Anxiety and Dissociation: What's the Connection?

Options for managing dissociation anxiety illustration

 Verywell / JR Bee

If you've ever felt disconnected from the world when you're anxious, you've probably wondered how to stop dissociating because of anxiety. 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 doesn't 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 on 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 learn ways to cope.

Symptoms of Anxiety and Dissociation

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:

  • Alterations in your perceptions
  • Distorted sense of time
  • Emotional or physical numbing
  • Feelings 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:

  • Feeling like the world around you is not real
  • Feeing the world as flat, dull, or grey
  • Having tunnel vision when you look at the world

Diagnosis of Dissociation

There are three types of dissociative disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, these are separate from dissociation related to anxiety:

  • Depersonalization disorder: Characterized by ongoing feelings that you are detached from the world around you
  • Dissociative amnesia: Characterized by trouble remembering events or having amnesia for events due to dissociation
  • Dissociative 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 as a symptom include:

Causes of Dissociation

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 the following types of trauma:

  • Accidents
  • Assault
  • Natural disasters
  • Military combat
  • Sexual or physical 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 likely not aware of.

Treatment of Anxiety and Dissociation

Anxiety is a treatable condition. The U.S. Preventative Services Task Force recommends that all adults below the age of 65 get screened for symptoms of an anxiety disorder during their regular doctor's visits.

Although there is no specific treatment for dissociation, medications, and psychotherapy 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). Eye movement desensitization and reprocessing (EMDR) is another therapy that is sometimes used.

Since dissociation can interfere with the effectiveness of treatment, your therapist may ask you to do the following things to snap out of a period of dissociation:

  • Make eye contact
  • Eat a piece of candy to snap into the moment
  • Get up and walk around for a bit
  • Name five animals with letters that match the first five letters of the alphabet
  • Name five things you see, hear, and feel
  • Smell a particular scent for grounding, such as lavender
  • Explain what happened if you look spaced out or recall what you were talking about when you spaced out
  • Remember how using spacing out is an avoidance strategy

How to Stop Dissociating

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 though 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:

  • Get enough sleep each night
  • Get regular exercise every day
  • Practice grounding techniques as noted in the treatment section above
  • Prevent anxiety from becoming overwhelming
  • Reduce daily stress and triggers

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 your treatment plan.

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.

Frequently Asked Questions

  • Is dissociation a symptom of anxiety?

    Dissociation can be a symptom of anxiety, particularly when a person is experiencing a great deal of stress or when the situation is inescapable. Dissociation can also be a symptom of other mental health conditions including post-traumatic stress disorder, schizophrenia, borderline personality disorder, and bipolar disorder.

  • What is anxiety dissociation like?

    When you experience dissociation caused by anxiety, you may feel detached and disconnected from yourself. Your perceptions may change and time may seem to go faster or slower. You may feel emotionally numb, and the experience may seem unreal, flat, or dull.

  • How do I know if I am dissociating?

    Signs that you might be dissociating include:

    • Feeling "zoned out"
    • Feeling like you are "losing time"
    • Feeling as if you are watching situations from outside of your body
    • Feeling as if the world is no longer real
    • Feeling emotionally numb and unable to respond how normally would
  • How do you fix dissociation anxiety?

    If you are experiencing dissociation, it is important to talk to a mental health professional. They can recommend treatments, including medications and therapy, that can help. In terms of managing dissociation on your own, finding ways to groud yourself in reality is important. When you start to dissociate, work on grounding and centering yourself in the moment. Making eye contact with another person, naming things you can detect with your senses, focusing on aspects of your environment, or consciously forcing yourself to avoid zoning out are a few strategies you can try.

6 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.
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  2. National Alliance on Mental Illness. Dissociative Disorders.

  3. 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.

  4. Lanius RA. Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience researchEur J Psychotraumatol. 2015;6. doi:10.3402/ejpt.v6.27905

  5. US Preventive Services Task Force. Screening for Depression and Suicide Risk in Adults: US Preventive Services Task Force Recommendation StatementJAMA. 2023;329(23):2057–2067. doi:10.1001/jama.2023.9297

  6. Cleveland Clinic. Dissociative Disorders: Management and Treatment.

Additional Reading

By Arlin Cuncic, MA
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." She has a Master's degree in psychology.