Dissociation After Trauma May Indicate Increased Mental Distress in the Future

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Key Takeaways

  • Researchers have found that dissociation after a traumatic event can indicate increased risk of mental health conditions later on.
  • The mental health conditions indicated by dissociation include depression, anxiety, and PTSD.
  • Preventative care is vital in addressing mental health issues before they become more intense.

Detachment and dissociation after a traumatic event can suggest a higher risk of serious mental health conditions later on in life, researchers have found. 

Results from a study led by investigators at McLean Hospital suggested that dissociation after trauma can indicate severe post-traumatic stress disorder (PTSD), depression, anxiety, physical pain, and social impairment. 

In a press release, lead author Lauren A. M. Lebois, PhD, director of the Dissociative Disorders and Trauma Research Program at McLean Hospital and an Assistant Professor in Psychiatry at Harvard Medical School, said, “Dissociation may help someone cope in the aftermath of trauma by providing some psychological distance from the experience, but at a high cost—dissociation is often linked with more severe psychiatric symptoms.”

In the study, researchers looked at data on 1,464 adults across the U.S. who all reported derealization, a severe form of dissociation.

After three months, they collected follow-up reports. They found that patients who experienced derealization were more likely to have higher levels of various mental health conditions.

Researchers also found that people who reported derealization were more likely to experience more severe PTSD, even when accounting for both childhood trauma and PTSD symptoms at the beginning of the study.

Dissociation and Its Links to Trauma

In essence, dissociation is a sort of disconnection between a person’s sense of self, sensory experience, or thoughts.

There are four core areas of personal functioning that usually work together without any issues: consciousness, identity, memory, and self-awareness. When this system is disrupted, it can lead to dissociation.

There are a number of factors that might play a role in the development of dissociation in an individual, including drug use and other mental health conditions.

Another is trauma—this might be because dissociating is a way of helping someone to distance themselves from the trauma, be it abuse, a natural disaster, a military experience, or something else.

Somia Zaman, MSc

Though dissociation starts out as a way for the mind to cope with prolonged stress, it can result in mental health problems including depression and anxiety. It is rarely a standalone issue.

— Somia Zaman, MSc

“When a person experiences a traumatic event, their brain can go into what is known as ‘dissociation’ or protective mode, in which it tries to detach itself from what is happening in the current moment," says Martin Preston, founder and chief executive at the private rehab clinic Delamere

"[Dissociation] is a defense mechanism that can kick-in in the context of experiencing particularly severe trauma. It’s a way in which the body and the mind become separated," Elena Touroni, PhD, a consultant psychologist and founder of The Chelsea Psychology Clinic, explains.

“The protective function is in order to survive an incredibly difficult experience. If that difficult experience is targeting our body, our mind becoming separate is a way of avoiding being fully present and registering what’s happening.”

This may go some way to explaining why experiencing dissociation may be an indicator of further mental health problems in the future.

“Once this defense mechanism has been implemented to survive trauma, it can automatically get activated in situations in daily life where it is not warranted and can be dangerous. Someone might, for instance, not feel in control of their actions when they are in this state,” Touroni says. 

Younger people may be particularly at risk too, says Somia Zaman, MSc, a psychotherapist specializing in cognitive behavioral therapy and eye movement desensitization and reprocessing at My Therapy Rooms.

“Sometimes long periods of dissociation, especially in a young person, can lead to the development of a deeper, longer-lasting dissociative disorder. Though dissociation starts out as a way for the mind to cope with prolonged stress, it can result in mental health problems including depression and anxiety. It is rarely a standalone issue,” she says.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies three types of dissociative disorders:

  • Dissociative identity disorder: This involves having two or more personality states, and used to be known as multiple personality disorder. Risk factors include abuse, neglect in childhood, and other forms of traumatic experiences.
  • Dissociative amnesia: This involves an inability to remember personal information or details of events, and risk factors include traumatic experiences—particularly when there are multiple traumatic events, or the trauma was more severe, frequent, or violent.
  • Depersonalization/Derealization disorder: This involves a sense of unreality or detachment, with regard to either your own body or your surroundings respectively. Again, trauma—particularly childhood trauma—is a real risk factor. 

What Are the Symptoms of Dissociation?

There are a number of symptoms of dissociation, with perhaps the most prominent being that you might think that either the world around you isn’t real, or that you are not real. You may also have gaps in your memory, or forget things more than usual.

However, these symptoms may also be experienced by people with dissociation:

  • Feeling like a different person sometimes
  • Having flashbacks to traumatic events
  • Losing touch with things going on around you
  • Feeling disconnected from your emotions
  • An altered sense of time and/or place

Two particularly severe forms of dissociation, as outlined above, are depersonalization and derealization—the type of dissociation focused on in this study.

The former involves feeling as if the self isn’t real, while the latter involves feeling as if the world isn’t real, and both are serious. They’re often a reaction to traumatic events. 

The Importance of Getting Mental Health Care

The findings of this study point to the need for preventative care—including screening patients for dissociation after trauma to identify people who may be at risk, so that they can receive help at an earlier stage.

“If left untreated, dissociation and trauma can lead to further health complications and destructive behaviors including abuse of substances such as alcohol or drugs, as a way to cope with the emotions and stress a person may be feeling. Though the effects of the substance may initially numb the pain, a dangerous cycle of addiction can begin as a result,” says Preston.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Speaking to a mental health professional is one way in which people can get help before any further mental health conditions may develop, and Touroni explains that “Processing these difficult experiences in therapy is a way of preventing any future mental health problems from occurring.”

Martin Preston

If left untreated, dissociation and trauma can lead to further health complications and destructive behaviors including abuse of substances such as alcohol or drugs, as a way to cope with the emotions and stress a person may be feeling.

— Martin Preston

There’s no medication approved specifically to treat dissociation, but a number of forms of psychotherapy may be used, as well as other medications that can help with symptoms associated with dissociation. These may include antidepressants, anti-anxiety medications, and sleep aids. 

“It’s important that the person finds a safe space to process the traumatic event and its impact on them,” says Touroni.

“This can happen in different ways through therapy. There are a range of psychological therapies that specifically target trauma such as trauma-focused cognitive behavioral therapy (CBT), schema therapy, and eye movement desensitization and reprocessing (EMDR) therapy.”

While preventative care is the best option, there are things that you can do to help manage both dissociation itself and related mental health conditions—of course, when you’re finding it difficult, this can be easier said than done. These include getting enough sleep, maintaining a healthy diet and a regular exercise routine, and doing your best to identify triggers.

Press Play for Advice on Healing From Trauma

Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring psychiatrist Dr. Bessel van der Kolk, shares science-backed strategies to heal from trauma. Click below to listen now.

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What This Means For You

Traumatic events can be difficult to deal with for anybody, and dissociation can be a way of coping in the aftermath. However, it'll have the opposite effect in recovery. If you find yourself struggling or dissociating after a traumatic event, reach out to someone for support.

2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lebois L, Harnett N, van Rooij S, et al. Persistent dissociation and its neural correlates in predicting outcomes after trauma exposureAJP. 2022. doi:10.1176/appi.ajp.21090911

  2. Lanius R. Trauma-related dissociation and altered states of consciousness: a call for clinical, treatment, and neuroscience researchEuropean Journal of Psychotraumatology. 2015;6(1). doi:10.3402/ejpt.v6.27905