men and late 20s for women. Meanwhile dissociative disorders affect 2.4% of Americans, respectively.

An individual living with schizophrenia is more likely to experience other conditions, too, including posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and major depressive disorder, as well as a higher risk of substance abuse.

Each type of dissociative disorder has different average onsets and frequency, though amnesic episodes can happen at any time, at any age, and last anywhere from minutes to years.

Studies indicate the dissociative symptoms do not differ between genders. Researchers speculate that the reason more women are diagnosed could be connected to the fact that men enter the legal system rather than the health system.

Potential Causes

There isn’t one single cause of schizophrenia. Research has noted a strong genetic link, as a family history of psychosis significantly increases a person’s risk of the disease.

Substance abuse also can increase the risk of schizophrenia when mind-altering drugs are taken during teenage or young adult years. This includes smoking marijuana, as it increases the risk of psychotic incidents.

Additionally, schizophrenia has also been linked to exposure to viruses or malnutrition during a mother’s first or second trimester of pregnancy, as well as altered brain chemistry involving the neurotransmitters dopamine and glutamate.

Dissociative disorders, on the other hand, typically develop in response to significant trauma. This might be military combat or physical or sexual abuse, experiences of which overwhelm the brain. The disorder may grow worse when an individual feels by stress. 

Treatment Options

Neither schizophrenia nor dissociative disorders can be cured, but they can be managed in a variety of ways. Standard treatment for schizophrenia includes antipsychotic medications, along with psychotherapy and community support services. 

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With proper medication, hallucinations and delusions can subside. Hospitalization might be necessary for the safety of both the person with schizophrenia as well as those around them.

Individuals with schizophrenia are also at a higher risk of suicide. In fact, the risk of suicide 20 times higher in people with schizophrenia, while 5 to 13% die from suicide.

Suicide can also be a serious issue for individuals with dissociative disorders, particularly dissociative identity disorder. More than 70% of individuals with dissociative identity disorder have attempted suicide. Multiple suicide attempts are common and self-injury may be frequent.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Dissociative disorders are commonly treated with talk therapy. Treatment options may include cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR). Antidepressants or other medications that may also be used.

A Word From Verywell

Both schizophrenia and dissociative disorders are highly misunderstood conditions. With proper treatment, people living with schizophrenia or dissociative disorder can lead productive, rewarding lives.

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