GAD Symptoms Dissociation as a Symptom of Anxiety By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Arlin Cuncic Medically reviewed by Medically reviewed by Steven Gans, MD on August 11, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on July 08, 2020 Print Verywell / JR Bee Table of Contents View All Table of Contents What Is Dissociation? Characteristics Causes Diagnosis Treatment Coping 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. 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. What Is Dissociation? 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 perceptionsDistorted sense of timeEmotional or physical numbingFeelings 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 greyFeeling like the world around you is not realHaving tunnel vision when you look at the world Depersonalization, Derealization, and Panic Disorder 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. What to Know About Mood Disorders 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 dissociationDepersonalization disorder: Characterized by ongoing feelings that you are detached from the world around youDissociative 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 contactSaying "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 feelAsking you to name five animals with letters that match the first five letters of the alphabetUsing a particular scent for grounding such as lavenderAsking you to eat a piece of candy to snap into the momentAsking you to get up and walk around for a bit Find Help With the Best Online Anxiety Support Groups 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. While you may not be able to control dissociation, you can reduce the likelihood of it happening and also try to learn to ignore it when it does happen rather than letting your anxiety make it spiral out of control. 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 dayGetting enough sleep each nightPracticing grounding techniques as noted in the treatment section aboveReducing daily stress and triggersPreventing 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. If you or a loved one are struggling with dissociation anxiety or another mental health issue, 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. How to Find a Therapist for Anxiety Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Lyssenko L, Schmahl C, Bockhacker L, Vonderlin R, Bohus M, Kleindienst N. Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale. Am J Psychiatry. 2018;175(1):37-46. doi:10.1176/appi.ajp.2017.17010025 National Alliance on Mental Illness. Dissociative Disorders. Gentile JP, Snyder M, Gillig P. Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder. Innov Clin Neurosci. 2014;11(7-8):37-41. Cleveland Clinic. Dissociative Disorders: Management and Treatment. Updated March 3, 2018. Additional Reading Moscariello MM, Ratti F, Quartini A, Forcén FE, Munuera JN, Bersani G. Dissociative symptoms in patients with mood and anxiety disorders. Riv Psichiatr. 2010;45(4):234-243. doi:10.1016/s0924-977x(09)70749-7 National Alliance on Mental Illness. Dissociative disorders. Prasko J, Grambal A, Kasalova P, et al. Impact of dissociation on treatment of depressive and anxiety spectrum disorders with and without personality disorders. Neuropsychiatr Dis Treat. 2016;12:2659-2676. doi:10.2147/ndt.s118058 University of Washington. What is dissociation and what to do about it? Warshaw MG, Fierman E, Pratt L, et al. Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD. Am J Psychiatry. 1993;150(10):1512-1516. doi:10.1176/ajp.150.10.1512