Why Dissociation Happens: Causes and Effects

AT A GLANCE

• About 75% of people experience at least one dissociative episode in their lifetime.
• Common causes include trauma, stress, and mental health conditions such as PTSD and anxiety.
• Mindfulness, therapy, and self-care techniques can help prevent and manage dissociation

Dissociation is an experience where you feel detached from yourself or from reality. You may feel disconnected from your body, thoughts, surroundings, memories, or even loved ones. A dissociative episode can last from a few minutes to several days, depending on the cause.

For many people, dissociation is an involuntary response to trauma or extreme stress. Out-of-body experiences are more common than most people think—research suggests that around 75% of individuals will experience at least one dissociative episode in their lifetime. However, frequent episodes may indicate an underlying mental health condition. Fortunately, therapy and prevention strategies can help reduce symptoms and improve overall well-being.

Symptoms

The most common symptom of dissociation is feeling detached from yourself or the world around you. While it is not a complete loss of reality, dissociation can significantly distort how you perceive things. Symptoms may include:

• Feeling like you are outside your body or watching yourself from above
• Emotional numbness or apathy
• Feeling disconnected from people around you
• A sense that your environment is unreal
• Distorted sense of time (too fast or too slow)
• Memory gaps
• Not remembering how you arrived somewhere
• Flashbacks that feel like they’re happening in the present
• Being absorbed in a fantasy world
• Hearing muffled voices or seeing bright flashes
• Depressed mood
• Persistent anxious thoughts

Causes

Dissociation can be linked to several mental health conditions and, less commonly, physical health issues affecting the brain. Common causes include:

• Dissociative Identity Disorder (DID): Presence of multiple distinct identities or “alters.”
• Depersonalization/Derealization Disorder (DPDD): Feeling detached from your body or environment.
• Dissociative Amnesia: Difficulty recalling important or traumatic events.
• Borderline Personality Disorder (BPD): Unstable emotions, fear of abandonment, and identity issues.
• Schizophrenia: Hallucinations, delusions, and impaired reality perception.
• Post-Traumatic Stress Disorder (PTSD): Caused by traumatic events such as abuse, violence, accidents, or loss.
• Depression: Persistent sadness and loss of interest.
• Panic Disorder: Intense fear without actual danger.
• Anxiety Disorders: Excessive worry triggered by stress.
• Traumatic Brain Injury (TBI): Brain damage from a forceful impact.
• Epilepsy: Repeated seizures affecting brain function.
• Migraine: Severe headaches that disrupt perception.
• Substance Use: Alcohol, marijuana, cocaine, methamphetamine, and other drugs.
• Sleep Deprivation: Lack of sleep blurs the line between reality and imagination.
• Stress: Everyday stressors or major life challenges can overwhelm the brain and trigger dissociation.

 

Diagnosis

If you experience dissociative episodes, it’s important to consult a healthcare professional. Your primary doctor may refer you to a psychiatrist or psychologist to evaluate your symptoms and rule out possible causes.

During diagnosis, your provider may:

• Review your medical history
• Discuss lifestyle habits
• Ask about trauma or stressful events
• Perform a physical exam
• Conduct a mental health assessment
• Order brain imaging if a neurological cause is suspected
  

Treatment

Psychotherapy is the main treatment for dissociation. Effective options include:

• Dialectical Behavior Therapy (DBT): Helps improve mindfulness, emotional regulation, and coping skills.
• Eye Movement Desensitization and Reprocessing (EMDR): Helps process and heal trauma.
• Hypnotherapy: May help reduce dissociative episodes and improve grounding and awareness.

How to Prevent Dissociation

While you may not be able to prevent every episode, the following strategies can help reduce frequency and intensity:

• Journaling or talking about your feelings
• Using healthier coping mechanisms (exercise, hobbies)
• Reducing or avoiding substance use
• Prioritizing regular sleep
• Staying socially connected
• Practicing mindfulness, meditation, or yoga
• Using self-soothing techniques like deep breathing or listening to calming music
• Writing positive affirmations
• Identifying and avoiding triggers when possible

Complications

People with dissociative disorders may face increased risks of substance use, self-harm, or suicidal thoughts—especially when dissociation stems from past trauma.

If you or someone else has thoughts of self-harm or suicide, seek emergency help immediately.