When Reality Dissolves: Dissociation, Anxiety and How to Cope
*Trigger warning: this article discusses dissociative episodes, anxiety and PTSD. If you do not have the space for this right now, we invite you to come back at a different time or read with a trusted friend/family member.
Imagine: you’ve been trapped in someone else’s body. You have their memories and their thoughts, but you still feel you’re in the wrong place. Although everything looks familiar, it feels foreign. You’re numb and going through the motions because although you can’t quite make sense of reality, being stagnant seems to make the feeling worse.
That’s what a dissociative episode feels like. People who experience this are often victims of anxiety and PTSD, in which case the brain tries to escape from trauma by emotionally removing itself from potentially stressful situations. Dissociation can occur with or without a trigger and can last hours to days. Dissociative disorders are diagnosable and symptoms can be managed with some medications, but there is no current medical intervention specific to any dissociative disorder. Although it is thought that anywhere from 0.01-15% of the population may suffer, most are likely undiagnosed. Thus, this particular lens into mental illness remains clouded.
People who experience this are often victims of anxiety and PTSD, in which case the brain tries to escape from trauma by emotionally removing itself from potentially stressful situations.
Most commonly, dissociation is described as feeling “not real,” which is difficult to conceptualize. We all have moments where life feels surreal or strange. But “foreign” is maybe more accurate - encapsulating the feeling of being a stranger in your own life. Not only does reality seem distant, but nothing is familiar anymore, including yourself. These are really my arms, with these tattoos? Why did I decide to paint my nails? This hair and these clothes belong to me? This is where I work? This is where I live? I have possessions? Not only does it feel foreign, but it feels wrong. And even if you realize it’s happening, there’s not much to do to stop it. You obviously want it to stop, but it’s hard to achieve anything when the things you see and touch don’t spark any particular emotion. Identifying something that could make you feel better is nearly impossible. Hunger and thirst don’t compel you to move. Sure, you might be hungry, and you can feel that hunger may even be making you exhausted. But because memories of feeling good or alive are nonexistent, you choose to sit and just exist rather than make decisions for this foreign body.
Although I haven’t been diagnosed with any specific dissociative disorder, I have been diagnosed with general anxiety and depression. My counselor also expects that I may suffer from mild PTSD following the development of a severe chronic illness during my late teens. Dissociation is something that was very common when I was first becoming very ill (and I have large gaps in my memory of that time period), but has become more frequent over the past year and a half or so, mostly due to heightened anxiety. My dissociative episodes don’t often have a trigger that I’m able to pinpoint — oftentimes, I wake up already in that state rather than find myself in it throughout my day.
I wanted to put this into words because the general information on health websites only seems to brush the surface. Not to mention that the recommendations for preventing dissociative episodes and coping with them make me want to scream. Exercise, eat better, get lots of sleep. That’s really difficult when I can’t bring myself to move during the day and then the psychological toll of anxiety makes it difficult to get consistent or quality sleep. You can do all of the “right” things and still be a victim of dissociation. Although it’s difficult to pull myself out of it when I’m in the middle of things, there are a few tools that I can personally recommend to help ease the blow and make transitioning into a healthier mental state a little bit smoother:
Stamp your feet on the ground. My counselor gave me this recommendation, and I used to do this in college classes when I was having a tough time staying grounded. Walking, or intentionally stamping your feet, can help stimulate your senses and bring you back to the present moment.
Chocolate. Harry Potter fans, remember when Professor Lupin gives Harry chocolate to help after the dementor attack? Honestly, it helps with real life, too. Eating a small piece of chocolate (my favorite are Lindor truffles because of the different textures), and really noticing the sweetness and sensations on your tongue, is amazing. A strong cup of coffee has a similar grounding effect. I know that coffee isn’t always an option for people struggling with anxiety, but for me, the process of making and drinking coffee is extremely helpful.
Writing. Take a pen, grab the nearest piece of paper, and write about anything. Write about what’s right in front of you, right about what you can’t feel, write about things that you know about yourself (the color of your hair, your street address, the place you work, etc.), or anything under the sun. Holding a pen and scratching against the paper’s surface while simultaneously identifying things about your life and surroundings is a very accessible grounding technique.
What’s Up? App. Having this app on my phone is a huge asset for when my mental health is struggling and I’m in a public place. It’s a completely free mental health service that has several features designed to help people put their mental health into perspective and calm down in times of trouble. My favorite feature is titled “Get Grounded,” and asks you to name five things in a category, e.g. five breakfast cereals, or give things around you that are red. It’s designed to stimulate the logical part of the brain and bring you back to the present when you are anxious or feeling out of your body.
I had two motivations for writing this article: to provide a better explanation of dissociation and why it happens for those who are unfamiliar, and to validate the experiences of those that are. Any kind of mental health episode can already feel incredibly isolating, and as difficult as it is to communicate what’s happening during a dissociative period, it’s equally difficult to remember what the experience was like when it’s over. Not to mention, health websites like WebMD tend to either underplay the symptoms or provide overly-clinical definitions that are difficult to relate with. Whether you struggle with dissociation or not, I hope this article was able to resonate with you. You are not alone!
