Dissociation (also called derealization) is often described as disconnection from one’s thoughts, memories, and body.
Although dissociation is actually a common symptom of many mental disorders, it is not unusual to see it in people with stable mental health as well. In fact, you’ve probably been in a state of derealization before. Although it is so common, there is not much awareness about it. A lot of people don’t even know it’s a concept. I didn’t realize it until I saw a therapist and got diagnosed. To help someone with dissociation, it is important to understand what it is.
What is dissociation?
Better Health describes dissociation as “a mental process of disconnecting from one’s thoughts, feelings, memories, or sense of identity.” The formal medical description of dissociation gives us a good idea of what it is. But thinking of examples can be difficult. Dissociation is an incredibly diverse group of symptoms. Here are some examples :
- don’t feel real
- Feeling that the environment is not real
- Feeling that the people around you aren’t real
- Feeling that you don’t control your body
- Feeling that your thoughts aren’t really “your own”
- fuzzy memories
- Out of body experiences
- Being overwhelmed by an emotion that may not make sense
- Feeling like your body is on “autopilot”
These examples are the most common, but they are not all. These feelings usually occur in “episodes” or over long periods of time ranging from minutes to weeks. Although common in individuals, those who experience frequent dissociation are often diagnosed with dissociative disorders. Additionally, post-traumatic stress disorder (PTSD) and depression are conditions that are often accompanied by dissociation. Within the framework of dissociation, there are more precise terms that are essential to understand it.
1. Derealization
It is the particular word that describes the feeling that the world is not real. When I experience derealization, the world seems blurry. I feel completely detached, like I’m watching the world from a security camera.
2. Depersonalization
This describes the feeling of being separated from one’s body. When I experience depersonalization, I feel like a passenger in my body, rather than the person driving. I call it the Go-Pro feeling because it sounds like one of those cycling YouTube videos.
3. Dissociative amnesia and identity confusion
Although uncommon in people without dissociative disorders, dissociative amnesia is associated with memory instability. Often people are unable to remember traumatic events. Micro-amnesia occurs when small gestures are forgotten during dissociative episodes. This often happens with identity confusion, or disconnection between self and self. It’s similar to depersonalization, though it connects directly to his worldview and self-view.
Why do we separate?
Dissociation is the mind’s response to intense trauma. The brain does this to protect itself, especially if the trauma is severe. Some people may subconsciously dissociate in response to stressors in order to calm themselves down. Dissociation can also be the result of substance use. In this case, it is important to consult a doctor. Whatever the reason it is caused, it is valid and something that needs more awareness.
What are the types of dissociative disorders?
Dissociation is a symptom of many other disorders. This includes, but is not limited to, borderline personality disorder (BPD), PTSD, schizophrenia, bipolar disorder, and depression.
1. Dissociative Amnesia (DA)
As described above, AD is the extensive forgetfulness of memories and information that is not explainable by other causes. It often coexists with other disorders.
2. Dissociative Fugue (DF)
DF is the unexpected journey from one place to another, in which the person is unable to remember why and/or how they got there. This is accompanied by the loss of memory before the trip and their identity. It can also cause amnesia from the trip itself.
3. Derealization/depersonalization disorder (DPDR)
DPDR is a disorder characterized by intense symptoms of derealization and depersonalization. It is diagnosed in people who have recurrent, but unaltered, feelings of dissociation (related to DID).
4. Dissociative Identity Disorder (DID)
It is an incredibly complex disorder. This is the most severe form of dissociation. DID is described as the presence of two or more identities in the mind and body of a host. This is the result of a fragmented sense of identity caused by repeated severe trauma during the developmental period. DID is often accompanied by DA and DF. A dissociative state in people with DID occurs primarily during transitions between identities. In many cases, it can be dangerous to forcibly shut off a “switch”, so be sure to ask how to help yourself before taking action.
How can we help?
Everyone is different, so there is no single way to help someone out of a dissociative episode without medication or a professional at hand. Remember: If you can’t help someone out of an episode, or if they become a danger to themselves or others, seek medical attention immediately.
When I am in a dissociative state, it is extremely difficult to get out of it. Usually, I am unable to take care of myself. But when I see an episode start, or a family member, I go to these strategies:
- Take a shower — Usually I take cold ones to help my body register my surroundings
- Listen to loud music — I prefer the opposite of soothing music
- deep pressure — Tight cuddles (if you don’t have anyone to cuddle, cuddle!), weighted blankets, animals
- To exercise — I wouldn’t try strenuous exercise; yoga or play just dance often works for me!
- Change environment — Get out, get down or change rooms
- get stimulated — Read, watch videos, play with puzzles
There are hundreds of other ways to ground yourself (or someone else!). For more ideas, go here. When helping others, remember to ask their opinion if they are able to communicate. If not, try to encourage hand signal communication and the use of text-to-speech features in technology.
If you struggle with dissociation, remember that you are not alone. There are resources online and potentially in your community that can help you on your journey. Healing is not linear, and remember to take care of yourself first. If you know someone who struggles with dissociation, support them in a non-binding way. Raising awareness of dissociation is essential, and educating yourself and others is an amazing first step.
More resources
- What is dissociation?
- Dissociative disorders
- Unlink FAQ
- Grounding Techniques
- International Society for the Study of Trauma and Dissociation
