What is dissociation?

Dissociation occurs when you get a mental disconnection from your thoughts, memories, feelings, or even your sense of identity. Dissociation is not a form of psychosis.
Dissociation occurs when you get a mental disconnection from your thoughts, memories, feelings, or even your sense of identity. Dissociation is not a form of psychosis.

Dissociation is not a form of psychosis. These are two different conditions that may easily be confused for each other. Someone going through a dissociative episode may be thought to be having a psychotic episode, and in some cases, dissociation may be the initial phase to having a psychotic episode. 

The difference between the two is that, while dissociation causes a disconnection from reality (i.e., loss of memory and sense of identity), psychosis causes some kind of additional experience (i.e. seeing and hearing things that don’t exist).

Dissociation occurs when you get a mental disconnection from your thoughts, memories, feelings, or even your sense of identity. Dissociative disorders are classified into three types:

  1. Dissociative amnesia
  2. Dissociative identity disorder
  3. Depersonalization or derealization disorder

You may develop some form of dissociative disorder when or after you are going through a traumatic event. It may go on for some hours, days, or even weeks after the experience. 

Usually, the traumatic event may seem unreal. You get the feeling of detachment from reality, like you are watching everything on television. The dissociation will most likely go away without medical intervention. In some cases, the condition may not resolve itself, thus necessitating treatment.

Sometimes, a dissociative disorder may be accompanied by another mental health condition like:

Symptoms of dissociative disorders

Symptoms include:

  • The feeling of disconnection from yourself
  • Sudden mood swings
  • Having memory issues not caused by a medical condition or injury
  • Mental issues like inability to concentrate
  • Inability to handle intense emotional situations
  • Distorted reality, or derealisation (feeling like the world is not real)
  • Identity confusion
  • Anxiety 
  • Depression

What causes dissociation?

The exact cause of dissociative disorders is unknown. However, dissociation is often linked to the experience of traumatic events like abuse (physical, emotional, or sexual).

Stressful events like kidnappings, war, and invasive medical procedures may cause some form of dissociative disorder. It’s a way for survivors to try to cope with what has happened to them.

Complications of dissociation

If an untreated dissociative disorder persists, you are likely to experience the following complications:

How to treat dissociative disorders

Treatment for dissociative disorders may take years. It may involve:

  • Stress management. Since stress may trigger dissociative episodes, your doctor may decide to teach stress management as a way to manage your disorder.
  • Psychiatric medications. Your doctor may prescribe some anti-depressants or barbiturates to help manage your dissociative disorder
  • Psychotherapy. Psychotherapy is also referred to as talking therapy. Your doctor may recommend long-term therapy counseling to manage the underlying causes of your condition. Examples of talk therapies include psychoanalysis and cognitive therapy. 
  • Safe environment. Your doctor may recommend that you stay in a safe, peaceful environment to ensure recovery.
  • Treatment for underlying conditions. Usually, having a dissociative disorder may mean that you have other underlying mental health issues like anxiety and depression. Treating these conditions may help you manage a dissociative disorder.

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What is psychosis?

Psychosis is more of a symptom than an illness. It occurs when there’s a disruption in your thoughts that makes you unable to tell the difference between what's real and what isn’t. 

During these disruptions, you may see, hear, or believe things that are not real. You may also get some strange and persistent thoughts, emotions or behaviors. 

Going through psychosis might be confusing and frightening. However, different individuals may have different experiences with psychosis.

Symptoms of psychosis

There are two main symptoms of psychosis:

  • Hallucination. This is when you see, hear, feel, smell, or even taste things that don’t exist in reality. Even though these things don’t exist, they may seem very real.
  • Delusions. This is when you have a strong belief that's not shared by other individuals, like believing that people are conspiring to harm you.

When you experience both hallucinations and delusions, you may become severely distressed. These symptoms might even cause a total behavioral change referred to as a psychotic episode.

What causes psychosis

As mentioned earlier, psychosis may happen as a symptom of other mental health conditions. These conditions include:

  • Schizophrenia. This is a condition that’s known to cause psychotic symptoms like hallucinations and delusions.
  • Bipolar disorder. Bipolar disorder is a mental health condition that causes changes in mood, especially extreme highs (mania), and lows (depression).
  • Severe depression. Severe depression may cause you to show symptoms of psychosis in severe cases.

Other things that might trigger psychotic episodes include:

  • Stress
  • Traumatic or life-changing events
  • Drug or substance abuse
  • Prescription medication side effects

How to treat psychosis

Your doctor may recommend the following combination of treatments:

  • Psychotherapies. Psychotherapy, or talking therapy, may help you to manage psychosis. Examples of psychological therapies include cognitive-behavioral therapy (CBT) and family interventions. Family interventions are a type of therapy that may involve close family members, friends, or partners. 
  • Anti-psychotic medications. Your doctor may prescribe some anti-psychotic medicine to manage psychotic symptoms. In some cases, your doctor may recommend long-term use of these medications (possibly for life). If you show improvements, though, your doctor may gradually reduce your dosage and potentially take you off of them. Suddenly stopping to take anti-psychotics may trigger a relapse of psychotic symptoms, though, so you shouldn’t stop unless your doctor tells you to.
  • Support. Adequate social support and opportunities like employment, education, or accommodation may go a long way in helping to treat psychosis. 

In case you do not show improvement and the symptoms continue to become severe, your doctor may have to recommend admission to a psychiatric hospital for better management. Possible complications of psychosis include drug or alcohol abuse and self-harm (including suicide).

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Medically Reviewed on 5/3/2022
References
SOURCES:

American Psychiatric Association: "What Are Dissociative Disorders?"

Better Health: "Dissociation and dissociative disorders."

National Alliance on Mental Illness: "Psychosis."

NHS: "Dissociative disorders," "Overview - Psychosis."

The Dissociative Initiative: "Psychosis & Dissociation."