Dissociation And Anxiety

Written by Jim Folk
Medically reviewed by Marie Filion, Msc, PRC.
Last updated October 13, 2021

dissociation and anxiety

Dissociation – feeling detached from yourself, like in a dreamlike state, feeling weird or off-kilter, and like everything is surreal – is a common anxiety disorder symptom experienced by many people who are anxious.

This article explains the relationship between anxiety and dissociation, its causes, and what you can do to stop this feeling.

Dissociation Common Symptom Descriptions

  • It feels like you are in a dreamlike state but fully awake.
  • It suddenly feels like things are surreal or unexplainably odd.
  • It feels like your emotions have become detached.
  • It feels like you’ve had an “out-of-body” experience.
  • It feels like you’ve experienced something “dreamlike.”
  • It feels like you’ve become detached from others and the physical environment.
  • You feel strange, weird, or that something is off.
  • You feel numb and sort of euphoric, but don’t know why.
  • You suddenly feel confused and as if you can’t think clearly.
  • You feel like things are unreal but can’t describe exactly why.
  • For some reason, you feel odd, unusual, and that something is not as it should be.
  • You feel something is out of sorts but don't know what it is or how to describe the feeling.
  • You feel like your body and emotions are unusually weird and off-putting, but you don't know why or what is exactly wrong.
  • It feels like your perception has been altered.
  • It can also feel like your memory has been impaired, or your recollection of events is missing or skewed.
  • You feel like your life experience is surreal, unusual, weird, or indescribably strange.
  • It feels like your thinking is muted, muddled, or mixed up.
  • You suddenly feel “brain dead” – where your rational mind has switched off.
  • You feel like you are numb to the traumatic situation or circumstance.

This dissociation, surreal, unreal, unusual, strange, and weird feeling can occur rarely, frequently, or persistently.

Dissociation might proceed, accompany, or follow an escalation of other anxiety sensations and symptoms or occur by itself.

Dissociation can precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur "out of the blue" due to a sudden trauma.

Dissociation can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and disappears the next.

This symptom can change from day to day and from moment to moment.

All the above combinations and variations are common.[1]

Dissociation can seem more disconcerting when undistracted, resting, doing deep relaxation, trying to go to sleep, or when waking up.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

---------- Advertisement - Article Continues Below ----------


Causes:

Medical Advisory

We recommend all new, changing, persistent, and returning symptoms be discussed with your doctor as there are medical conditions and medications that can cause anxiety-like symptoms.

If you've done that and your doctor has attributed your symptoms solely to anxiety or stress, you can be confident there isn't a medical condition or medication causing your symptoms.

First, the amygdala is often referred to as the “fear center” of the brain because it appears to be central to the detection and reaction to a threat, even though other parts of the brain are involved with the reaction to danger.

To be clear, the amygdala is NOT responsible for the feelings of fear, but the detection and reaction to danger. As doctor Joseph E. LeDoux puts it, “While amygdala circuits are directly responsible for behavioral/physiological responses elicited by threats, they are not directly responsible for feelings of “fear.”

Second, the amygdala, which is a part of the limbic system (the system primarily responsible for emotion responsiveness), is also often referred to as the “emotional processing core” of the brain, even though other parts of the brain are involved with and react to our emotions.

And third, even though the amygdala is mostly referred to as a single part of the brain, there are two amygdalae – a right amygdala and a left amygdala. While they perform together, they perform different functions. For example:

  • The amygdala on the right side of the brain is thought to be primarily responsible for the detection and reaction to danger (anxiety/fear reaction). Marie Filion, one of our recommended psychotherapists calls this amygdala, AMY.
  • The amygdala on the left side of the brain is thought to be primarily responsible for detecting and reacting to the emotions of sadness, low mood, and the feelings of helplessness. Marie calls this amygdala, MEG.

For simplicity's sake, Marie refers to these twins as the amygdala sisters. The symptom dissociation occurs because of how AMY and MEG interact under certain situations.

For example, the moment we believe we could be in danger, AMY detects the fear message and signals the appropriate system to take action. The degree of perceived danger determines which system responds and the degree of stress response: first degree or second degree stress response. For more information about the two systems and degrees of stress responses, see the “Hyperstimulation” article.

The degree of stress response is directly proportional to the degree of perceived threat: the greater the perceived threat, the higher the degree of stress response.

Since stress hormones are powerful stimulants. Higher degree stress responses bring about more dramatic effects.

For instance, if a person is only slightly afraid, the body experiences a minor stress response and subsequent changes. Oftentimes, these minor stress responses aren’t even noticeable to the person.

However, it the person believes he is in grave danger, the body can produce a high degree stress response with the effects being profound and unmistakeable. In some instances, the stress response changes can be so dramatic that they affect behavior.

One example is with very high degree fears that cause very high degree stress responses. These high degree stress responses can be so powerful that they make us feel paralyzed with fear.

We often hear of people saying they were so afraid that they felt like they were paralyzed like a “deer in caught in headlights.” So, high degree fears can produce high degree reactions, including feeling “paralyzed with fear.” This is the reason some people refer to the survival mechanism as the “fight, flight, or freeze” system.

Dissociation is most often associated with high degree fears, such as when experiencing great trauma that makes you feel paralyzed. Here’s why:

The body is an incredibly designed machine with an automatic survival mechanism ready to keep us safe. The two amygdalae are part of this survival mechanism.

The right detects and reacts to the notion of danger, and the left detects and reacts to the notions of sadness, low mood, and feeling helpless.

When we feel threatened, the right amygdala (AMY) springs into action by signalling the HPA axis (hypothalamic–pituitary–adrenal axis), which in turn triggers the stress response – the body’s way of supercharging itself into immediate action. This reaction is beneficial when in real danger.

When we feel sad or helpless, the left amygdala (MEG) springs into action by signalling the body to produce natural opiates (opioids) in an attempt to numb us from what we are feeling. Opioids suppress the nervous system, creating pain relief and a euphoric feeling. Morphine, methadone, and codeine are opioid drugs that recreate this feeling.

Both of these actions are designed to help us survive difficult situations. One helps us deal with a threat and the other helps us deal with negative emotions.

When these factors come together - when intense fear is combined with feeling helpless, or when we feel so helpless that we threatened - both amygdalae become active and produce BOTH effects: a stress response reaction to danger and an opiate reaction to feeling helpless. It’s this combined reaction that causes dissociation.

This effect can be illustrated as:

Dissociation

Hyperarousal

  • Detached
  • Numb
  • Compliant
  • Decrease heartrate
  • Suspension of time
  • De-realization
  • ‘Mini-psychoses’
  • Fainting
  • Hypervigilance
  • Anxious
  • Reactive
  • Alarm response
  • Increase heartrate
  • Freeze: Fear
  • Flight: Panic
  • Fight: Terror

The more threatened and helpless we feel, the more dramatic the reaction (the greater the combination of stress hormones and opiates).

Moreover, as our perception of danger increases, the right amygdala becomes more active, suppressing activity in the cortex (the rationalization areas of the brain). And as our perception of sadness and helplessness increases, the left amygdala becomes more active, also suppressing the activity in the cortex.

As the notions of fear and helplessness increase, we spend more time activating the limbic system and less time thinking rationally. Again, this combination can cause feelings of dissociation.

Here are some examples of how dissociation can set up:

Catastrophizing over emphasizes worst case scenarios, making them seem like insurmountable and catastrophic issues: Consequently, the threat becomes massive, and you start thinking about it more and more. This rumination can block you from taking action. This blocking action can:

  • Prevent us from being able to focus.
  • Prevent us from thinking clearly and rationally.
  • Generate anxiety, which activates AMY (the right amygdala) and its subsequent actions.
  • Cause us to spend too much time activating the limbic system, and therefore, suppressing the cortex (rational thought/reasoning).
  • Cause a physical reaction: stress responses and an increase in anxiety symptoms, which can also lead to issues with anger, frustration, and despair.

Feeling helpless - believing the situation, circumstance, or event is going to impact all areas of your life and that you have no control over it: Consequently, you might conclude that the bad things are here to stay.

For those who struggle with anxiety issues, they might also believe that anxiety is something they’ll never be able to get rid of. As a result, they conclude there is nothing they can do about it and it’s going to ruin every aspect of their lives. Feeling helpless can cause:

  • Feeling drained; devoid of energy.
  • Feeling like giving up.
  • A lack of motivation.
  • Low mood, which activates MEG (the left amygdala) and its subsequent actions.
  • Withdrawal from loved ones; withdrawal from life.
  • A lack of interest in the things once found enjoyable.
  • Passivity.
  • Feelings of being depleted.
  • Dissociation.

When we experience grave danger, we can disassociate. When we feel chronically helpless, we can disassociate. When we experience both, we can disassociate.

We create anxiety when we catastrophize (imagine worst case outcomes that seem threatening). We create the feelings of helplessness when we feel like there is nothing we can do about our situation.

Other factors:

Other factors can cause and contribute to this symptom, including:

Select the relevant link for more information.

NOTE: Dissociation can create symptoms similar to anxiety and low blood sugar. If you are feeling faint, dissociated, weak, numb, shaky, etc., yet your blood sugar is well within the normal range, these symptoms could be caused by dissociation rather than blood sugar related.

---------- Advertisement - Article Continues Below ----------


Treatment:

When dissociation is caused or aggravated by other factors, addressing those factors can reduce and eliminate it.

If you’ve determined your dissociation is caused by anxiety or helplessness, containing your anxiety/helplessness behavior will eventually quiet down the amygdalae. As their activity diminishes, you should see the dissociation feeling subside…in time.

Similar to how symptoms of hyperstimulation can take time to diminish, so, too, can anxiety/helplessness-caused dissociation take time to diminish.

Faithfully practicing your recovery strategies, containing anxious/helplessness behavior, addressing the underlying factors of your anxiety so that your body can recover, and giving your body ample time to recover will reverse anxiety/helplessness-caused dissociation.

Reversing the actions that caused dissociation will eliminate dissociation in time.

Continuing to ruminate, worry, and catastrophize will keep the Limbic System dominant, causing anxiety/helplessness-caused dissociation to persist.

Containing worrisome behavior will shift brain activity to the cortex and away from the Limbic System. As the cortex regains its normal activity, you should see anxiety/helplessness-caused dissociation subside.

Overall, because worrying, fretting, and becoming emotionally upset about stress-caused sensations and symptoms also stress the body, these types of behaviors can interfere with the recovery process, and ultimately, the elimination of stress-caused sensations and symptoms.

Passively accepting this symptom in the short-term—allowing it to persist without reacting to it, resisting it, worrying about it, or fighting it—while faithfully practicing your recovery strategies will bring about success.

Acceptance, practice, and patience are keys to recovery. The more successful you are with these strategies, the more opportunity your body will have to recover.

Dissociation is a common symptom of anxiety and feeling helpless. Like other symptoms of stress, it needn't be a cause for concern.

Faithfully applying the above-mentioned strategies will bring an end to this symptom in time. For some people, the symptom will subside quickly. For others, especially those whose level of hyperstimulation is elevated into the high and very high degree ranges, it may take more time to eliminate this symptom.

Faithfully practicing your recovery strategies, containment, passive acceptance, patience, and time will lead to success!

---------- Advertisement - Article Continues Below ----------


Prevalence

In an online poll we conducted, 31 percent of respondents said they experienced this symptom because of their struggle with anxiety.

NOTE: If dissociation persists despite your Level One recovery efforts, you may want to consider working with one of our recommended anxiety disorder therapists to help you identify and address the Level Two recovery concepts that may be preventing this symptom from subsiding. Oftentimes, Level Two recovery aspects can interfere with experiencing success from Level One recovery work.

---------- Advertisement - Article Continues Below ----------


The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including dissociation anxiety symptoms.

References

1. Şar, Vedat. “The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry.” Clinical Psychopharmacology and Neuroscience, Korean College of Neuropsychopharmacology, Dec. 2014.