Dissociation in ADHD

People with attention-deficit hyperactivity disorder (ADHD) may have a higher risk of experiencing dissociation, which involves feeling disconnected from yourself and your surroundings. This risk is higher for people with ADHD who have also experienced trauma.

While dissociation is not a symptom of ADHD, the two are closely related because they are often comorbid. People with dissociative disorders may also show symptoms of ADHD and vice versa.

What Is Dissociation?

Dissociation is a broad term that encompasses a wide range of disorders in which people cope with stress or trauma by mentally “escaping” reality. In media, you usually see it presented as dissociative identity disorder (formerly known as “split personalities”) or amnesia (extreme, isolated bouts of memory loss).

But it’s not always so extreme as that. For many, it takes the form of depersonalization or derealization, where your automatic survival/protective response kicks in, causing you to "detach" from the pain or stress you're experiencing. You might feel like you’re on the outside of your own life, watching events unfold as a spectator rather than as the protagonist.

For some people, this can take the form of becoming so absorbed in a book, movie, or other imaginary world that you become less self-aware and oblivious to the outside world. This phenomenon is referred to as dissociative absorption.

When a person experiences something traumatic, one way to cope with that intense emotional pain is to make a clean mental break with yourself. If you can’t physically escape the situation or remove the memory, you can at least mentally escape it.

It’s your brain’s way of trying to keep you safe and happy. But the drawback is that you don’t just detach from the pain. You detach from everything. It can be hard to maintain healthy relationships or stay focused at work or school if you don’t feel like any of it is your life.

You might start feeling numb or emotionally unavailable. You might also begin to feel a sense of unreality, as if the world around you or even you aren’t real. Often, you’ll find yourself “checking out” involuntarily or “spacing out” in the middle of doing something.

Understanding Disassociation in ADHD

Dissociative disorders are most commonly linked to trauma, so how is it related to ADHD? The connection lies in the fact that trauma and ADHD are closely linked. Otherwise typically developing children who experience trauma can end up developing ADHD-like symptoms.

Conversely, people with ADHD may be more likely to experience trauma—either as the result of being targeted for bullying or abuse because of their ADHD symptoms or because of negative experiences related to those symptoms.

As a child, I had a vivid imagination and would often daydream or mind-wander during anything: class, family dinner, watching TV, playing sports. The number of goals other teams scored on me during soccer games because I was distracted by my brain is too high to count.

But the ability to hyperfocus when under pressure meant that I performed well on tests, so I usually managed to pass my classes. So, even when other symptoms like my impulsive behavior or emotional dysregulation became bad enough for my parents to seek treatment, I wasn’t diagnosed with ADHD because my grades weren’t bad enough, and I wasn’t hyperactive.

By adulthood, I was struggling to hold down a steady job, barely scraping by in college classes, and wrestling with low self-esteem. I was also dealing with some traumatic experiences that resulted from past impulsive decisions.

The dissociative symptoms started to get really noticeable around high school. It was different than just having my mind wander like I was used to growing up. Regular daydreaming just felt like storytelling or entertainment, but I was always still myself and still emotionally invested in my life—just struggling to stay tuned into it all the time.

Dissociating, on the other hand, felt like completely leaving. I described it to a therapist once as floating somewhere above my body, watching things happen, and feeling like maybe I should help that person, but not like it really had anything to do with me.

How to Deal With Dissociative Symptoms

The “checking out” might happen involuntarily and you might have no idea what triggers it yet, but you can slowly regain control and prevent dissociative episodes with practice and treatment. Here are six strategies I find helpful.

Go to Therapy

Whether the ADHD or the trauma came first, therapy will be crucial for recovery and symptom management. Even if you can’t pinpoint any particular experience or event, dissociative symptoms are usually the result of your brain trying to protect you from emotional pain.

Difficulties in school or struggling to make friends, for example, may not seem as painful or severe as going to war or watching a loved one die, but the chronic stress they cause can be enough for your brain to kick into protection mode.

Practice Grounding Exercises

If you notice you’re dissociating, a grounding exercise—where you practice being present in the moment—can help you come back to yourself. All that really means is taking a few minutes to become aware of your senses and your surroundings.

For best results (in my opinion), take a walk outside while you do this so that you have plenty of sensory input to work with. And if you can’t think of enough things for any specific sense, just skip it.

I usually struggle with naming a taste unless I’m actively eating or drinking something, for example. So I just loop back around to things I can see and keep going until I feel more aware and in tune with my surroundings.

Engage Your Senses

Pet your cat, and focus on how soft the fur feels. Light a scented candle and take a few moments to inhale and enjoy the smell. Go to a park and walk barefoot on the grass, paying attention to the feeling of grass beneath your feet.

Really any positive physical sensation can help. Then, just do your best to focus on that sensation.

Get Some Exercise

I love going for a run when I need to ground myself or just get rid of some built-up restlessness. But even if you don’t want to break a sweat, going for a walk or dancing around to your favorite music will also get you moving without feeling like exercise.

Even if you’re at work, doing some lunges or squats can do the trick. Exercise can help because it’s another way of engaging your senses.

Keep a Journal

Dissociating comes with memory gaps and a poor ability to connect to your emotions. Journaling is an exercise that can help with both of those. Make it a daily habit to sit down and write about your day, focusing on how you felt and what you were thinking about throughout it.

Schedule Self-Care Activities

Whatever the cause, dissociation is your brain’s way of protecting you from negative experiences. If you’re stressed all the time or have a negative relationship with your body, that can make dissociative symptoms worse.

To counteract that, make a habit of doing kind, healthy things for yourself. Ending each workday with a bubble bath and a book or starting each morning with a 10-minute dance session to your favorite playlist can help build a more positive relationship with yourself.

Over time, those acts of kindness and nurturing will strengthen your connection to yourself, just like they would in a relationship with another person.