Anxiety & Dissociation: What is the Connection?

Spacing out is a normal human experience. We let our minds wander, let our thoughts drift, and sometimes we can do it for so long that time seems to pass without us even noticing it.

It’s perfectly normal to do this occasionally, but when spacing out begins to affect your life or when daydreaming leaves you missing out on the day because you’ve been too into the dream, it can be something called dissociation. 

The average person might consider dissociation to be an extreme — when someone “blacks out” for hours or days or years before suddenly becoming themselves again. But dissociation is far more elusive of an experience than those extremes, and it can be caused by far more subtle triggers than you might expect. 

People who dissociate might do this for a number of reasons. If you’re a person with an anxiety disorder, or if a loved one has anxiety and seems to dissociate on a regular basis, you might wonder if there’s a connection. 

It turns out that anxiety and dissociation have a lot more in common than you might think.

Dissociation is a state in which your consciousness, memory, thoughts and identity temporarily disconnect from reality, resulting in things like out-of-body experiences, feelings of detachment and even a lack of self-identity.

There are levels of dissociation. Milder forms may have some similarities to that feeling of “spacing out” that we mentioned, where you lose track of time and miss a conversation that’s going on right in front of you.

But more often than not, the serious, mental health condition versions of dissociation and dissociative disorder occur as a result of trauma — dissociative disorder typically develops as a coping mechanism to deal with those traumatic experiences.

Trauma can lead to a lot of conditions, from the telltale signs of posttraumatic stress disorder to generalized anxiety disorder to dissociative disorder. In children, for instance, dissociation symptoms might be the result of the trauma of being neglected, or emotionally or sexually abused.

As adults, the same types of abuse might cause dissociative experiences and disorders, as might living through combat, natural disasters and other traumatic events.

Dissociation, first and foremost, is not a dangerous condition. It’s important to understand this, because while there are some examples of people with dissociative disorder committing crimes and other horrible acts while in a dissociative episode, the reality is that most dissociative people are not criminally violent or evil. Instead, they’re in a reactive state because their brain has perceived some sort of danger.

Symptoms of dissociation and dissociative disorders are far more introspective than you might imagine. They include memory loss, out-of-body experiences, a lack of self-identity, emotional numbness and detachment from your own emotions.

People with dissociative disorders or people who have experienced dissociative episodes are also at a heightened risk for conditions like depression, anxiety and suicidality or suicidal ideation.

A person with dissociation might also experience specific disorders as a result of their dissociation. For example, dissociative amnesia is amnesia due to dissociation, while depersonalization is a detachment from your own actions, feelings and thoughts.

It’s fair to say that dissociation and anxiety are sort of siblings in the space of mental health disorders. Both can be caused by traumas of the past. Both can be symptoms of something greater that hasn’t been addressed. 

Both conditions are the result of your own mind trying to protect you, either from fear or worry or from memories of traumas past.

These conditions also increase risk factors for one another — anxiety can cause dissociation and dissociation can cause anxiety.

Is dissociation common in patients with anxiety disorders? As you probably expect by now, the answer is a firm yes. 

Data shows a lot of connections between the two conditions — dissociative experiences are a somewhat commonly reported symptom of panic disorder, which is one of the more extreme types of anxiety disorders.

Recent research shows that depersonalization is particularly common in conditions like panic disorder, though future studies are needed to fully understand the relationship between dissociation and anxiety.

According to the National Alliance on Mental Illness, the best options for getting dissociation symptoms under control are the common therapeutic categories of medication and psychotherapy.

In particular, they point to two kinds of therapy that are considered effective in helping people with dissociative disorders: cognitive behavioral therapy (CBT) and a related form called dialectical behavioral therapy or DBT.

CBT, in fact, is highly regarded for effectively helping people cope with anxiety. At its heart, CBT isn’t a therapy so much as it’s a therapeutic process — one geared toward learning to spot, control, and manage anxious thoughts rather than let them control you. 

CBT is all about learning self awareness, and training yourself to reject irrational thoughts and those extreme anxiety responses that may cause dissociation and other issues if left unmanaged.

The process of DBT is similar to CBT but with an emphasis on accepting uncomfortable thoughts and feelings instead of fighting against them, in order to understand that change is possible.

As for pharmacological treatment, dissociation can be helped with antidepressants, a class of medications originally approved to treat depression symptoms and people with depressive disorders. While treating depression is their primary use, antidepressants can also be used to treat other mental health disorders such as anxiety and dissociative disorder.

Antidepressants like the popular selective serotonin reuptake inhibitors (or SSRIs) help your brain rebalance neurotransmitter supplies — this, in turn, regulates mood and can help with dissociation symptoms.

Whether you’ve been dissociating for a long time and are just now seeing the pattern, or you’ve experienced your first dissociative episode and want to get help immediately, we can tell you that you’re not abnormal, weird or alone. 

Like other mental health conditions, dissociation has been unfairly painted with Hollywood’s brush over the years, which comes with stigma and some unfair shame for people dealing with these problems. 

The truth is that dissociation might be the result of conditions like dissociative identity disorder, borderline personality disorder, post-traumatic stress disorder or other conditions, and a healthcare professional is the only person who can help you determine where this all begins for you.

You are not the problem — you are someone in need of treatment and support. There is no worse treatment than no treatment.

Ready to get the support you deserve and the treatment that will help you live your life again? We can help. 

We can start with more information: explore our mental health resources guide if you have lingering questions about mental health treatment. 

If you’re ready to put your first foot forward on treatment, we can help with that too — consider our telepsychiatry or online counseling for your therapy needs today.

Help is available now. Start your treatment journey today.