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Dissociation? What, why, how?

You might have heard about dissociation. It is a term you hear usually when talking about mental health. 

Let’s have a small talk about what it is, why it appears, and how you can treat it.

What?

What is dissociation? The textbook definition is the following: “Dissociation is a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity”. Dissociative disorders can vary in symptoms; there is dissociative amnesia, dissociative fugue, and depersonalisation disorder. Usually, the symptoms of dissociation are:

  • Feeling disconnected from yourself
  • Problems with handling intense emotions
  • Feeling as though the world is distorted or not real
  • Memory problems that aren’t linked to physical injury or medical conditions
  • Other cognitive (thought-related) problems such as concentration problems

There are other, more rare, and more severe symptoms, such as psychogenic fugue, which means the sudden, unexpected loss of one’s memory of their past, or identity alteration, when a person’s whole personality can change suddenly. But we are going to focus on the two most common symptoms in this post. 

  • Dissociative amnesia is when a person can’t remember the details of a traumatic or stressful event, although they do realise they are experiencing memory loss. This is also known as psychogenic amnesia. This type of amnesia can last from a few days to one or more years. Chronic anxiety can also trigger dissociative amnesia, to the point where a person can feel that years of their lives are a blur.

Can you recall an event that happened and you cannot remember details about it, like it’s blurred out in your memory?

  • Depersonalization disorder is characterised by feeling detached from one’s life, thoughts and feelings, like the world around them is not real. People with this type of disorder say they feel as if they are watching a character in a boring movie. Other typical symptoms include problems with concentration and memory. The person may report feeling ‘spacey’ or out of control. Time may slow down. They may perceive their body to be a different shape or size than usual; in severe cases, they cannot recognise themselves in a mirror. From my personal experience, when suffering a dissociative episode, you might look at yourself in the mirror or at your surroundings and feel like watching a video filmed with a GoPro camera instead of feeling “there”. 

Can you recall a moment in your life when you felt like you were watching someone else’s point-of-view?

Why?

Why does dissociation appear? Dissociation is experienced by most people at least once in their lives, resolving itself without the need for treatment usually. Other people, however, might develop chronic dissociation. 

Most often, dissociation appears when a person suffers a traumatic event, either during or after the event. The event itself can be “unreal” in the person’s memory, like remembering a movie, and the person can feel disconnected from their own body and thoughts for hours, days, or even weeks after. 

Basically, dissociation is a protection mechanism of the brain in response to high stress or trauma. For the traumatised individual, dissociation may help him or her to survive circumstances that may have otherwise been intolerable. Dissociation can help a person feel as if situations, their bodily sensations, and emotions that would have been overwhelming, are muted and distorted so they can then go into “autopilot” mode and survive extreme situations and circumstances.

Can you recall any event that made you feel disconnected from reality after it happened?

Unfortunately, some people can develop dissociation without suffering a traumatic event. Usually, chronic dissociation appears as a symptom of chronic anxiety, which can appear gradually due to a person’s unwise lifestyle choices, such as a lack of physical activity, use of drugs such as alcohol, cannabis, or hallucinogens, lack of proper rest, bad diet, and many more. Basically, an unhealthy lifestyle can put stress on the brain, which will protect itself by dissociating.

Some people can develop it for no apparent reason at all, despite having a healthy lifestyle and not having suffered a traumatic event. This is a very rare occurrence, and can be caused by unusual conditions such as brain tumours or other illnesses. 

Most people with chronic dissociation disorder develop it when they are young. The average age for developing depersonalization disorder is 16 years. It rarely begins after age 40.

How?

Did you respond with “yes” to any of the questions so far? If so, you might have experienced dissociation. It might have been a fleeting feeling, or reading about it might have made you realise it is a common occurrence.

So, how can you fix it? 

Unfortunately, this question has challenged experts for a long time. Most of the time, dissociation is a temporary condition, which passes by itself without requiring any treatment. Some people might not even realise they suffered from it before reading about it. But chronic dissociation is a tough fighter, especially due to the fact that it can be caused by a huge amount of factors, so treating it can be a marathon, taking years and multiple attempts in some cases. 

A couple of treatment options are:

  • Seeing a professional therapist. Since dissociation is oftentimes caused by a traumatic event, talking to someone about it can make you overcome it, thus helping you reduce anxiety and dissociation. Usually, they will propose Cognitive-Behavioural Therapy (CBT), which is a very powerful tool focused on changing thinking patterns, feelings, and behaviours.
  • Improving your lifestyle. Quitting alcohol, working out, changing your diet, and other such actions can greatly affect your mood and reduce anxiety and stress, which will in turn reduce dissociation.
  • Meditation and relaxation techniques: Mindfulness may help you tolerate symptoms. You can learn to tune in to your thoughts and feelings. It also can help settle your body’s responses.
  • Medication. Sometimes, more traditional, natural treatment options can just not work for you, and that is fine. Unfortunately, there isn’t a medicine for dissociative disorders, but treating anxiety can indirectly treat it. Anxiety in general is a complex matter, and for some people medication can be the only way of getting over it. 

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Robert Tiganetea
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