Dissociation (also called derealization) is often described as the disconnection from one's thoughts, memories, and body.
While dissociation is actually a common symptom of many mental disorders, it is not out of the ordinary to see it in people with stable mental health, too. In fact, you have probably been in a state of derealization before. Although it is so common, there isn't much awareness about it. Many people aren't even aware that it's a concept. I didn't realize it until I saw a therapist and received a diagnosis. To help someone suffering from dissociation, it's important to truly 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 decent idea of what it is. But thinking of examples may be hard. Dissociation is an incredibly diverse group of symptoms. Some examples include:
- Not feeling real
- Feeling as though the environment is not real
- Feeling that the people around you are not real
- Feeling that you are not in control of your body
- Feeling that your thoughts aren't actually "yours"
- Hazy memories
- Out-of-body experiences
- Being overcome with 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 of them. These feelings usually occur in "episodes," or extended periods of time that range from minutes to weeks. Although this is common in individuals, those who experience frequent dissociation are often diagnosed with dissociative disorders. In addition, post-traumatic stress disorder (PTSD) and depression are conditions that are often accompanied by dissociation. Within the umbrella of dissociation, there are more precise terms that are essential to understanding it.
This is the particular word that describes the feeling that the world is not real. When I experience derealization, the world feels hazy. I feel completely detached, as if I were watching the world from a security camera.
This describes the feeling of being separated from one's body. When I experience depersonalization, it feels as if I am a passenger in my body, rather than the person driving. I call this the Go-Pro feeling because it feels like one of those cycling Youtube videos.
3. Dissociative Amnesia and Identity Confusion
Although not very common 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 actions are forgotten in dissociative episodes. This often occurs with identity confusion, or the disconnection between one and oneself. It is similar to depersonalization, although it connects directly to one's worldview and view of oneself.
Why do we dissociate?
Dissociation is the mind's response to intense trauma. The brain does this in order to protect itself, especially if the trauma is severe. Some people may unconsciously dissociate in response to stressors in order to calm down. Dissociation can also be a result of substance intake. In that case, it is important to seek medical attention. For whatever 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, DA is the extensive forgetfulness of memories and information that is not explainable by other causes. This often coexists with other disorders.
2. Dissociative Fugue (DF)
DF is the unexpected travel from one place to another, in which the person is unable to recall 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 of the actual journey.
3. Derealization/Depersonalization Disorder (DPDR)
DPDR is a disorder characterized by intense symptoms of derealization and depersonalization. It is diagnosed in people who have recurring feelings of dissociation, but with no alters (related to DID).
4. Dissociative Identity Disorder (DID)
This is an incredibly complex disorder. It is the most severe form of dissociation. DID is described as the presence of two or more identities in a host's mind and body. This is a result of a fragmented sense of identity caused by repeated severe trauma in the developing period. DID is often accompanied by DA and DF, as well. A dissociative state in people with DID mainly occurs during transitions between identities. In many cases, it can be harmful to forcefully stop a "switch," so be sure to ask how to help before acting.
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 on hand. Remember: if you cannot help someone out of an episode, or they become a danger to themselves or others, consult a doctor immediately.
When I'm in a dissociative state, it is extremely difficult to "shock" myself out of it. Usually, I am unable to take care of myself. But when I do catch an episode starting, or a family member does, I steer towards these strategies:
- Taking a shower — Usually, I take cold ones to help my body register my surroundings
- Listening to loud music — I prefer the opposite of calming music
- Deep pressure — Tight hugs (if you have no one to hug, hug yourself!), weighted blankets, animals
- Exercising — I wouldn't try heavy exercise; yoga or playing Just Dance often works for me!
- Changing your environment — Go outside, go downstairs, or to a different room
- Stimulating yourself — Reading, watching videos, playing with mind teasers
There are hundreds of other ways to ground yourself (or someone else!). For more ideas, visit here. When helping others, always remember to ask for their input if they are able to communicate. If they aren't, attempt to encourage communication by hand signals and using text to voice 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 isn't linear, and remember to take care of yourself first. If you know someone who struggles with dissociation, support them in ways that are non-straining towards you. Spreading awareness of dissociation is essential, and educating oneself and others is an amazing first step.