Anxiety and Dissociation: What's the Connection?

Table of ContentsView AllTable of ContentsWhat Is Dissociation?SymptomsDiagnosisCausesTreatmentCopingFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

What Is Dissociation?

Symptoms

Diagnosis

Causes

Treatment

Coping

Frequently Asked Questions

If you’ve ever felt disconnected from the world when you’re anxious, you’ve probably wondered how to stop dissociating because of anxiety. Dissociation anxiety is not a specific diagnosis or set of symptoms. Rather, dissociation is a symptom, and it may be related to anxiety.

When a person experiences dissociation, they become disconnected from their surroundings or from themselves. This reaction works to temporarily alleviate potentially overwhelming emotional experiences such as traumatic memories and may temporarily reduce feelings of shame, anxiety, or fear—but it doesn’t function as a healthy long-term fix.

Dissociation related to anxiety may occur during a stressful, anxiety-inducing event or during or after a period of intense worry. Because dissociation is based onavoidance coping, it “works” in the short term but has long-term negative consequences.

Dissociation refers to being disconnected from the present moment. It is a subconscious way of coping with and avoiding a traumatic situation or negative thoughts.

While about half of people may have experienced an event of dissociation in their lifetime, only about 2% are actually diagnosed with what is known as a dissociative disorder.

Dissociation usually happens in response to a traumatic life event such as that which is faced while being in the military or experiencing abuse. In this way, dissociation is usually associated with trauma and post-traumatic stress disorder (PTSD). However, dissociation can also happen in the context of anxiety symptoms andanxiety disorders.

Often, dissociation that happens due to extreme stress or panic is recognized but attributed to other causes such as health issues. A person with panic disorder may seek medical attention for these symptoms and feel powerless to stop them.

Overall, dissociation interferes with the treatment of all types of disorders and makes it hard to pay attention to the present moment. It can also slow or prevent healthytrauma processing and coping. Because of this, it’s important to address dissociation through treatment and learn ways to cope.

Symptoms of Anxiety and Dissociation

The process of dissociation usually occurs outside your own awareness, though you may also realize it is happening, particularly if it is in the context of anxiety. The experience involves a disconnection between your memory, consciousness, identity, and thoughts.

In other words, while normally your brain processes events (such as your memories, identity, perceptions, motor function, etc.) together, during dissociation, these parts splinter, leaving you with a feeling of disconnection. Dissociation is a general term that refers to a detachment from many things.

Depersonalization

With depersonalization, your mind feels disconnected from your thoughts, feelings, actions, or body. Examples of this include feeling like you are watching a movie about yourself or that you don’t have an identity.

Some of the symptoms experienced as a result of depersonalization include:

Derealization

Derealization causes a sensation where the world does not feel real. Examples of this include seeing the world all in shades of grey or having tunnel vision when looking at the world.

The symptoms involved with derealization include:

Depersonalization, Derealization, and Panic Disorder

Diagnosis of Dissociation

There are three types of dissociative disorders in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5). However, these are separate from dissociation related to anxiety:

Again, there is no diagnosis of “dissociation anxiety,” although dissociation can be a symptom associated with anxiety disorders. The major anxiety disorders that may be related to dissociation as a symptom include:

Causes of Dissociation

While the exact cause of dissociation is unclear, experts note that dissociation correlates with mood and anxiety disorders and is also a way of dealing with trauma. As a result, dissociation often affects people who have experienced the following types of trauma:

When dissociation is related to anxiety or panic, it tends to occur for a shorter period of time than when it is due to trauma or abuse or as a symptom of a diagnosable dissociative disorder.

In the case of anxiety, it is constant, low-level stress that puts a strain on your nervous system and eventually may cause you to dissociate to protect yourself; but remember, this all happens mostly at a level that you are likely not aware of.

What to Know About Mood Disorders

Treatment of Anxiety and Dissociation

Anxiety is a treatable condition. The U.S. Preventative Services Task Force recommends that all adults below the age of 65 get screened for symptoms of an anxiety disorder during their regular doctor’s visits.

Although there is no specific treatment for dissociation, medications, and psychotherapy have been shown to help.

Medications

While there are no medications to specifically treat dissociation, your doctor may prescribe antipsychotics, antidepressants, or anti-anxiety medications to alleviate some of the symptoms of a dissociative condition.

Psychotherapy

Treatment for dissociation related to anxiety usually will involve psychotherapy (such ascognitive behavioral therapyordialectical behavior therapy).Eye movement desensitization and reprocessing (EMDR) is another therapy that is sometimes used.

Since dissociation can interfere with the effectiveness of treatment, your therapist may ask you to do the following things to snap out of a period of dissociation:

Find Help With the Best Online Anxiety Support Groups

How to Stop Dissociating

While you may not be able to control dissociation, you can reduce the likelihood of it happening and also try to learn to ignore it when it does happen rather than letting your anxiety make it spiral out of control.

In other words, the dissociation will stop when your brain no longer feels the need to protect you. Some preventative steps that you can take to manage dissociation related to anxiety include the following:

A Word From Verywell

If you are finding yourself very worried about dissociation symptoms, such as feeling detached from the world or things not feeling real, it’s important to speak to your doctor or a mental health professional about how you are feeling and what can be done to help you feel better. Only a professional can determine whether your symptoms are related to trauma or anxiety, or some combination of the two, which will influence your treatment plan.

Finally, if you don’t notice dissociation yourself, but others seem concerned about your behavior, it may still be worth seeking help. Dissociation is not always consciously recognized, so you may still be experiencing it.

If you or a loved one are struggling with dissociation anxiety or another mental health issue, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

Dissociation can be a symptom of anxiety, particularly when a person is experiencing a great deal of stress or when the situation is inescapable. Dissociation can also be a symptom of other mental health conditions including post-traumatic stress disorder, schizophrenia, borderline personality disorder, and bipolar disorder.

Signs that you might be dissociating include:Feeling “zoned out"Feeling like you are “losing time"Feeling as if you are watching situations from outside of your bodyFeeling as if the world is no longer realFeeling emotionally numb and unable to respond how normally would

Signs that you might be dissociating include:

If you are experiencing dissociation, it is important to talk to a mental health professional. They can recommend treatments, including medications and therapy, that can help. In terms of managing dissociation on your own, finding ways to groud yourself in reality is important. When you start to dissociate, work on grounding and centering yourself in the moment. Making eye contact with another person, naming things you can detect with your senses, focusing on aspects of your environment, or consciously forcing yourself to avoid zoning out are a few strategies you can try.

How to Find a Therapist for Anxiety

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N.Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale.Am J Psychiatry. 2018;175(1):37-46. doi:10.1176/appi.ajp.2017.17010025National Alliance on Mental Illness.Dissociative Disorders.Gentile JP, Snyder M, Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41.Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6. doi:10.3402/ejpt.v6.27905US Preventive Services Task Force.Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement.JAMA.2023;329(23):2057–2067. doi:10.1001/jama.2023.9297Cleveland Clinic.Dissociative Disorders: Management and Treatment.Additional ReadingMoscariello MM, Ratti F, Quartini A, Forcén FE, Munuera JN, Bersani G.Dissociative symptoms in patients with mood and anxiety disorders.Riv Psichiatr. 2010;45(4):234-243. doi:10.1016/s0924-977x(09)70749-7National Alliance on Mental Illness.Dissociative disorders.Prasko J, Grambal A, Kasalova P, et al.Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.Neuropsychiatr Dis Treat. 2016;12:2659-2676. doi:10.2147/ndt.s118058University of Washington.What is dissociation and what to do about it?Warshaw MG, Fierman E, Pratt L, et al.Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD.Am J Psychiatry. 1993;150(10):1512-1516. doi:10.1176/ajp.150.10.1512

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N.Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale.Am J Psychiatry. 2018;175(1):37-46. doi:10.1176/appi.ajp.2017.17010025National Alliance on Mental Illness.Dissociative Disorders.Gentile JP, Snyder M, Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41.Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6. doi:10.3402/ejpt.v6.27905US Preventive Services Task Force.Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement.JAMA.2023;329(23):2057–2067. doi:10.1001/jama.2023.9297Cleveland Clinic.Dissociative Disorders: Management and Treatment.Additional ReadingMoscariello MM, Ratti F, Quartini A, Forcén FE, Munuera JN, Bersani G.Dissociative symptoms in patients with mood and anxiety disorders.Riv Psichiatr. 2010;45(4):234-243. doi:10.1016/s0924-977x(09)70749-7National Alliance on Mental Illness.Dissociative disorders.Prasko J, Grambal A, Kasalova P, et al.Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.Neuropsychiatr Dis Treat. 2016;12:2659-2676. doi:10.2147/ndt.s118058University of Washington.What is dissociation and what to do about it?Warshaw MG, Fierman E, Pratt L, et al.Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD.Am J Psychiatry. 1993;150(10):1512-1516. doi:10.1176/ajp.150.10.1512

Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N.Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale.Am J Psychiatry. 2018;175(1):37-46. doi:10.1176/appi.ajp.2017.17010025National Alliance on Mental Illness.Dissociative Disorders.Gentile JP, Snyder M, Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41.Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6. doi:10.3402/ejpt.v6.27905US Preventive Services Task Force.Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement.JAMA.2023;329(23):2057–2067. doi:10.1001/jama.2023.9297Cleveland Clinic.Dissociative Disorders: Management and Treatment.

National Alliance on Mental Illness.Dissociative Disorders.

Gentile JP, Snyder M, Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41.

Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6. doi:10.3402/ejpt.v6.27905

US Preventive Services Task Force.Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation Statement.JAMA.2023;329(23):2057–2067. doi:10.1001/jama.2023.9297

Cleveland Clinic.Dissociative Disorders: Management and Treatment.

Moscariello MM, Ratti F, Quartini A, Forcén FE, Munuera JN, Bersani G.Dissociative symptoms in patients with mood and anxiety disorders.Riv Psichiatr. 2010;45(4):234-243. doi:10.1016/s0924-977x(09)70749-7National Alliance on Mental Illness.Dissociative disorders.Prasko J, Grambal A, Kasalova P, et al.Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.Neuropsychiatr Dis Treat. 2016;12:2659-2676. doi:10.2147/ndt.s118058University of Washington.What is dissociation and what to do about it?Warshaw MG, Fierman E, Pratt L, et al.Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD.Am J Psychiatry. 1993;150(10):1512-1516. doi:10.1176/ajp.150.10.1512

National Alliance on Mental Illness.Dissociative disorders.

Prasko J, Grambal A, Kasalova P, et al.Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders.Neuropsychiatr Dis Treat. 2016;12:2659-2676. doi:10.2147/ndt.s118058

University of Washington.What is dissociation and what to do about it?

Warshaw MG, Fierman E, Pratt L, et al.Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD.Am J Psychiatry. 1993;150(10):1512-1516. doi:10.1176/ajp.150.10.1512

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?

Symptoms of Anxiety and Dissociation#

Depersonalization#

Derealization#

Diagnosis of Dissociation#

Causes of Dissociation#

Treatment of Anxiety and Dissociation#

Medications#

Psychotherapy#

How to Stop Dissociating#

A Word From Verywell#