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What is dissociation and what does it mean to be dissociated?
These days, we have a much larger vocabulary to describe our feelings than a generation ago. From more words for anxiety to a more encompassing definition of sadness, there is an abundance of words for symptoms, side effects and the burdens of mental illness.
But within the growing body of terms, dissociation is arguably the least well understood word in the game.
If you’ve been told you’ve experienced dissociation, if you’ve been feeling different or like you’re not “present,” then you may worry that dissociation might be at play. Could it lead to bigger problems? Is it the result of a bigger mental health disorder or mental health crisis you need to prevent?
What our mental health does or doesn’t do largely depends on how we take care of it, so coming here to learn about dissociation is a great first step to protecting yourself from further harm or problems. Knowledge is a useful tool for dealing with mental health conditions.
As for dissociation, it’s not as confusing as you might suspect. In fact, it’s pretty simple to understand the basics.
Let’s start by dropping the stigma around the idea of dissociating. Dissociation is something we all do, to a degree. In fact, a good example of dissociation is just daydreaming. When you “zone out” or let your thoughts wander away from the moment, you’re dissociating.
Like sleeping, dissociation is generally a safe thing to do, as long as you consider context — it’s fine to space out when you’re laying on the couch on the weekend, but doing so while operating heavy machinery can be very dangerous. And that’s very important to understand, because context also determines how healthy or unhealthy dissociative behaviors really are.
Getting lost in a movie, losing track of time while reading or experiencing the trance-like state of “highway hypnosis” while on a long-haul drive are all fairly common experiences, but not all dissociations are caused by everyday triggers — and not all of them have healthy outcomes.
According to the American Psychological Association, dissociation is really just a defense mechanism. In a dissociative episode, for instance, a person’s fears or impulses to respond to something are compartmentalized or separated from the rest of their psyche.
Put another way: dissociation is a coping mechanism our brains employ to protect us from our own thoughts.
This can be powerful in people with anxiety disorders or post-traumatic stress disorder (PTSD) because it can prevent those intrusive thoughts from taking hold and sending someone into a panic attack when reliving those traumatic events.
Shutting out thoughts might also mean shutting out external stimuli, like the people talking directly to you.
As a result, there are some side effects (or symptoms, depending on how you view dissociation) that can result from a dissociative episode, like memory loss or detachment from reality.
We’re going to focus on the dangerous kind of dissociation now, because while daydreaming through a class may harm your grade in geometry, it’s not necessarily a disorder.
Disordered dissociation can cause several problems.
Dissociation can first and foremost affect your memory. You can forget about entire events (adverse events or otherwise) and conversations, and potentially longer stretches of your life as a dissociative disorder makes days or weeks simply fail to save to your brain’s hard drive.
People who dissociate might also experience an emotional detachment from reality. It’s necessary for the brain’s successful dissociation to sometimes just pretend something isn’t there.
That’s why you’ll sometimes see hoarders, people with eating disorders or people with major depressive disorder simply refuse to acknowledge the problem: they may not be able to.
In some cases, dissociation may be so severe that it appears as a catatonic state. In rare circumstances, this can appear as the individual having a wholly separate personality.
Dissociative identity disorder is a disorder describing just this scenario: a person’s dissociation has become extreme enough to have implications for who they are, how they act and how they identify themselves.
It’s a rare condition — only about 1.5 percent of the population may have it. But in its extremes, it can lead to violence or suicidal ideation, both of which can come from what is described as a unified sense of self as a result of trauma.
So, what do we do about dissociation? Can it be treated? Well, it depends.
You’re likely not going to be able to stop daydreaming. On the other hand, dissociative disorders can be treated over time and can help some people find a fuller measure of their “self” and a new balance.
It does, however, depend on what your ultimate goal is for treatment. Making dissociations go away is often going to be possible only with treatment for the bigger issue, and those may be difficult things to treat.
Most people seek safety and stability, and to reintegrate their consciousness by dealing with whatever trauma may have caused the fracture in the first place.
Let’s take a look at how that’s done.
Coping with individual dissociative episodes and patterns of dissociation can be difficult for you and your loved ones, so there are some basic techniques that can help with management.
Experts point to grounding techniques (which can help someone return to the present) as one way of helping a loved one or yourself cope in the moment.
In the larger picture, however, dealing with trauma and other disorders that are causing dissociations is the key to getting things under control.
Generally, this care will come in the form of therapy like cognitive behavioral therapy, which can help people master the patterns of thought that lead to dissociations with practice.
Although this is where we have to stop and say that, while there’s a laundry list of treatment options, generally, the best treatment for you is going to be tailored, specific and a combination of effective tools, including what we’ve already mentioned.
In other words, the best treatment for dissociation will be whatever results from a conversation between you and the right professional.
Dissociative episodes are typically a signal that something may not be the way it’s supposed to be, and if you’ve begun to see dissociation as a problem for your quality of life, it may be time to get help.
If you’re wondering where to start the search, consider our online therapy platform, where you can be connected with mental health professionals that can help get you the treatment you need.
Our mental health resources can also help you learn more about how dissociation’s associated disorders work, and how they can be treated.
Dissociation isn’t always harmful, but if zoning out is putting you in danger of not living life to the fullest, get back in the zone and get help today.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.
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