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.

While about half of people may have experienced an event of dissociation in their lifetime, only about 2% are actually diagnosed with what is known as a dissociative disorder.

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.

Characteristics

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:

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

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 some sort of trauma, such as sexual or physical abuse, or a life-threatening or traumatic event, such as natural disasters or long-term 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.

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:

• Dissociative amnesia: Characterized by trouble remembering events or having amnesia for events due to dissociation
• Depersonalization disorder: Characterized by ongoing feelings that you are detached from the world around you
• 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 panic disorder, generalized anxiety disorder, specific phobias, and social anxiety disorder.

Treatment

Although there is no specific treatment for dissociation, medications and counseling 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) or medication (such as antidepressants). Eye movement desensitization and reprocessing (EMDR) is another therapy that is sometimes used.

During a therapy session, the therapist may do some of the following things to get you to snap out of a period of dissociation. This is important because dissociation can interfere with the effectiveness of treatment for anxiety disorders:

• Asking you to make eye contact
• Saying "You look spaced out, what happened?"
• Saying "Let's check what we were talking about when you spaced out"
• Saying "Remember when we talked about how you use spacing out as an avoidance strategy?"
• Asking you to name five things you see, hear, and feel
• Asking you to name five animals with letters that match the first five letters of the alphabet
• Using a particular scent for grounding such as lavender
• Asking you to eat a piece of candy to snap into the moment
• Asking you to get up and walk around for a bit

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:

• Getting regular exercise every day
• Getting enough sleep each night
• Practicing grounding techniques as noted in the treatment section above
• Reducing daily stress and triggers
• Preventing anxiety from becoming overwhelming

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.