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Not all PTSD looks the same. Explore the science behind dissociative PTSD, the symptoms most miss, and the powerful tools for healing in 2025.

 


Dissociative PTSD: When Trauma Makes You Disappear From Yourself

Inside the lesser-known, more complex face of post-traumatic stress disorder that many still misdiagnose or misunderstand.

“I feel like I’m watching my life from outside my body.”

If you've ever heard someone describe trauma that way, you’re not alone—and neither are they. That feeling isn’t just dramatic language. It’s a real psychological state called dissociation, and when it hijacks your brain after trauma, it becomes something deeper: Dissociative PTSD.

And yes, it’s very real. And very misunderstood.

What Is Dissociative PTSD, Exactly?

Dissociative PTSD is a subtype of post-traumatic stress disorder marked by intense, chronic episodes of depersonalization (feeling detached from yourself) and derealization (feeling like the world around you isn’t real). It’s not just about flashbacks or nightmares — it’s about losing your sense of self.

The Clinical Definition

The DSM-5 recognizes Dissociative PTSD as PTSD “with dissociative symptoms”, where individuals meet all standard PTSD criteria plus:

  • Depersonalization: feeling as though you're observing yourself from outside your body.

  • Derealization: the sense that your surroundings aren’t real, like a dream or a movie.

“Dissociation is not a glitch — it’s the brain’s defense strategy in the face of overwhelming threat,” says Dr. Ruth Lanius, a psychiatrist and leading trauma researcher at Western University.

Why Does It Happen?

The Brain’s Emergency Exit Plan

Imagine your nervous system pulling the fire alarm during trauma. If you can’t escape, your brain might shut things down to protect you — emotionally and cognitively.

According to a 2023 NeuroImage: Clinical study, individuals with dissociative PTSD show altered functional connectivity in areas like the prefrontal cortex, amygdala, and insula, which control fear regulation, body perception, and self-awareness (source).

The dissociative subtype is especially common in people who have:

  • Childhood trauma or abuse

  • Complex PTSD

  • Repeated interpersonal trauma (e.g., domestic violence, trafficking)

How It Feels (and Why It’s So Hard to Explain)

People with dissociative PTSD often describe life like this:

  • "I look in the mirror and don’t recognize myself."

  • "It’s like my emotions are on mute."

  • "Sometimes I can’t remember huge chunks of my day."

Sound confusing? That’s the point. Dissociation confuses even the person experiencing it, which is why it's so often misdiagnosed as:

  • Bipolar disorder

  • Psychosis

  • Schizophrenia

  • Borderline Personality Disorder

Diagnosis: A Gray Area in Psychiatry

Despite being officially recognized, dissociative PTSD is often underdiagnosed — even by mental health professionals.

According to a 2022 study in European Journal of Psychotraumatology, over 30% of people diagnosed with PTSD actually meet the criteria for the dissociative subtype, but are never told they have it (source).

Why the gap?

  • It hides in plain sight.

  • Patients often don’t know how to describe dissociation.

  • Clinicians may lack training in trauma-informed assessments.

Treatment: Healing from the Inside Out

The good news? There’s help. And more importantly — there’s hope.

Trauma-Focused Therapies

These therapies help people safely revisit and process trauma while staying grounded:

  • Eye Movement Desensitization and Reprocessing (EMDR)

  • Sensorimotor Psychotherapy

  • Internal Family Systems (IFS)

  • Trauma-focused CBT (TF-CBT)

Bottom-Up + Top-Down Approaches

Experts like Dr. Bessel van der Kolk emphasize using both body-based (bottom-up) and cognitive (top-down) healing methods. Dissociation often lives in the body, so therapies like yoga, somatic experiencing, and neurofeedback are becoming essential tools.

The Future of Dissociative PTSD Research

In 2025, the field is rapidly evolving. Neuroimaging studies are improving our understanding of dissociation as a neurobiological response — not a “personality flaw.”

Organizations like the International Society for the Study of Trauma and Dissociation (ISSTD) and NIH-funded projects are working to improve diagnostic tools and reduce stigma.

If This Sounds Like You, You're Not Broken

You’re protecting yourself the only way your nervous system knows how.

Healing from dissociative PTSD doesn’t mean you “snap out of it.” It means you gently come back into your body, piece by piece, with the help of safe relationships, therapy, and time.

You’re not faking. You’re surviving.

And survival is your superpower — even when it doesn’t feel like it.

Want to Learn More?

Tags

#DissociativePTSD #TraumaHealing #MentalHealth #Neuroscience #PTSD #CPTSD #Therapy #MindBodyConnection #MediumHealth #SurvivorStories

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