Dissociative disorders
डिसोसिएटिव (विघटनकारी) विकार
In dissociation, the mind temporarily 'disconnects' from awareness, memory, movement or identity — usually in response to overwhelming stress or conflict. The person is not pretending.
In India these episodes are often attributed to spirits or 'upri hawa'. Scientific treatment helps them stop.
Medically reviewed by Dr. Kuldeep Budania, MBBS, MD Psychiatry
Common symptoms
- Fits or unresponsive episodes during stress
- Trance or 'possession-like' episodes (bhav aana)
- Sudden loss of voice, vision, movement or sensation
- Gaps in memory for stressful events
- Feeling detached from oneself or surroundings (depersonalisation)
Causes
- Acute stress, family conflict, exam or marriage pressures
- Past trauma or abuse
- Difficulty expressing distress in words
Risk factors
- Severe stress, conflict or trauma, especially when it is hard to talk about
- Past episodes of similar "attacks"
- Depression or anxiety
How it is diagnosed
- Careful history from the patient and a family member who saw the episodes
- Neurological examination and, when needed, EEG or brain imaging to rule out epilepsy and other causes
- Understanding stresses around the time of onset, without blaming the patient
Classification: ICD-10 F44 · ICD-11 6B60–6B6ZDissociative disorders (ICD-11 also includes dissociative neurological symptom disorder, 6B60).
Treatment options
- 1Careful assessment to rule out epilepsy and other medical causes
- 2Explaining the condition to patient and family without blame
- 3Psychotherapy to address stress and express emotions
- 4Family counselling — calm response during episodes, not excessive attention
- 5Treating associated depression or anxiety
Psychotherapy and counselling
- Psychoeducation: the symptoms are real and not "put on", and they can improve
- CBT and stress-management skills; trauma-focused therapy when relevant
- Family sessions to reduce conflict and avoid reinforcing the episodes
Guidance for family
- During an episode, keep the person safe, stay calm and avoid crowding
- Avoid both scolding and excessive attention; respond in a calm, matter-of-fact way
- Do not take the person to faith healers instead of medical care; this delays recovery
When to see a psychiatrist
- Repeated episodes, especially under stress
- A first-ever fit — medical check needed
- Episodes with self-harm or danger
Thoughts of self-harm or a medical emergency? Call Tele-MANAS 14416 (24×7, free) or 112.
Frequently asked questions
Is the person faking?
No. Dissociative symptoms are involuntary responses to stress.
Does it need epilepsy medicine?
Usually not — and unnecessary anti-epileptics should be reviewed. Some people have both, so assessment matters.
What should family do during an episode?
Keep the person safe, stay calm, avoid crowding, and talk about the stress later when they are settled.
Help is available — confidential, in Hindi or English.
Private video consultation from anywhere in India with an Ajmer-based psychiatrist. Psychiatry consultation ₹500.
This page is for education and does not replace a personal consultation. Do not start or stop any medicine without a doctor's advice.