People with attention deficit hyperactivity disorder (ADHD) may be at risk of developing dissociation, particularly if they have also experienced trauma. Doctors may use psychotherapies to treat severe dissociation.
Dissociation occurs when people lose awareness of their immediate surroundings. It causes a disconnect between a person’s thoughts, actions, feelings, memories, or sense of self.
Experiences of trauma may link ADHD and dissociation. Developmental issues and how people with ADHD respond to stressful life events may also increase the risk of dissociation.
This article looks at the link between ADHD and dissociation, the signs and symptoms of dissociation, how to seek help, and how people with ADHD can manage symptoms of dissociation.
What is dissociation in ADHD?
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According to the American Psychiatric Association (APA), everyone will experience mild dissociation from time to time. Symptoms of mild dissociation include daydreaming or becoming fully engrossed in something, such as a book or film.
Severe dissociation takes these feelings further. It can cause a disconnect in identity and perception, and people may become emotionally numb. An example might be if a person experiences a traumatic event but has no feelings about it.
People with a dissociative disorder may experience memory loss and feelings of being outside their bodies. The APA suggests dissociative disorders usually link to previous trauma.
A 2018 article suggests that people with ADHD may develop symptoms of dissociation. ADHD may significantly increase mental stress levels. Developmental issues may affect how a person responds to stressful life events, which may lead to dissociation.
A 2022 study suggests that children with hyperactive and impulsive symptoms of ADHD show a greater frequency of traumatic experiences, which can increase the risk of exhibiting dissociative symptoms.
Zoning out vs. dissociation
Zoning out can include mind wandering, daydreaming, or any time attention wanders from a task. Zoning out shares symptoms with mild dissociation, which is a natural and common experience. Severe dissociation goes further than zoning out.
The International Society for the Study of Trauma and Dissociation (ISSTD) associates dissociative disorders with the experience of trauma. People may dissociate from a traumatic experience to disconnect from the distress the trauma causes.
If dissociation continues, people may disconnect from emotional or distressing situations, becoming emotionally numb. According to the ISSTD, people with dissociative disorders may feel like a passenger in their own bodies.
Causes of dissociation
According to the ISSTD, environmental and biological factors can cause dissociation. This may include repetitive trauma in childhood, including physical, sexual, or emotional abuse or severe neglect.
The ISSTD suggests that people cannot inherit a tendency to dissociate, but children may develop dissociation if their parents dissociate.
Unpredictable, frightening, or highly contradictory communication within a family may also cause dissociation in children. Continued trauma in childhood is a significant risk factor for adults developing dissociative disorders.
According to a 2022 study, the hyperactive and impulsive symptoms of ADHD are associated with an increased prevalence of trauma, which can predispose people to dissociative symptoms.
Symptoms of ADHD and dissociation may also have overlapping features, such as memory problems and emotional dysregulation.
Early experiences of severe trauma may play a significant role in developing ADHD symptoms. Research in this article also suggests an increased likelihood of children with ADHD experiencing traumatic events, which could lead to dissociation in adulthood.
Symptoms
Signs and symptoms of dissociation in people with ADHD may include:
- emotional numbing, which is having no feelings about a traumatic or extremely upsetting event
- out-of-body experiences, such as carrying out a task or action as though being controlled by an external force, or feeling as though they are watching themselves, as in a movie
- the feeling of an emotion coming out of nowhere or taking over, which does not appear to make sense at that moment
- doing something abnormal or out of character but being unable to stop themselves, as though compelled
- significant gaps in memory of certain times, events, or people
- mental health conditions, such as anxiety, depression, or suicidal thoughts
- a lack of a sense of self or self-identity
When to speak with a doctor about dissociation
It can be natural for people to daydream or have occasional lapses in attention. However, if people are experiencing severe symptoms of zoning out or experiencing symptoms of a dissociative disorder, they may choose to contact a doctor.
A doctor may assess any symptoms and personal history, which may indicate dissociation. A doctor may also refer people to a mental health specialist to make a diagnosis.
Doctors may use criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) to diagnose dissociative disorders.
How to manage dissociative symptoms
Psychotherapy is usually the standard treatment for dissociation. It can help people manage their symptoms and regain control. Therapies that can help people cope with previous traumatic events may include:
- cognitive behavioral therapy (CBT)
- dialectical behavioral therapy (DBT)
- hypnosis
- eye movement desensitization and reprocessing (EMDR)
Although no medications can treat dissociative symptoms directly, medication can treat co-occurring conditions, such as depression.
Supporting a child with ADHD and dissociative symptoms
Certain dissociative symptoms in children are natural, such as complete absorption in a game. Dissociation is not a problem if it does not affect a child’s development or sense of self.
If a child with ADHD is zoning out due to overwhelm by a task or situation, it may help to break down a task into smaller steps, create a checklist, or develop a reward system.
Dissociation may be problematic if it occurs as a way of escaping or coping with a frightening or traumatic event.
Learning about dissociation can help people better understand the condition and help a child who is experiencing it. People may find it helpful to talk with psychiatrists, school counselors, or social workers.
People can acknowledge how a child is feeling, no matter how extreme the feelings may appear. People can ask a child where those feelings came from and how they can support them to feel safe.
Outlook
According to the APA, getting the correct treatment can help people manage symptoms of dissociation, improve functioning, and help them live fulfilling and productive lives.
A therapist can help adults and children understand the possible cause of dissociation, support the processing of previous trauma, and reduce dissociative responses.
Summary
ADHD is a potential risk factor for dissociative disorders. ADHD and dissociation may have overlapping features, such as experiencing trauma in childhood.
Psychotherapies may help treat severe dissociation in adults and children with ADHD. If a person is concerned about dissociative feelings, they can talk with a healthcare professional to seek further treatment.
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