What Is Dissociation?

Medically Reviewed by Zilpah Sheikh, MD on July 14, 2024
Written by Keri Wiginton, Sarah Amandolare, Kristin Mitchell
8 min read

Dissociation is a break in how your mind handles information. You may feel disconnected from your thoughts, feelings, memories, and surroundings. It can affect your sense of identity and your perception of time.

The symptoms can go away on their own. It may take hours, days, or weeks. You may need treatment, though, if your dissociation is happening because you've had an extremely troubling experience or you have a mental health disorder like schizophrenia.

Dissociation vs. disassociation

Dissociation is an involuntary experience that occurs when you feel disconnected from yourself or your environment.

Disassociation is used in contexts outside of mental health but can also be used to describe a mental process. It is a conscious separation or detachment from something or someone and can be a coping mechanism.

When you have dissociation, you may forget things or have gaps in your memory. You might think the physical world isn't real or that you aren't real.

You may notice other changes in the way you feel, such as:

  • Have an out-of-body experience
  • Feel like you are a different person sometimes
  • Feel like your heart is pounding or you're lightheaded
  • Feel emotionally numb or detached
  • Feel little or no pain

Other symptoms you can get are:

  • Have an altered sense of time
  • Not remember how you got somewhere
  • Have tunnel vision
  • Hear voices in your head
  • Have intense flashbacks that feel real
  • Become immobile
  • Get absorbed in a fantasy world that seems real

What does dissociation feel like?

You may feel outside of your body, as if you're watching yourself. You might also feel detached from your emotions and identity. Some people suddenly realize that they can't remember something. They might wander while dissociating and forget how they arrived at a certain place. They might also forget especially distressing or shocking experiences. Some people with dissociation hear voices in their head or feel overtaken by alternate identities.

Dissociation anxiety

Dissociation is linked to anxiety. You might experience anxiety or panic because of how disorienting dissociation feels. Dissociation is also a symptom of some anxiety disorders, including acute stress disorder and posttraumatic stress disorder (PTSD). People who have experienced trauma may dissociate to avoid returning to the experience in their minds.

Trauma. You may psychologically disconnect from the present moment if something really bad happens to you. This is called peritraumatic dissociation. Experts believe this is a technique your mind uses to protect you from the full impact of the upsetting experience you had.

Peritraumatic dissociation can happen when you've been through things like:

  • Sexual or physical assault
  • Childhood abuse
  • Combat or military survival training
  • Torture or capture
  • Motor vehicle accidents
  • Natural disasters

If you've had disturbing experiences over and over, you may get severe forms of dissociation known as dissociative disorders. You may leave your normal consciousness, forget things, or form different identities within your mind.

Hypnosis. When you daydream or let your mind wander, you are in a type of "auto-hypnotic state." You may no longer have a strong awareness of your body. Other types of hypnosis may put you in a deeper dissociated state. A trained professional may use therapeutic hypnotherapy to help you manage pain, anxiety, addictive behaviors, or PTSD.

Certain drugs. You may lose your sense of identity or reality if you drink alcohol or take illicit drugs. Research shows that people who take psychedelics, like psilocybin and LSD, report briefly losing their sense of self.

Meditation. Like daydreaming, you may become less aware of the here and now while you meditate. Some expert meditators say they lose an awareness of their self or body during certain mindfulness meditation practices.

If you've had disturbing experiences over and over, you may get severe forms of dissociation known as dissociative disorders. You may leave your normal consciousness, forget things, or form different identities within your mind.

Types include:

  • Depersonalization disorder. This can feel out of body or like separating from yourself.
  • Derealization disorder. The world seems dreamlike and separate from you. Your sense of time could be affected, creating a sense that time is speeding up or slowing down.
  • Dissociative amnesia. Usually occurring suddenly, this type of memory loss can last only minutes or hours, or in rare cases months or years. You may forget traumatic experiences or basic information about your life.
  • Dissociative identity disorder. This disorder used to be known as multiple personality disorder. It may feel like people are living inside your mind, interfering with your sense of self. You may switch identities.

Albuminocytologic dissociation

Albuminocytologic dissociation refers to cerebrospinal fluid with a high protein level and normal cell count. It is used to help diagnose Guillain-Barré syndrome, a condition where nerve cells are attacked by the immune system, causing weakness and sometimes paralysis

You may have dissociation with certain mental health disorders. Besides schizophrenia and PTSD, dissociation is also linked to:

Autism and dissociation

People on the autism spectrum may be prone to dissociate. Experiences that can trigger dissociation, like anxiety and trauma, are common among people with autism.

Autism symptoms, such as sensory challenges and problems with feeling emotions, can be intertwined with dissociation. Dissociation may be a way for people with autism to cope with sensory overload, feeling overwhelmed by noise or touch, or changes in surroundings.

It can be tricky to recognize dissociative identity disorder in people who mask (hide) their autism spectrum disorder. Masking can cause identity confusion and a feeling of being disconnected from your true self. Many people on the autism spectrum have rich inner worlds and are prone to daydreaming, which can be confused for dissociation.

Dissociation and depression

If you have frequent episodes of dissociation, you're also more likely to have chronic depression. Most people who have dissociative identity disorder also have depression.

There's no specific medication for dissociation, but your doctor may prescribe antidepressants to treat your connected symptoms, like depression and anxiety.

 

A person might dissociate during or after a traumatic experience, such as:

  • Being in a car accident
  • Being the victim of a crime
  • Being sexually or physically assaulted
  • Experiencing childhood trauma or abuse
  • Being a combat veteran
  • Surviving a natural disaster, like a hurricane or tornado

It's possible to have dissociation and not know it. If you have a dissociative disorder, for example, you may keep your symptoms hidden or explain them another way.

Common signs you or a loved one should watch out for include:

  • Rapid mood swings
  • Trouble remembering personal details
  • Forgetfulness about things you've said or done
  • Behavior or abilities that change (altered identities)
  • Depression, anxiety, or panic attacks
  • Thoughts of suicide or self-harm
  • Substance abuse
  • Failed treatments or hospitalizations for mood disorders

Children with a dissociation disorder may:

  • Seem absent-minded
  • Stare out the window a lot
  • Have imaginary friends
  • Forget they've said or done something
  • Have ADHD or other learning disabilities

Your doctor may refer you to a mental health specialist for a diagnosis. You might see a psychiatrist, psychologist, or psychiatric social worker. They will want to know about any severely troubling events you've had in the past.

Dissociation test

Your doctor will give you a physical exam and ask about any past physical or mental health issues. You should let them know if you take illicit drugs or any medication. They may check a sample of your blood or run other tests to rule out an illness or other medical condition as the cause of your dissociation. They may also order an electroencephalogram, a painless test that measures brain waves, to rule out certain types of seizure disorders that can sometimes cause dissociation.

A mental health specialist may give you other tests, including:

  • Dissociative Experiences Scale
  • Structured Clinical Interview for Dissociation

There is no specific drug to treat dissociation, but it's possible to get better with a mix of medication and counseling. Your doctor will tailor your care based on how severe your symptoms are and their cause.

Your treatment may include:

Psychotherapy. This kind of treatment may help you find the cause of your dissociation. But the goal is to help you manage or get rid of your symptoms.

Types of psychotherapy may include:

Cognitive behavioral therapy. It's designed to help you see and change negative thoughts and behaviors.

Hypnotherapy. You may find it easier to explore and process your memories when you are in a relaxed state. You should only do this with a professional certified in hypnosis who is trained in dissociative disorders and PTSD.

Phasic trauma treatment. This treatment aims to help you stop suicidal thoughts or self-destructive behavior first. Then your psychotherapist will slowly help you process any traumatic memories and reintegrate your identities, if necessary.

Family treatment. You may find it helpful to get support from a spouse, partner, or other loved one.

Dialectical behavioral therapy. It may help you learn skills to control your emotions and stop harmful behavior. This is a common treatment for borderline personality disorder.

Eye movement desensitization and reprocessing. It uses techniques from cognitive behavioral therapy along with visual exercises to help you work through memories of severely troubling events. It may help stop your nightmares, flashbacks, or other PTSD symptoms.

Add-on medication. Your doctor may give you antidepressants, a mood stabilizer, or other drugs to help with anxiety or sleep problems. If you have schizophrenia, you may need an antipsychotic.

Dissociation makes you feel disconnected from yourself and your surroundings. You may also experience gaps in memory, an altered sense of time, or intense flashbacks. Mental health conditions, such as PTSD, panic disorder, and depression can involve dissociation.

What are the four stages of dissociating?

While there aren't specific stages of dissociating, there are many types, from milder to severe. If you've had disturbing experiences over and over, you may get severe forms of dissociation and forget things or form different identities within your mind.

How do I know I'm dissociating?

You may not realize that you're dissociating, or you could feel detached from your body and yourself.

At what stage do I know I need to consult the doctor for dissociation?

Talk to a doctor or health care provider if you experience recurring symptoms of dissociation, which can include having an out-of-body experience or feeling like you're a different person from time to time.

Does "dissociation" come under the umbrella of medical mental health disorder?

Dissociative disorders are mental health conditions; however, you can have dissociation symptoms without having a dissociative disorder. Dissociation can be a symptom of a mental health condition such as PTSD or depression.

What is dissociative amnesia? 

Dissociative amnesia is a dissociative disorder that involves memory loss, usually due to a traumatic experience.