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Table of Contents

Types

Symptoms

Causes

Diagnosis

Treatment

Complications

Coping With

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Dissociation is a disconnection between a person’s sensory experience, thoughts,sense of self, or personal history. If you have trouble remembering a certain period of time in your life, for example, you may be experiencing a type of dissociation called dissociative amnesia.

The American Psychological Association (APA) defines dissociation as “a defense mechanism in which conflicting impulses are kept apart or threatening ideas and feelings are separated from the rest of the psyche.”

This disconnection can occur as part of a dissociation disorder, or it may be a symptom of another mental health issue. For instance, people with borderline personality disorder, post-traumatic stress disorder, and schizophrenia sometimes experience dissociation.

What Dissociation Feels Like

Someone with dissociation might feel a sense of unreality and lose their connection to time, place, and identity. This unusual experience is because dissociation disrupts four areas of personal functioning that usually operate together smoothly, automatically, and with few or no problems.

These areas are:

Breaks in this system of automatic functions can cause dissociation symptoms. Dissociation can range from feeling a mild sense of detachment (daydreaming) to experiencing a more severe disconnection from reality (feeling as if the world is unreal).

Types of Dissociation

In addition to these dissociative disorders, dissociation may also occur as a symptom of another condition. Conditions in which someone may experience dissociation include:

Symptoms of Dissociation

If you have a dissociation disorder or a mental health condition involving dissociation, you may sometimes have felt “disconnected” from yourself. Examples of dissociation include:

It is possible to experience dissociation without being aware of it.Sudden mood changes,difficulty remembering personal detailsabout yourself or your life, and feeling disconnected are all symptoms of dissociation.

Some people with dissociation may experience additional symptoms of depersonalization (feeling as if the self is not real) and derealization (feeling as if the world is not real). Both of these are serious mental health issues.

Depersonalization and derealization are often responses to overwhelming traumatic events that cannot be escaped, such aschild abuseand the trauma of war.They help the person to keep functioning in the moment of being severely traumatized.

An example of depersonalization is an out-of-body experience, where people see themselves from above. This survival mechanism lets them feel that whatever is occurring “is not happening to me.” In states of derealization, people are detached from their surroundings. This makes them feel that their situation isn’t real or “just a dream.”

Causes of Dissociation

Several factors can play a role in the development of dissociation. Among the potential causes are trauma, drug use, and other mental conditions.

Trauma

The leading cause of dissociative disorders istrauma.In cases such as this, dissociation occurs as a way to keep memories of the traumatic event from feeling overwhelming or too massive to handle.

Dissociation also helps the person distance themselves from the situation.Assault, abuse, accidents, natural disasters, andmilitary combatare all sources of trauma that can cause dissociation.

Drug Use

Substance usecan also cause dissociation. Experiences with dissociation and trauma can even predict the potential foraddiction, according to a study published in theInternational Journal of High Risk Behaviors and Addiction.

Another study in theJournal of Trauma & Dissociationshowed “relatively high levels” of dissociation among women with both substance use disorder and PTSD but also suggested that more research into how substances affect dissociation would be helpful.

Three Types of Dissociative Drugs and Their Effects

Other Mental Conditions

Diagnosis of Dissociation

To be diagnosed with dissociation, your healthcare provider will assess your symptoms, take your medical history, perform a physical exam, and possibly order lab tests to rule out any underlying medical conditions. They may also refer you to a mental health professional for diagnosis.

Several assessments can be used to help evaluate and diagnose dissociation. If you are experiencing dissociative symptoms, you may be given:

CAPS Assessment

Treatment for Dissociation

If you or someone you love has a dissociative disorder, it’s important to know that treatment can be a lengthy and sometimes difficult process.However, several treatment options have been found effective and can include psychotherapy, medication, or a combination of both.

Psychotherapy

Your health provider may recommend psychotherapy to help treat dissociation. Types of psychotherapy used for dissociation treatment include:

Medications

There are no medications specifically approved for the treatment of dissociation. However, there are some medicines that can be prescribed to help manage its symptoms.

For example, you may be prescribedantidepressants, sleep aids, oranti-anxiety drugsto help manage dissociation symptoms related to mood, anxiety, and sleep. If the dissociation is due to a psychiatric condition such as schizophrenia, your health provider may prescribe anantipsychoticmedication.

Complications of Dissociation

If left untreated, symptoms of dissociation can be lifelong.This makes seeking treatment when signs first appear important to recovery. Research has also connected dissociation with worsened psychiatric symptoms in the future.

Another complication of dissociation is that it increases a person’s vulnerability to abuse since the disconnection leaves them unprotected.Sadly, this abuse sometimes occurs in the form of a therapist sexually abusing a patient with dissociation. This is a form of revictimization known as “sitting duck syndrome.”

Taking the time tofind the right therapistcan help avoid this type of situation. It is also helpful to know thesigns of a bad therapistand make a switch should any of these become apparent during treatment sessions.

Dissociation After Trauma May Indicate Increased Mental Distress in the Future

Coping With Dissociation

Since stress and anxiety sometimes trigger dissociation, finding ways to deal with these issues can help you better cope with their symptoms. Actions to consider taking include:

If you or a loved one are struggling with dissociation, 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.

If you or a loved one are struggling with dissociation, 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.

Final Thoughts

If the situation isn’t actually threatening, you may appear “spaced out” to others. On the other hand, if there is a real threat, dissociating from it when escape might not otherwise be possible could expose you to harm. Talk to your health provider if you think you might be experiencing symptoms of dissociation or a related condition.

12 Ways to Deal With Trauma

15 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.American Psychological Association.Dissociation.Seligman R, Kirmayer LJ.Dissociative experience and cultural neuroscience: Narrative, metaphor and mechanism.Cult Med Psychiatry. 2008;32(1):31-64. doi:10.1007/s11013-007-9077-8Valdez CE, Lilly MM.The effects of dissociation on analogue trauma symptoms after trauma processing among women with varying histories of lifespan victimization.J Interpers Violence. 2019;36(13-14):NP7596-NP7618. doi:10.1177/0886260519829273Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6:27905. doi:10.3402/ejpt.v6.27905National Alliance on Mental Illness.Dissociative disorders.Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N.Predicting addiction potential on the basis of early traumatic events, dissociative experiences, and suicide ideation.Int J High Risk Behav Addict. 2014;3(4):e20995. doi:10.5812/ijhrba.20995Najavits LM, Walsh M.Dissociation, PTSD, and substance abuse: An empirical study.J Trauma Dissociation. 2012;13(1):115‐126. doi:10.1080/15299732.2011.608781Černis E, Evans R, Ehlers A, Freeman D.Dissociation in relation to other mental health conditions: An exploration using network analysis.J Psychiatr Res. 2021;136:460-467. doi:10.1016/j.jpsychires.2020.08.023TraumaDissociation.com.Dissociative Experiences Scale - II.Weathers FW, Bovin MJ, Lee DJ, et al.The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.Psychol Assess. 2018;30(3):383-395. doi:10.1037/pas0000486Subramanyam A, Somaiya M, Shankar S, et al.Psychological interventions for dissociative disorders.Indian J Psychiatry. 2020;62(8):280. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_777_19American Association for Marriage and Family Therapy.Dissociative identity disorder.Lebois L, Harnett N, van Rooij S, et al.Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure.AJP. 2022;179(9):661-672. doi:10.1176/appi.ajp.21090911Şar V.The many faces of dissociation: Opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171Schäflein E, Sattel H, Schmidt U, Sack M.The enemy in the mirror: Self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder.Eur J Psychotraumatol. 2018;9(Suppl 3). doi:10.1080/20008198.2018.1472991Additional ReadingLanius RA, Hopper JW.Re-experiencing/hyperaroused and dissociative states in posttraumatic stress disorder.Psychiatric Times.2008;25(13):31-36.Schiavone FL, Frewen P, McKinnon M, Lanius RA.The dissociative subtype of PTSD: An update of the literature.PTSD Research Quarterly. National Center for PTSD. 2018;29(3):1-13.

15 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.American Psychological Association.Dissociation.Seligman R, Kirmayer LJ.Dissociative experience and cultural neuroscience: Narrative, metaphor and mechanism.Cult Med Psychiatry. 2008;32(1):31-64. doi:10.1007/s11013-007-9077-8Valdez CE, Lilly MM.The effects of dissociation on analogue trauma symptoms after trauma processing among women with varying histories of lifespan victimization.J Interpers Violence. 2019;36(13-14):NP7596-NP7618. doi:10.1177/0886260519829273Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6:27905. doi:10.3402/ejpt.v6.27905National Alliance on Mental Illness.Dissociative disorders.Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N.Predicting addiction potential on the basis of early traumatic events, dissociative experiences, and suicide ideation.Int J High Risk Behav Addict. 2014;3(4):e20995. doi:10.5812/ijhrba.20995Najavits LM, Walsh M.Dissociation, PTSD, and substance abuse: An empirical study.J Trauma Dissociation. 2012;13(1):115‐126. doi:10.1080/15299732.2011.608781Černis E, Evans R, Ehlers A, Freeman D.Dissociation in relation to other mental health conditions: An exploration using network analysis.J Psychiatr Res. 2021;136:460-467. doi:10.1016/j.jpsychires.2020.08.023TraumaDissociation.com.Dissociative Experiences Scale - II.Weathers FW, Bovin MJ, Lee DJ, et al.The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.Psychol Assess. 2018;30(3):383-395. doi:10.1037/pas0000486Subramanyam A, Somaiya M, Shankar S, et al.Psychological interventions for dissociative disorders.Indian J Psychiatry. 2020;62(8):280. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_777_19American Association for Marriage and Family Therapy.Dissociative identity disorder.Lebois L, Harnett N, van Rooij S, et al.Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure.AJP. 2022;179(9):661-672. doi:10.1176/appi.ajp.21090911Şar V.The many faces of dissociation: Opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171Schäflein E, Sattel H, Schmidt U, Sack M.The enemy in the mirror: Self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder.Eur J Psychotraumatol. 2018;9(Suppl 3). doi:10.1080/20008198.2018.1472991Additional ReadingLanius RA, Hopper JW.Re-experiencing/hyperaroused and dissociative states in posttraumatic stress disorder.Psychiatric Times.2008;25(13):31-36.Schiavone FL, Frewen P, McKinnon M, Lanius RA.The dissociative subtype of PTSD: An update of the literature.PTSD Research Quarterly. National Center for PTSD. 2018;29(3):1-13.

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.

American Psychological Association.Dissociation.Seligman R, Kirmayer LJ.Dissociative experience and cultural neuroscience: Narrative, metaphor and mechanism.Cult Med Psychiatry. 2008;32(1):31-64. doi:10.1007/s11013-007-9077-8Valdez CE, Lilly MM.The effects of dissociation on analogue trauma symptoms after trauma processing among women with varying histories of lifespan victimization.J Interpers Violence. 2019;36(13-14):NP7596-NP7618. doi:10.1177/0886260519829273Lanius RA.Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research.Eur J Psychotraumatol. 2015;6:27905. doi:10.3402/ejpt.v6.27905National Alliance on Mental Illness.Dissociative disorders.Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N.Predicting addiction potential on the basis of early traumatic events, dissociative experiences, and suicide ideation.Int J High Risk Behav Addict. 2014;3(4):e20995. doi:10.5812/ijhrba.20995Najavits LM, Walsh M.Dissociation, PTSD, and substance abuse: An empirical study.J Trauma Dissociation. 2012;13(1):115‐126. doi:10.1080/15299732.2011.608781Černis E, Evans R, Ehlers A, Freeman D.Dissociation in relation to other mental health conditions: An exploration using network analysis.J Psychiatr Res. 2021;136:460-467. doi:10.1016/j.jpsychires.2020.08.023TraumaDissociation.com.Dissociative Experiences Scale - II.Weathers FW, Bovin MJ, Lee DJ, et al.The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.Psychol Assess. 2018;30(3):383-395. doi:10.1037/pas0000486Subramanyam A, Somaiya M, Shankar S, et al.Psychological interventions for dissociative disorders.Indian J Psychiatry. 2020;62(8):280. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_777_19American Association for Marriage and Family Therapy.Dissociative identity disorder.Lebois L, Harnett N, van Rooij S, et al.Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure.AJP. 2022;179(9):661-672. doi:10.1176/appi.ajp.21090911Şar V.The many faces of dissociation: Opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171Schäflein E, Sattel H, Schmidt U, Sack M.The enemy in the mirror: Self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder.Eur J Psychotraumatol. 2018;9(Suppl 3). doi:10.1080/20008198.2018.1472991

American Psychological Association.Dissociation.

Seligman R, Kirmayer LJ.Dissociative experience and cultural neuroscience: Narrative, metaphor and mechanism.Cult Med Psychiatry. 2008;32(1):31-64. doi:10.1007/s11013-007-9077-8

Valdez CE, Lilly MM.The effects of dissociation on analogue trauma symptoms after trauma processing among women with varying histories of lifespan victimization.J Interpers Violence. 2019;36(13-14):NP7596-NP7618. doi:10.1177/0886260519829273

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

National Alliance on Mental Illness.Dissociative disorders.

Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N.Predicting addiction potential on the basis of early traumatic events, dissociative experiences, and suicide ideation.Int J High Risk Behav Addict. 2014;3(4):e20995. doi:10.5812/ijhrba.20995

Najavits LM, Walsh M.Dissociation, PTSD, and substance abuse: An empirical study.J Trauma Dissociation. 2012;13(1):115‐126. doi:10.1080/15299732.2011.608781

Černis E, Evans R, Ehlers A, Freeman D.Dissociation in relation to other mental health conditions: An exploration using network analysis.J Psychiatr Res. 2021;136:460-467. doi:10.1016/j.jpsychires.2020.08.023

TraumaDissociation.com.Dissociative Experiences Scale - II.

Weathers FW, Bovin MJ, Lee DJ, et al.The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.Psychol Assess. 2018;30(3):383-395. doi:10.1037/pas0000486

Subramanyam A, Somaiya M, Shankar S, et al.Psychological interventions for dissociative disorders.Indian J Psychiatry. 2020;62(8):280. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_777_19

American Association for Marriage and Family Therapy.Dissociative identity disorder.

Lebois L, Harnett N, van Rooij S, et al.Persistent dissociation and its neural correlates in predicting outcomes after trauma exposure.AJP. 2022;179(9):661-672. doi:10.1176/appi.ajp.21090911

Şar V.The many faces of dissociation: Opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171

Schäflein E, Sattel H, Schmidt U, Sack M.The enemy in the mirror: Self-perception-induced stress results in dissociation of psychological and physiological responses in patients with dissociative disorder.Eur J Psychotraumatol. 2018;9(Suppl 3). doi:10.1080/20008198.2018.1472991

Lanius RA, Hopper JW.Re-experiencing/hyperaroused and dissociative states in posttraumatic stress disorder.Psychiatric Times.2008;25(13):31-36.Schiavone FL, Frewen P, McKinnon M, Lanius RA.The dissociative subtype of PTSD: An update of the literature.PTSD Research Quarterly. National Center for PTSD. 2018;29(3):1-13.

Lanius RA, Hopper JW.Re-experiencing/hyperaroused and dissociative states in posttraumatic stress disorder.Psychiatric Times.2008;25(13):31-36.

Schiavone FL, Frewen P, McKinnon M, Lanius RA.The dissociative subtype of PTSD: An update of the literature.PTSD Research Quarterly. National Center for PTSD. 2018;29(3):1-13.

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