6 Common Causes of Dissociation and What You Can Do About It

Dissociation is when you feel disconnected from yourself or your surroundings. You might feel like you’re in a dream or watching yourself from outside of your body. It can sometimes be a defense mechanism to protect against overwhelming stress or trauma. 

Dissociation can be different for everyone, and it can happen in different situations. Nearly everyone experiences dissociation at times. For example, if you’ve ever gotten lost in your thoughts while driving and missed your exit, then you’ve experienced dissociation. 

But sometimes, dissociation can be a lot harder to deal with. For some people, dissociation even gets in the way of being able to think and to function. And sometimes, people who experience dissociation may have a mental health condition.

Let’s take a closer look at the most common causes of dissociation — and what you can do about it if it’s a problem. And please: Be aware. This article will mention topics that could be triggering for some readers, including abuse, sexual assault, and self-harm. 

What causes dissociation?

Dissociation has many causes. It can be caused by mental health conditions, past trauma, substance use, or neurological conditions. Keep reading to learn more about the different causes of dissociation. 

1. Trauma

Trauma is when you experience a scary or upsetting event (or events), followed by physical and emotional symptoms — including dissociation. Examples of traumatic events include:

• Physical abuse

• Sexual abuse

• War

• Accidents

• Natural disasters

Some people who experience trauma go on to develop post-traumatic stress disorder (PTSD). There’s also a strong link between past trauma and a group of mental health conditions called dissociative disorders (more on these below). 

We don’t know exactly why trauma causes dissociation. But many experts believe it’s a coping mechanism. A person may be in a situation that they can’t escape, such as childhood abuse or a war zone. In these instances, they may find ways to separate themselves mentally and emotionally from the situation. This is especially the case if they can’t physically get away. 

In the moment, dissociation can help the person survive. But problems may arise, though. One way is if the person continues to depend on this coping mechanism after the traumatic event is over. Another is if they’re no longer in the traumatic environment.

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2. Substance use

Dissociation can also occur when a person is under the influence of psychedelic or dissociative drugs. These drugs impact your perception of reality. They can make people feel disconnected from themselves and the world around them. 

Examples of dissociative drugs include:

• LSD

• Psilocybin (magic mushrooms)

• DMT

• Mescaline (peyote)

• Ketamine

Dissociation often resolves once the effects of the drug have worn off. However, the drug’s dissociative symptoms may return for some people, called flashbacks. 

3. Panic attacks

A panic attack is an episode of fear or dread, accompanied by physical and emotional symptoms — including dissociation. Panic attacks can be triggered by a specific situation. Or they can feel like they happen out of nowhere.

Panic attacks can be frightening, even though the symptoms usually go away in 20 to 30 minutes. It can be scary to suddenly feel detached from yourself or your surroundings. Along with the other physical and emotional symptoms, a panic attack can even make you feel like you’re dying or “going crazy.” 

4. Sex

It’s normal to feel “checked out” during sex sometimes. But, sometimes, dissociation during sex can be a symptom of a larger issue. Causes of dissociation during sex include: 

• Trauma

• Anxiety about not being able to have an erection or an orgasm

• Anxiety about sex in general

• Body image challenges

• Stress

• Feeling emotionally disconnected from your partner

• Fear of intimacy

Dissociation during sex may be especially common in people who’ve experienced sexual assault or abuse. The likelihood of experiencing dissociation during sex increases with the length of abuse and the number of perpetrators.

5. Borderline personality disorder 

Borderline personality disorder (BPD) is a mental health condition that affects your sense of self and your ability to manage strong emotions.

Many people with BPD also have trouble with relationships. And in truth: Around 4 in 5 people with BPD also experience dissociation. These symptoms are more common when a person is under stress or during episodes of self-harm.

There’s also a strong link between BPD and a history of trauma. So, it’s possible that for people with BPD, dissociation could have developed as a way of coping with distressing events. 

6. Neurological causes

Dissociation can also have a neurological cause. This includes health conditions like: 

• Brain tumors

• Traumatic brain injury

• Migraines

• Seizures

These neurological conditions can affect many different parts of the brain. This can change how your brain processes sensory information, and it can cause dissociation as a symptom. 

What are dissociative disorders?

Dissociative disorders are a group of mental health conditions that cause problems with your thoughts, emotions, and sense of self. They can also cause dissociation, memory problems, and more. 

The three main types of dissociative disorders are discussed below.

Dissociative identity disorder (DID)

DID was previously referred to as multiple personality disorder. People with this condition have two or more personal identities, each with their own thinking and behavior patterns. These personalities are noticeable to other people. 

People with DID often have gaps in their memories. 

Dissociative amnesia

This is a condition where it’s hard for you to remember important details about yourself or your life. People with dissociative amnesia have a hard time remembering specific events or time periods. 

In rare cases, a person with dissociative amnesia might not recall any details about their identity or history.

Depersonalization/derealization disorder

People with this condition experience two types of dissociative symptoms: depersonalization and/or derealization. Depersonalization is a sense of detachment from oneself. Derealization is a sense of detachment from the outside world. 

Just like many of the causes of dissociation listed above, dissociative disorders are often linked to past trauma. Unlike traumatic brain injury or other neurological causes of dissociation, dissociative disorders aren’t typically caused by physical changes or damage to the brain. 

How to tell if you’re dissociating

Remember: It’s normal to experience mild dissociation from time to time. If it doesn’t cause you to feel upset or interfere with your ability to function, then it’s probably OK. 

Examples of mild dissociation include:

• Daydreaming

• Getting engrossed in an activity

• A sense that time just passed very quickly

But sometimes, dissociation can become a problem. And in some cases, it could be a sign that you’re dealing with a mental health condition. Possible warning signs that you’re having trouble with dissociation include:

• Difficulty remembering key details of past events

• Difficulty remembering important information about yourself

• Having trouble taking care of your daily responsibilities

• Having problems in your personal or professional relationships

• Having feelings or doing things that don’t seem like your “usual” self

Dissociation can be hard to deal with — both for the person experiencing it and for their family and friends. Fortunately, treatment is available for dissociative disorders. We’ll go into treatment options below.

Getting help for dissociation

Dissociation can be distressing, but help is available. Dissociation can be linked to different conditions and experiences. So, the best treatment will depend on figuring out what’s causing your dissociation — and going from there.

Therapy can help with many different conditions, including those that cause dissociation. Good options include:

• Dialectical behavior therapy (DBT): DBT helps you learn to manage strong feelings and intense emotions. It can also help you get along better with other people. It’s used to treat BPD and other conditions, including dissociative disorders. 

• Cognitive behavioral therapy (CBT): CBT helps you understand how your thoughts, feelings, and actions are connected. It’s good for treating problems like PTSD, anxiety, substance use, and dissociative disorders. 

• Eye movement desensitization and reprocessing (EMDR): In EMDR, a therapist helps you work through traumatic memories while you move your eyes in a certain pattern. EMDR can help with many problems related to trauma, like PTSD and dissociative disorders. 

• Internal family systems (IFS) therapy: IFS is a type of therapy that can help you understand the different parts of your personality and how they interact as a “family” in your mind. Through IFS, you can learn how to help these different parts work together better. 

When it comes to medication, there aren’t any available to specifically treat dissociation. But if you have other symptoms along with dissociation, such as anxiety or depression, then medications might be able to help.

If you’re concerned about dissociation, reaching out to a healthcare professional or therapist is a good first step. To find a treatment program or provider that specializes in dissociation, you can:

• Ask your healthcare professional for a referral

• Contact your health insurance company for a list of in-network providers

• Use an online directory, such as Psychology Today

• Contact the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-HELP (4357)

• Search SAMHSA’s online treatment locator tool

Why trust our experts?

Written by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

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For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text “HOME” to 741-741 to reach the Crisis Text Line.