ADHD Symptom Spotlight: Dissociation

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ADHD Symptom Spotlight is a series that dives deep into a hallmark or overlooked symptom of ADHD each week. This series is written by experts who also share their tips on managing these symptoms based on firsthand experience and research-backed insights.

While dissociation is not a symptom of ADHD, the two are closely related because they are often comorbid. People with dissociative disorders may also show symptoms of ADHD and vice versa. Here’s a guide to what dissociation is, why it’s so closely linked to ADHD, and how you can regain control of your dissociative symptoms.

What Is Dissociation?

Dissociation is a broad term that encompasses a wide range of disorders in which people cope with stress or trauma by mentally “escaping” reality. In media, you usually see it presented as dissociative identity disorder (formerly known as “split personalities”) or amnesia (extreme, isolated bouts of memory loss).

But it’s not always so extreme as that. For many, it takes the form of depersonalization or derealization, where your automatic survival/protective response kicks in, causing you to "detach" from the pain or stress you're experiencing. You might feel like you’re on the outside of your own life, watching events unfold as a spectator rather than as the protagonist.

It can also cause you to neglect real-life tasks and instead retreat from the real world and into your imagination. Instead of studying for that exam, you cultivate a rich fantasy life in which you’ve already finished college and begun living your dream life.

When a person experiences something traumatic, one way to cope with that intense emotional pain is to make a clean mental break with yourself. If you can’t physically escape the situation or remove the memory, you can at least mentally escape it.

It’s your brain’s way of trying to keep you safe and happy. But the drawback is that you don’t just detach from the pain. You detach from everything. It can be hard to maintain healthy relationships or stay focused at work or school if you don’t feel like any of it is your life.

The more often you dissociate, either through detaching from yourself and your life or through maladaptive daydreaming, the more disconnected you feel from your thoughts, memories, and surroundings.

You might start feeling numb or emotionally unavailable. You might also begin to feel a sense of unreality, as if the world around you or even you aren’t real. Often, you’ll find yourself “checking out” involuntarily or “spacing out” in the middle of doing something.

Disassociation in ADHD

Dissociative disorders are most commonly linked to trauma, so how is it related to ADHD? The connection lies in the fact that trauma and ADHD are closely linked. Otherwise typically developing children who experience trauma can end up developing ADHD-like symptoms.

While trauma and ADHD can both cause similar symptoms, it is important to note that trauma does not cause ADHD. One way to differentiate the two is if you start healing from trauma, and the symptoms go away, then they were probably caused by trauma. If they stick around, then it is more likely to be ADHD.

Conversely, people with ADHD may be more likely to experience trauma—either as the result of being targeted for bullying or abuse because of their ADHD symptoms or because of negative experiences related to those symptoms.

As a child, I had a vivid imagination and would often daydream or mind-wander during anything: class, family dinner, watching TV, playing sports. The number of goals other teams scored on me during soccer games because I was distracted by my brain is too high to count.

But the ability to hyperfocus when under pressure meant that I performed well on tests, so I usually managed to pass my classes. So, even when other symptoms like my impulsive behavior or emotional dysregulation became bad enough for my parents to seek treatment, I wasn’t diagnosed with ADHD because my grades weren’t bad enough, and I wasn’t hyperactive.

Decades of misdiagnosis meant that I was being punished and criticized over behavior that I had little control over, all while being treated for the wrong things—and feeling a growing sense of defeat that nothing was working.

By adulthood, I was struggling to hold down a steady job, barely scraping by in college classes, and wrestling with low self-esteem. I was also dealing with some traumatic experiences that resulted from past impulsive decisions.

The dissociative symptoms started to get really noticeable around high school. It was different than just having my mind wander like I was used to growing up. Regular daydreaming just felt like storytelling or entertainment, but I was always still myself and still emotionally invested in my life—just struggling to stay tuned into it all the time.

Dissociating, on the other hand, felt like completely leaving. I described it to a therapist once as floating somewhere above my body, watching things happen, and feeling like maybe I should help that person, but not like it really had anything to do with me. Logically, I knew it was me. But emotionally, she was a stranger.

How to Deal With Dissociative Symptoms

The “checking out” might happen involuntarily and you might have no idea what triggers it yet, but you can slowly regain control and prevent dissociative episodes with practice and treatment. Here are six strategies I find helpful.

Go to Therapy

Whether the ADHD or the trauma came first, therapy will be crucial for recovery and symptom management. Even if you can’t pinpoint any particular experience or event, dissociative symptoms are usually the result of your brain trying to protect you from emotional pain.

That doesn’t mean you have repressed memories. It means the dissociation may have been triggered by something that isn’t commonly seen as traumatic. Difficulties in school or struggling to make friends, for example, may not seem as painful or severe as going to war or watching a loved one die, but the chronic stress they cause can be enough for your brain to kick into protection mode.

Practice Grounding Exercises

If you notice you’re dissociating, a grounding exercise—where you practice being present in the moment—can help you come back to yourself. All that really means is taking a few minutes to become aware of your senses and your surroundings.

Grounding Exercise

My go-to routine is to take a break from what I’m doing and name:

  • 5 things I can see
  • 4 things I can hear
  • 3 things I can feel
  • 2 things I can hear
  • 1 thing I can taste

For best results (in my opinion), take a walk outside while you do this so that you have plenty of sensory input to work with. And if you can’t think of enough things for any specific sense, just skip it. I usually struggle with naming a taste unless I’m actively eating or drinking something, for example. So I just loop back around to things I can see and keep going until I feel more aware and in tune with my surroundings.

Engage Your Senses

Similar to the grounding exercise, stimulating your senses can help bring you back into your body.

Pet your cat, and focus on how soft the fur feels. Light a scented candle and take a few moments to inhale and enjoy the smell. Go to a park and walk barefoot on the grass, paying attention to the feeling of grass beneath your feet.

Really any positive physical sensation can help. Then, just do your best to focus on that sensation.

Get Some Exercise

I love going for a run when I need to ground myself or just get rid of some built-up restlessness. But even if you don’t want to break a sweat, going for a walk or dancing around to your favorite music will also get you moving without feeling like exercise. Even if you’re at work, doing some lunges or squats can do the trick.

Exercise can help because it’s another way of engaging your senses. When I run, I can feel the muscles working and feel my lungs inhaling and exhaling. That helps me reconnect to my body.

Keep a Journal

Dissociating comes with memory gaps and a poor ability to connect to your emotions. Journaling is an exercise that can help with both of those. Make it a daily habit to sit down and write about your day, focusing on how you felt and what you were thinking about throughout it.

When you come back from a dissociative episode, pull out your journal and try to write through it. Describe what was happening in the moments leading up to it and how you came out of it. Those details can help you identify triggers as well as what might be the most effective way to pull yourself back to reality.

Schedule Self-Care Activities

Whatever the cause, dissociation is your brain’s way of protecting you from negative experiences. If you’re stressed all the time or have a negative relationship with your body, that can make dissociative symptoms worse.

To counteract that, make a habit of doing kind, healthy things for yourself. Ending each workday with a bubble bath and a book or starting each morning with a 10-minute dance session to your favorite playlist can help build a more positive relationship with yourself.

Find little ways to be kind to yourself or treat yourself every day, not as a reward for “good behavior” but just because. Even if you lose a whole day to decision paralysis or burnout, you still deserve to unwind at the end of it, if only because not unwinding just means you’re likely to go into tomorrow with the same stress you were fighting today.

Over time, those acts of kindness and nurturing will strengthen your connection to yourself, just like they would in a relationship with another person.

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9 Sources
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