Many who struggle with various types of trauma end up developing dissociative disorders, sometimes referred to as PTSD dissociation. ¹ In short, traumatic events can become so overwhelming that an individual will dissociate from the event to cope.

However, such coping isn’t a healthy way to process traumas. Furthermore, those who attempt to dissociate from their traumas may develop other life complications.

Dissociation vs. Dissociative Disorders

Trauma is a complex issue that can have equally complex effects on a person’s psyche. For this reason, it’s important for us to properly define the differences between dissociation and dissociative disorders:

Dissociation

Dissociation is a disconnection between a person’s feelings, memories, behaviors, thoughts, perceptions, and/or identity. Naturally, everyone will experience dissociation at some point in their lives. Common examples include daydreaming or zoning out.

Dissociative Disorders

The key difference between “normal” dissociation and a disorder is how it affects your life. You struggle with a dissociative disorder if your dissociation has interfered with your work, schooling, or social life.

It’s believed that 2% of the population struggles with dissociative disorders. Such statistics have not found any differences in relativity among ages, ethnic groups, and socioeconomic backgrounds. ²

Still, dissociative disorders are more commonly diagnosed in women than men. While this may indicate that women struggle with this illness more than men, evidence suggests that men simply don’t seek out help as frequently for these symptoms.

The most common symptoms found within dissociative disorders include:

• Emotional detachment
• Feeling physically detached from one’s body
• Lacking a sense of self
• Memory loss (involving people, places, or events)

Dissociative disorders may also produce other consequences, such as:

• Anxiety
• Depression
• Employment issues
• Relationship problems
• Thoughts of self-harm

Types of Dissociative Disorders

Since symptoms vary from person to person, dissociative disorders are divided into the following categories:

• Dissociative Amnesia – Memory loss concerning an important event or period in one’s life. ³

• Dissociative Fugue – Wandering off and having no memories of a specific event or time. ³

• Depersonalization (Derealization) – Sense of being outside your body or watching your life from the outside. While classified as a disorder, some people may experience a single (or multiple) episode(s) of depersonalization. ⁴

• Dissociative Identity Disorder – When one experiences confusion and alterations concerning identity. This condition may lead to “split” personalities in more severe cases. ⁵

It’s also worth noting that some dissociative disorders are not specified as they don’t fit into a single category.

The Link Between Dissociation and Trauma

Among mental health experts, it’s common knowledge that those who experience trauma (notably, childhood trauma) are likely to develop dissociation disorders. In fact, 90% of people with dissociative conditions have experienced some kind of traumatic event(s) in their lives. ⁶

The trauma we associate with post-traumatic stress disorder (PTSD) is often linked to a single event. ⁷ However, people with both PTSD and dissociative symptoms may have experienced ongoing trauma.

Dissociation as a Coping Mechanism

As mentioned, many people develop dissociative behaviors as a means of coping with previous traumas. When trauma occurs, it’s natural for our brains to dissociate from the environment. For example, a child experiencing abuse may find themselves in a dissociative state to escape the full experience of the trauma.

This process is complex and varies from person to person. For example, one child may enter a derealization state to make reality feel like a dream. Another child may simply try to forget the trauma over time. ⁸

On top of this, children may develop dissociative symptoms from emotional abuse and neglect. ⁹ However, these processes are much more difficult to identify than physical and sexual abuse.

Long-Term Dissociative Effects

While PTSD dissociation initially helps you cope with the stress induced by trauma, it can lead to other problems that may not immediately be present. These will largely appear in day-to-day life, from work to school to relationships.

In many cases, people with dissociative disorders don’t realize they use dissociation as a means of coping with previous traumas. This is one of the reasons many may not address the condition before receiving a diagnosis.

Trauma and Dissociation Age Onset

Dissociative disorders can appear in any person of any age group, and the severity of the condition largely depends on the severity of the trauma.

However, most research agrees that dissociative disorders are most common when a person experiences trauma during childhood. ¹⁰

More specifically, the most vulnerable age groups are children of preschool age (ages four to five) and of pre-adolescents age (ages eight to nine). Furthermore, dissociative disorders appear more commonly in those who have ongoing trauma before the age of nine. ¹¹

How Trauma and Dissociation Change the Brain

According to a 2018 review, children who experience trauma will also undergo changes in brain and neural connections. ¹² In turn, this can lead to the symptoms and behaviors we associate with PTSD dissociation.

While we don’t know the full depth of these changes, we understand it may lead to communication changes between limbic and frontal lobe activity. Still, we need more research to better understand this topic.

What is PTSD Dissociation?

While PTSD and dissociation are closely related, they’re also considered separate conditions. To differentiate the two, some psychologists consider dissociative disorders a subtype (or subset) of PTSD. ¹³

As mentioned, PTSD typically develops from a single traumatic event. This may include witnessing a violent event, a natural disaster, or experiencing the loss of a loved one. Furthermore, PTSD can develop at any point in a person’s life, whereas dissociative disorders tend to begin in childhood. ¹⁴

With that said, people who develop PTSD during adulthood are less likely to develop dissociative disorders. On top of this, dissociative disorders are more commonly seen as a result of ongoing trauma rather than a single event.

What is the Dissociative Subtype of PTSD?

If you experience symptoms of both PTSD and dissociative disorder, you’ll receive a diagnosis of PTSD with a dissociative subtype. As with other forms of dissociation, this is most commonly displayed in those who experienced childhood trauma and had more exposure to trauma.

How to Treat Dissociation

Many people with dissociative disorders don’t seek out treatment simply because they’re unaware of what they struggle with. In turn, undiagnosed dissociation can lead to anxiety, depression, substance use disorder, and work and/or relationship issues.

Luckily, it’s possible to recover from dissociative disorders and PTSD under the right treatment. This usually involves a combination of psychotherapies and medications.

Psychotherapy is the most important element here as it will allow you to safely confront and cope with your traumatic experience. On top of this, such therapies provide you with a better understanding of your thought processes and how to overcome dissociative symptoms.

Final Word

If you went through ongoing childhood trauma, there’s a chance you developed PTSD and a dissociative disorder. However, if you develop PTSD during adulthood, then you’re less likely to develop dissociation.

In either case, both conditions can be properly treated. You must seek out treatment for these conditions as it will prevent further complications down the road.

References

¹ Farina B, Liotti M, Imperatori C. The Role of Attachment Trauma and Disintegrative Pathogenic Processes in the Traumatic-Dissociative Dimension. Front Psychol. 2019 Apr 26;10:933. doi: 10.3389/fpsyg.2019.00933. PMID: 31080430; PMCID: PMC6497769.

² Kihlstrom JF. Dissociative disorders. Annu Rev Clin Psychol. 2005;1:227-53. doi: 10.1146/annurev.clinpsy.1.102803.143925. PMID: 17716088.

³ Clouden TA. Dissociative Amnesia and Dissociative Fugue in a 20-Year-Old Woman With Schizoaffective Disorder and Post-Traumatic Stress Disorder. Cureus. 2020 May 26;12(5):e8289. doi: 10.7759/cureus.8289. PMID: 32483516; PMCID: PMC7255065.

⁴ Gatus A, Jamieson G, Stevenson B. Past and Future Explanations for Depersonalization and Derealization Disorder: A Role for Predictive Coding. Front Hum Neurosci. 2022 Mar 7;16:744487. doi: 10.3389/fnhum.2022.744487. PMID: 35321264; PMCID: PMC8934883.

⁵ Gillig PM. Dissociative identity disorder: a controversial diagnosis. Psychiatry (Edgmont). 2009 Mar;6(3):24-9. PMID: 19724751; PMCID: PMC2719457.

⁶ Loewenstein RJ. Dissociation debates: everything you know is wrong. Dialogues Clin Neurosci. 2018 Sep;20(3):229-242. doi: 10.31887/DCNS.2018.20.3/rloewenstein. PMID: 30581293; PMCID: PMC6296396.

⁷ Mann SK, Marwaha R, Torrico TJ. Posttraumatic Stress Disorder. 2024 Feb 25. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32644555.

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⁹ Schalinski I, Teicher MH. Type and timing of childhood maltreatment and severity of shutdown dissociation in patients with schizophrenia spectrum disorder. PLoS One. 2015 May 19;10(5):e0127151. doi: 10.1371/journal.pone.0127151. PMID: 25992568; PMCID: PMC4438058.

¹⁰ Scheeringa MS. PTSD in Children Younger Than the Age of 13: Toward Developmentally Sensitive Assessment and Management. J Child Adolesc Trauma. 2011 Sep;41(3):181-197. doi: 10.1080/19361521.2011.597079. Epub 2014 Jan 11. PMID: 30792828; PMCID: PMC6379904.

¹¹ Hagan MJ, Hulette AC, Lieberman AF. Symptoms of Dissociation in a High-Risk Sample of Young Children Exposed to Interpersonal Trauma: Prevalence, Correlates, and Contributors. J Trauma Stress. 2015 Jun;28(3):258-61. doi: 10.1002/jts.22003. PMID: 26062136.

¹² Krause-Utz A, Elzinga B. Current Understanding of the Neural Mechanisms of Dissociation in Borderline Personality Disorder. Curr Behav Neurosci Rep. 2018;5(1):113-123. doi: 10.1007/s40473-018-0146-9. Epub 2018 Feb 12. PMID: 29577011; PMCID: PMC5857558.

¹³ Stein DJ, Koenen KC, Friedman MJ, Hill E, McLaughlin KA, Petukhova M, Ruscio AM, Shahly V, Spiegel D, Borges G, Bunting B, Caldas-de-Almeida JM, de Girolamo G, Demyttenaere K, Florescu S, Haro JM, Karam EG, Kovess-Masfety V, Lee S, Matschinger H, Mladenova M, Posada-Villa J, Tachimori H, Viana MC, Kessler RC. Dissociation in posttraumatic stress disorder: evidence from the world mental health surveys. Biol Psychiatry. 2013 Feb 15;73(4):302-12. doi: 10.1016/j.biopsych.2012.08.022. Epub 2012 Oct 9. PMID: 23059051; PMCID: PMC3589990.

¹⁴ Ditlevsen DN, Elklit A. The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder? Ann Gen Psychiatry. 2010 Jul 21;9:32. doi: 10.1186/1744-859X-9-32. PMID: 20663164; PMCID: PMC2917414.