Bipolar disorder can sometimes lead to distinct dissociative experiences. But dissociation is not a standard symptom of bipolar disorder.

Bipolar disorder is a mental health condition that affects millions of people worldwide. It’s characterized by episodes of mania and depression that can significantly impact your daily life.

Bipolar disorder can sometimes incorporate dissociative symptoms distinct from bipolar symptoms listed in the Diagnostic and Statistic Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Symptoms like detachment from reality or gaps in memory are a couple of examples of dissociation.

Recognizing the difference between bipolar and dissociative symptoms can help you understand the extent that bipolar may be affecting you. It may also lead to changes in your treatment approach and potentially better treatment outcomes.

Dissociation is a phenomenon that can occur in response to intense emotional or physical trauma or in certain mental health conditions. It can be thought of as a defense mechanism that your brain uses to cope with overwhelming experiences or emotions, according to the American Psychiatric Association.

Dissociation can take many forms. One example is a feeling of being disconnected or detached from your surroundings or yourself. This can manifest as a feeling of being in a dreamlike state or as a sense of disorientation.

Dissociation can be related to a distinct dissociative disorder, like depersonalization-derealization disorder, for example. But symptoms of dissociation can also be experienced as a part of bipolar disorder.

If you’re living with bipolar disorder, you may experience symptoms of dissociation during episodes of mania or depression.

During a manic episode, you may feel restless and easily distracted in what’s essentially a heightened state of arousal. This state may develop to an extreme and result in an overall feeling of disconnection or dissociation from reality.

During a depressive episode, you may feel numb or disconnected from your emotions and surroundings. This general dissociation may make your depression feel worse and generally make it harder to cope with daily life.

Bipolar dissociation symptoms

Common symptoms of bipolar dissociation can vary and may depend on whether you’re experiencing a manic or depressive episode. But some of the symptoms of dissociation in bipolar disorder can include:

  • feeling disconnected from yourself or your surroundings
  • feeling as though you’re in a dreamlike state
  • difficulty concentrating or feeling easily distracted
  • feeling emotionally numb or detached from your feelings
  • memory loss or difficulty recalling important details of past events
  • feeling as though time is passing more quickly or slowly than usual
  • feeling as though you’re watching yourself from outside of your body
  • feeling disoriented or confused

It’s well-known that bipolar disorder often co-occurs with other mental health disorders. But the relationship between bipolar disorder and dissociative symptoms is generally an understudied topic.

A small 2021 study of 100 bipolar patients examined the frequency of dissociative symptoms and found that about 45% experienced dissociative symptoms.

A larger 2022 review found that dissociative symptoms occurred in about 10-20% of bipolar cases. The review also noted that it can be difficult to identify and diagnose dissociative symptoms in bipolar properly.

Bipolar disorder and dissociative disorders can occur together, but the research demonstrating specific links is limited.

A 2019 study found that dissociative disorders frequently co-occurred in about 35% of participants living with bipolar disorder. The most common dissociative disorder noted in this study was depersonalization disorder.

A 2022 review noted that smaller studies have similarly identified the co-occurrence of bipolar and other dissociative disorders. In addition to depersonalization disorder, these also included dissociative amnesia and dissociative identity disorder.

While dissociative disorders do seem to coincide with bipolar, their frequency and overall prevalence are still being explored.

Treatment for bipolar dissociation typically involves addressing the underlying bipolar disorder through a combination of medication and therapy.

Medications like mood stabilizers and atypical antipsychotics are commonly prescribed for bipolar disorder. Mood stabilizers like lithium or valproate aim to reduce the severity of mood episodes and ideally prevent them.

Psychotherapy is also commonly recommended for both bipolar disorder and dissociative disorders. It may include different types of therapies, like cognitive behavioral therapy, which aims to provide you with new strategies and skills to manage your symptoms.

Additionally, grounding skills and sensory awareness techniques may also be helpful, specifically for dissociative disorders, according to 2020 research.

Bipolar dissociation involves experiencing distinct symptoms that are unique from bipolar symptoms. Dissociative disorders are a bit more involved and can sometimes be present alongside bipolar, but they can be challenging to identify.

If you’re living with bipolar disorder, you may at some point experience dissociative symptoms, but it’s not always the case. Following through with prescribed treatments is important in preventing dissociative episodes and helping you achieve a greater sense of balance in your day-to-day life.

With the right treatment plan and care team, bipolar and dissociative symptoms can seem less complex and more easily manageable.