What’s The Connection Between PTSD and Dissociation?

Are you struggling with PTSD and disconnection from yourself? You might be experiencing dissociation. Learn how dissociation connects to PTSD, its symptoms, and treatment options.

Post-traumatic stress disorder (PTSD) is a trauma-related mental health disorder triggered by experiencing or witnessing a traumatic event. It is commonly associated with flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Dissociation, which is a disconnection between thoughts, memories, surroundings, and more, is one of the most complex psychological responses to trauma. Here is a breakdown of the link between PTSD and dissociation, their symptoms, and potential treatment options. 

What is PTSD?

PTSD develops after a person has gone through a highly stressful or traumatic event, such as a natural disaster, war, accident, domestic violence, or abuse. While not everyone exposed to trauma will develop PTSD, a significant percentage of people may experience distressing symptoms that impact their daily functioning. PTSD symptoms can be divided into four main categories:

1. Intrusive thoughts

Intrusive thoughts involve the involuntary and unwanted recurrence of a traumatic memory, images, or sensations associated with a traumatic event. These intense, vivid thoughts can manifest in the form of flashbacks, nightmares, or memories and are often emotionally overwhelming. Flashbacks, perhaps the most intense form of intrusive thoughts, make a person feel as though they are re-experiencing their trauma and result in a dissociative response. A person may be so fully immersed in a past event that they lose awareness of their current surroundings, leading to a state of panic. 

2. Avoidance

Characterized by a conscious or unconscious effort to evade thoughts, feelings, places, or more that are associated with a traumatic event, avoidance is another symptom of the psychological trauma that comes with PTSD. This behavior is a way to protect oneself from the intense distress and anxiety that reminders of trauma can evoke. Although it may provide temporary relief by reducing immediate discomfort, avoidance often reinforces PTSD symptoms over time, preventing people from processing their trauma and fully recovering. 

3. Changes in thinking and mood

PTSD can induce negative changes in thinking and mood, deeply affecting how a person perceives themself, others, and the world around them. Feelings of hopelessness, emotional numbness, memory loss or amnesia, and difficulty maintaining close relationships are all ways that these changes in thought and mood patterns can present and delay a person’s recovery. 

4. Physical and emotional reactions

Also known as hyperarousal, changes in physical and emotional reactions are a defining symptom of PTSD that reflects the body and mind’s heightened state of alertness following a traumatic event. This occurs when the body remains in a state of “fight-or-flight” long after a threat has passed, making a person constantly feel tense or “on edge,” experience difficulty sleeping, and have outbursts of anger. Hyperarousal can be a chronic condition, significantly impacting a person’s quality of life and emotional regulation. 

What is dissociation?

Dissociation, a psychological phenomenon where a person disconnects from their thoughts, feelings, memories, or sense of identity, is often considered a defense mechanism to cope with trauma. Dissociation can range from mild detachment from reality, such as daydreaming, to severe detachment, such as dissociative identity disorder (DID). This form of dissociation is usually considered severe and can be linked to chronic trauma in early childhood. 

Depersonalization, derealization, dissociative amnesia, and dissociative disorder all fall under the label of a dissociative subtype and can often be debilitating. Dissociation symptoms can include feeling as though one is an outsider observer of one’s own body and gaps in memory or the inability to recall certain information. 

The link between PTSD and dissociation

While dissociation is not exclusive to PTSD, it is commonly experienced by people with the disorder to serve as a protective mechanism, helping a person avoid the intense emotions and memories associated with trauma. This disconnection may provide temporary relief but risks becoming a long-term coping strategy that can impede a person’s path to recovery. 

PTSD dissociation is often linked to the severity of the trauma and the age at which it occurred. Those who have experienced early childhood trauma or prolonged exposure to traumatic events are more likely to develop dissociative symptoms, which can elevate the diagnosis and treatment of complex PTSD. Additionally, the connection between PTSD and dissociation may lead to other mental health disorders such as bipolar disorder, multiple personality disorder, depression, and anxiety.

Symptoms of dissociative PTSD

When PTSD and dissociation co-occur, people may experience emotional numbing, re-living their trauma, and detachment from their emotions, in addition to the classic symptoms of PTSD. Depending on a person’s PTSD severity, dissociation can cause them to feel as though different aspects of themself are compartmentalized, thus not integrated within their daily life. This can lead to difficulties in forming or maintaining close relationships and significant gaps in memory related to the traumatic event, often leading to confusion, anxiety, and, in some cases, panic attacks. 

Causes and risk factors for PTSD and dissociation

The nature of a person’s trauma, their psychological makeup, and the availability of support systems can influence the development of co-existing dissociation and PTSD. Traumas experienced in early childhood, when someone’s personality and coping mechanisms are still developing, can lead to a higher PTSD symptom severity and more severe dissociative responses depending on the severity and duration of the traumatic event. 

A family history of mental health disorders may also increase susceptibility to PTSD and dissociation. Through genetic factors, it is possible to determine how a person might respond to trauma and stress. Learned behaviors are also common among people with abuse-related PTSD, as it is often experienced somewhere generationally within their family. 

Treatment approaches for PTSD and dissociation

Due to the complexity of symptoms, treating PTSD and dissociation by finding an integrated approach that addresses both disorders is essential to a person’s recovery. There are a number of treatment options, such as psychotherapy, medication, and self-care strategies, or a combination of multiple. 

1.  Psychotherapy

Psychotherapy is the cornerstone of treatment for PTSD treatment and dissociation due to several therapeutic modalities that have proven effective, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and trauma-focused therapy. These approaches focus on changing negative thought patterns and behaviors associated with trauma, helping people build emotional regulation and mindfulness skills in order to gain insight into managing their symptoms.

2. Medications

While there is no specific medication for dissociation, certain medications can help manage PTSD symptoms, which may indirectly reduce dissociative symptoms. Antidepressants are commonly prescribed to help reduce anxiety and depressive symptoms associated with PTSD, and in cases of PTSD patients who experience severe dissociative symptoms or other comorbid conditions, atypical antipsychotics may be used to help manage symptoms. Mood stabilizers can also be effective in managing mood swings and reducing impulsivity associated with PTSD and dissociative disorders.

3. Self-care and coping strategies

In addition to professional treatment, self-care plays a crucial role in managing symptoms related to PTSD and dissociation. Practices such as mindfulness and grounding techniques, journaling, building a support network, and regular physical activity can help people stay present and reduce dissociative episodes. To go along with these methods, connecting with others who have experienced similar traumas, such as through support groups, can provide validation and a sense of community to people who feel isolated, bringing about greater motivation to recover and heal. 

How Charlie Health can help

If you or a loved one are struggling with a mental health disorder, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions, including post-traumatic stress disorder (PTSD), dissociation, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing your mental health is possible. Fill out the form below or give us a call to start healing today.