Getting Disability Benefits Because of a Dissociative Disorder

Having a dissociative disorder can affect your ability to keep a full-time job, especially one with work stresses, which can worsen your symptoms. Dissociative disorders are mental impairments in which individuals sometimes experience disconnection ("dissociation") between their:

• thoughts and feelings
• memories
• perception
• movement
• behavior
• body representation, and
• identity.

People with dissociative disorders can sometimes feel disconnected from who they are or have a sense of being disconnected from their own bodies or their surroundings. Such disconnects can be temporary or last for an extended amount of time.

The severity of dissociative disorders can vary greatly from one individual to the next. Thus, the effect a dissociative disorder has on your overall ability to function could be very different from its effect on someone else's functioning.

If your dissociative disorder leads to significant disruptions in your ability to function at home and work, you might qualify for disability benefits through the Social Security Administration (SSA).

Types of Dissociative Disorders

The American Psychiatric Association's latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes five types of dissociative disorders:

• depersonalization/derealization disorder (DPDRD)
• dissociative identity disorder (DID)
• dissociative amnesia (DA)
• other specified dissociative disorders (OSDD), and
• unspecified dissociative disorder (UDD).

Each type has different symptoms and can affect functioning differently.

What Is Depersonalization/Derealization Disorder?

Depersonalization/derealization (DPDR) disorder is thought to be the most common form of dissociation, affecting about 2% of the general population. DPDR is more prevalent among adolescents and young adults and affects the following groups more than others:

• up to half of those with depression
• up to 20% of those with an anxiety disorder
• about 17% of those with borderline personality disorder
• around 16% of those with schizophrenia, and
• up to 6% of substance abusers (drugs or alcohol).

A main symptom of depersonalization is the feeling of being outside yourself and watching your actions from a distance. With derealization, the world might seem unreal to you, or things you view can become distorted, and you might feel detached from your surroundings.

Someone with this type of dissociative disorder might have symptoms of depersonalization, derealization, or both. DPDR symptoms can last for a few moments or can come and go for years.

What Is Dissociative Identity Disorder (DID)?

Once known as multiple personality disorder, dissociative identity disorder is rare. It's estimated to affect about 1% of the population and is diagnosed even less often.

Individuals with DID often feel two or more different people are living inside their heads and might assume these alternate identities in times of stress. Each identity is different in personal history and characteristics, including physical qualities.

What Is Dissociative Amnesia (DA)?

The main symptom of dissociative amnesia is loss of memory that isn't caused by another medical condition. DA also isn't typical forgetfulness; the memory loss can be extreme. If you have DA, you might not be able to recall certain traumatic periods or people in your life.

Other Specified and Unspecified Dissociative Disorders

With other specified dissociative disorder (OSDD) and unspecified dissociative disorder (UDD), the person's symptoms meet the definition of a dissociative disorder (like loss of awareness or orientation to your surroundings). But with OSDD, the symptoms don't fully meet the criteria of one of the dissociative disorder types listed above. And with UDD, there might not be enough information to make a more specific diagnosis.

Symptoms of Dissociative Disorders

Despite the differences between the different types of disorders, there are common symptoms that can affect any individual with any dissociative disorder, such as:

• anxiety
• a sense of being detached from yourself
• depression
• memory loss of certain time periods, events, or people
• distortion of people and things around you, and
• a confused sense of identity.

Dissociative disorders can have long-term effects on an individual, including the following:

• self-harming behaviors, such as cutting
• suicide attempts
• substance abuse
• depression
• sleep disorders
• anxiety disorders
• eating disorders
• severe headaches
• significant difficulty with relationships, and
• difficulty dealing with stress.

Qualifying for Social Security Disability for a Dissociative Disorder

There are two ways you can qualify medically for Social Security disability benefits—whether it's for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI):

• meeting the criteria of a medical listing, or
• proving that you can't work because of your condition.

Meeting a Listing With a Dissociative Disorder

You can automatically qualify for disability benefits if your condition meets the requirements of one of the medical conditions listed in Social Security's Blue Book. The listings cover both physical and mental impairments.

Unfortunately, there's no specific listing for dissociative disorders. But DSM-5 includes a dissociative subtype for post-traumatic stress disorder (PTSD). So, if you happen to have PTSD with dissociation, and your symptoms are severe enough, you might meet the listing for PTSD (which is evaluated under listing 12.15).

Dissociative symptoms might also be associated with other listed conditions like:

• bipolar disorder and depression (evaluated under listing 12.04)
• anxiety disorder, panic disorder, or obsessive-compulsive disorder (all evaluated under listing 12.06), or
• eating disorders (evaluated under listing 12.13).

Those with a dissociative disorder who've abused drugs or alcohol might also qualify for disability benefits. Although Social Security no longer has a listing for substance use disorders, it's still possible to get disability benefits based on impairments caused by substance abuse.

Proving a Dissociative Disorder Affects Your Ability to Work

If you don't meet a listing, you might still qualify for disability benefits. But you'll need to prove to Social Security that you can't work because of the combined effect of all of your impairments, including your dissociative disorder symptoms.

How Social Security Assesses Your Struggles With Dissociation

Social Security will assess your mental (and physical) abilities and limitations in determining whether or not you can be expected to work. Social Security will assess your mental abilities in several areas, such as your ability to:

• understand and complete tasks
• interact appropriately with coworkers, and
• handle work stresses.

The ability to handle work stresses is the biggest obstacle for those with DPDR or another dissociative disorder, as the symptoms of the disorder generally occur during times of stress.

Personality changes, leaving work abruptly, and feeling outside of yourself can all affect your ability to hold down a job. Personality changes can impact your ability to interact appropriately with others at work. Other symptoms, including anxiety and depression, might also have an effect on your ability to complete work and your interactions with others.

Your chance of getting disability benefits improves if you have serious physical limitations in addition to your mental or emotional difficulties. For more information, see our article on how Social Security assesses the combined effects of physical and mental impairments.

Recurrent or Periodic Dissociation

Dissociative disorders and DPDR can be treated with psychotherapy and medications. Dissociative disorders generally develop as a coping mechanism in response to a traumatic event or series of traumas. Those with dissociative disorders who learn new ways of coping can sometimes significantly decrease their dissociative symptoms.

If your symptoms improve through treatment, you might not qualify for disability benefits—unless you're at risk of "decompensating," or mentally deteriorating again when under stress.

How to Apply for Disability for Dissociative Disorders

The quickest way to apply for SSDI or SSI disability benefits for a dissociative disorder is to use Social Security's online application. You can also apply for benefits at your local Social Security office (make an appointment to minimize your wait time). Or make an appointment to apply by phone by calling 800-772-1213 (TTY 800-325-0778).

No matter which method you use, Social Security will ask for a lot of information. You can make the process easier by gathering as much of the following as you can before you begin:

• your original birth certificate or other proof of birth
• proof of citizenship or immigration status (if you weren't born in the United States)
• your Social Security number (SSN)
• information about your family members, including your spouse (or ex-spouse) and dependent children
• your employment history (for the last two years)
• your earnings records (including your W2 or self-employment tax return for last year)

You'll also need to provide Social Security with all your medical records related to your impairment(s), including:

• doctors' or psychologists' reports
• hospitalization records, and
• all the medications and treatments you've tried (along with their effectiveness).

Don't delay filing if you don't have some of these documents. Social Security will help you gather anything you're missing.

Learn more about applying for Social Security disability benefits.