Dissociation as a Symptom 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 does not 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 in avoidance coping, it "works" in the short-term but has long-term negative consequences.

What Is Dissociation?

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.

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 and anxiety 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 healthy trauma processing and coping. Because of this, it's important to address dissociation through treatment and learning ways to cope.

Symptoms

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 the following:

• Alterations in your perceptions
• Distorted sense of time
• Emotional or physical numbing
• Feelings of yourself being unreal or absent

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:

• Feeling like the world around you is not real
• Feeing the world as flat, dull, or grey
• Having tunnel vision when you look at the world

Diagnosis

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

• Depersonalization disorder: Characterized by ongoing feelings that you are detached from the world around you
• Dissociative amnesia: Characterized by trouble remembering events or having amnesia for events due to dissociation
• Dissociative identity disorder: Characterized by the presence of two or more distinct personalities and gaps in memory (formerly known as multiple personality disorder)

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 include: 

• Generalized anxiety disorder
• Panic disorder
• Social anxiety disorder
• Specific phobias

Causes

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:

• Accidents
• Assault
• Natural disasters
• Military combat
• Sexual or physical abuse

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 not aware of.

Treatment

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 as cognitive behavioral therapy or dialectical 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:

• Make eye contact.
• Eat a piece of candy to snap into the moment.
• Get up and walk around for a bit.
• Name five animals with letters that match the first five letters of the alphabet.
• Name five things you see, hear, and feel.
• Smell a particular scent for grounding, such as lavender.
• Explain what happened if you look spaced out or recall what you were talking about when you spaced out.
• Remember how using spacing out is an avoidance strategy.

Coping

The key to managing dissociation related to anxiety is to practice grounding techniques to bring yourself back into the present moment. You can do this by always having a "grounding plan" that you put in place when you find yourself spacing out or otherwise feeling as those you are dissociating.

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:

• Get enough sleep each night
• Get regular exercise every day
• Practice grounding techniques as noted in the treatment section above
• Prevent anxiety from becoming overwhelming
• Reduce daily stress and triggers

A Word From Verywell

Are you concerned about dissociation anxiety? It could be that you actually have anxiety about your dissociation, rather than dissociation that is simply caused by anxiety.

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 treatment.

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.