From daydreaming to altering personalities, dissociation can look different for everyone.
Though a somewhat vague term, disassociation involves cognitive disconnections between your thoughts, memories, and actions.
Disassociation can also affect your sense of identity and alter your perception of the world around you. It’s the hallmark symptom of dissociative disorders, including dissociative identity disorder (DID), previously known as multiple personality disorder.
But people with various mental and physical conditions can experience dissociative events, in addition to other symptoms.
If left untreated, dissociation can lead to significant problems in daily functioning and worsening mental health. But learning coping strategies can help you manage these potentially distressing events.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), dissociation is generally defined as a disruption or discontinuity in:
- motor control
These components of your cognition may not come together as they should during dissociative events, which could last for just a few minutes or years, in extreme cases.
Awareness of yourself and what’s going on around you can be compromised during dissociation, which might feel like an unwelcome and frightening intrusion into your mind.
On a psychological level, dissociating can be an involuntary means of coping with acute stress, such as physical abuse. Disassociation can act as an emergency escape route, preventing your mind from focusing on an overwhelming or traumatizing stimulus.
Approximately 73% of people who endure a traumatic incident experience dissociation during and directly following the event.
But in protecting you from trauma in the short term, dissociation creates negative consequences in the long term, like:
- personality altering
- memory loss
- emotional disfunction
Dissociation looks and feels different for each person who experiences it. But what’s typically consistent in most cases is a sense of departing from reality.
A participant in a 2021 study explained their fragile relationship with reality, saying, “It’s kind of like walking on thin ice, it can break at any moment.”
You may suddenly lose your sense of identity or recognition of your surroundings. You could feel as though you’re observing yourself from the outside in — or what some describe as an “out-of-body experience.” Your thoughts and perceptions might be foggy, and you could be confused by what’s going on around you.
In some cases, dissociation can be marked by an altering of your:
You might feel as though you’ve become a different person altogether with different attributes and thoughts.
Dissociation can take place during a traumatic or stressful event and can sometimes continue in the days or weeks after, such that your memories and events recounted to you might not line up.
One first-hand account describes a woman who reported being told that she had said and done things that she had absolutely no memory of.
While some people have no recollection of their dissociations, others can remember when it occurred and what it felt like.
Voices on dissociation
People who experience disassociation are raising their voices to combat stigma in columns and blogs:
Symptoms of dissociation are wide-ranging in their type and severity and can be both physical and psychological.
Some of the most common mental signs and symptoms of dissociation include:
- fogginess and confusion
- memory loss
- difficulty accessing or retrieving information
- alexithymia (difficulty recognizing or describing your emotions)
- sudden behavioral changes
- significant shifts in mood
Some people experience physical symptoms as well, such as:
- dulled senses, including pain
- sense of weightlessness or emptiness
- pounding heart
- lightheadedness or dizziness
There’s generally a broad spectrum in the severity of dissociation. Most people have experienced dissociation at some point in their lives.
Situations that can be considered dissociative include:
- a wandering mind during class
- losing track of the road as you’re driving
- certain meditative states
But the more severe types of dissociation — those typically associated with mental disorders — take many forms, including:
- Dissociative amnesia. The central symptom is loss of memory — forgetting entirely or misremembering details about specific events, periods of time, or your own life history.
- Dissociative fugue. This is a form of amnesia involving physical movement, in which you travel from one place to another with no memory of how you arrived there. Sense of identity is often lost.
- Depersonalization. This is a detachment from your thoughts, emotions, body, or life altogether. It may feel like you’re watching yourself from an outside perspective.
- Derealization. The world around you seems unreal, including other people. This is despite a maintained logical awareness that your surroundings are, in fact, real.
- Identity alteration or confusion. You may adopt a different personality, voice, behavior, and sense of self. In milder forms, this could be a sense that you are or have acted in a way that doesn’t align with your true identity.
Unlike many other mental health events, genetics likely play little to no role in a person’s tendency to disassociate.
The overwhelming consensus among researchers and mental health experts is that traumatic events — particularly in youth — may be the most common underlying cause of dissociation and many related disorders.
Childhood trauma leading to dissociation could include:
- sexual abuse
- physical abuse
- exposure to war or violence
- car accidents
- natural disasters
There are some potential physical causes of dissociation as well, like:
- head trauma
- brain tumors
For those who begin to dissociate once they’ve already reached adulthood, physical conditions are more likely to be responsible, including:
- repeated abuse
Dissociating might be considered a form of protection in these traumatizing situations, shielding you from unbearable or overwhelming experiences.
But in some cases, dissociation can become your go-to defense mechanism. Possible triggers of dissociation can include:
- substances like phencyclidine (PCP) and ketamine
- depressive episodes
- acute stress or anxiety
Sleep might also play an important role in the frequency of dissociative events, with poorer quality sleep potentially making dissociation more likely.
Some 2017 research tells us that dissociation can be a symptom of many mental health conditions.
Of course, dissociative events are most commonly associated with dissociative disorders.
Data suggests that about 7% of the population has met the criteria for a dissociative disorder at some point in their lives. Still, difficulty identifying these conditions could mean this estimate isn’t entirely accurate.
The DSM-5 defines five dissociative disorders:
- dissociative identity disorder (DID)
- dissociative amnesia, including fugue
- depersonalization or derealization disorder
- other specified dissociative disorder
- unspecified dissociative disorder
But dissociation isn’t found only in dissociative disorders — it can also be a symptom of other mental conditions, such as:
- post-traumatic stress disorder (PTSD)
- substance use disorder
- borderline personality disorder (BPD)
- obsessive-compulsive disorder (OCD)
It’s also common for people who experience dissociation to have depression or an anxiety disorder, largely due to the psychological stress dissociation can create.
Even though dissociation can be frustrating and intrusive, there are techniques and strategies to help you manage your symptoms and regain control of your life.
What works for one person may not work for another. You may have to try multiple strategies before discovering the tools that are most beneficial to you.
Professional guidance with a therapist, such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT), may be the best option for meaningful, long-term improvements in managing disassociation.
Record your reality
Referring back to something you created could help jog your memory and reduce the frustration of forgetfulness associated with disassociation.
If you have difficulties with memory loss and disassociation, try keeping a daily diary or taking pictures to help you record:
Dedication to mindfulness can work wonders for several mental health conditions and symptoms. To mitigate dissociative events, 2022 research suggests that practicing mindfulness and reassuring yourself that you’re safe in the present moment might be helpful.
Grounding techniques can also firmly connect you back to reality in times of disassociation. This could include exercising all your senses, like:
- smelling essential oils
- reading a poem aloud
- petting your dog
Lifestyle changes are accessible at home and can make a big impact on mental health. Simple self-care measures for managing disassociation might include:
- keeping a consistent sleep schedule
- exercising regularly
- eating nutritious food
- spending time outdoors
Those who experience dissociation may face stigma or skepticism from friends, family, and even some doctors who still have misconceptions about this condition.
But as scientific knowledge and exploration grow, so does the understanding of this complicated phenomenon.
If you’re experiencing dissociative events or related symptoms, you’re not alone. Reaching out to your doctor or therapist can be an important first step.
If you’re ready to get help but don’t know where to begin, you can visit Psych Central’s guide to finding mental health care.
Management and even resolution of dissociation are possible with the right strategies and guidance.
For more information about dissociation, you can check out the International Society for the Study of Trauma and Dissociation (ISSTD) “Dissociation FAQs” page.