Some people with Functional Neurological Disorder (FND) describe feeling distant from themselves or the world around them. They may feel “spaced out”, detached, or as though things are happening behind a glass screen.
People often describe these experiences as dissociation. Dissociation can happen alongside FND, but it does not happen to everyone, and it does not mean that symptoms are imagined or deliberate.
What is dissociation?
Dissociation is a word used for experiences in which someone feels disconnected from themselves, their surroundings, their feelings, or what is happening around them. It can be brief or last longer, and it can feel different for different people.
Some people describe:
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feeling detached from their body, thoughts or emotions
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feeling that the world is distant, dreamlike or unreal
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feeling “spaced out”, vacant or not fully present
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finding it difficult to take in what people are saying or what is happening
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having gaps in their memory for some events
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feeling emotionally numb or disconnected from their feelings
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changes in how their body feels, such as a sense that a body part does not quite belong to them
People may use different words for similar experiences. Some may not find the word “dissociation” helpful or recognise themselves in every description.
Is dissociation the same as a functional seizure?
No. Dissociation describes a type of experience. A functional seizure describes a particular kind of episode. Dissociation can happen during a functional seizure, but it can also happen at other times. Not everyone who experiences dissociation has functional seizures.
Functional seizures can look different from one person to another. Some involve prominent movements; others may involve changes in awareness or responsiveness. Symptoms alone cannot determine what an episode is. If you are unsure what is happening, speak with a healthcare professional who can assess your circumstances.
Can stress cause dissociation?
Dissociation can occur during or after overwhelming stress, but it is not always linked to an obvious stressful event. Some describe it as a way the mind responds when someone feels overloaded. That description may help some people make sense of their experience, but it will not explain every person’s symptoms.
The body’s stress response can also cause physical sensations. For example, breathing quickly or shallowly may bring on tingling, light-headedness or other sensations in some people. Pins and needles can have many possible causes, though, so it is not a specific sign of dissociation or proof that a flare is about to happen.
How can dissociation interact with FND?
Dissociation and FND can occur together. Some people notice that when they feel detached or overwhelmed, their other symptoms become harder to manage. For others, there is no clear connection. Some people experience dissociation without a change in their FND symptoms.
Stress, fatigue, pain, sensory overload and other pressures may affect symptoms for some people. They do not mean that someone is choosing their symptoms, and they are not the cause of every FND episode.
If you notice a pattern, you could briefly note what you felt, what was happening around you, and how your symptoms changed. This may help you discuss it with your clinician. Try to treat it as information about your own experience rather than a rule that must apply every time.
What might help in the moment?
Different approaches work for different people. If you feel disconnected, you might try gently bringing your attention to the present—for example, noticing the feel of your feet on the floor, naming a few things you can see, or listening to a familiar sound.
Some people find slow, comfortable breathing helpful if they notice themselves breathing quickly. You don't need to force deep breaths. If an approach makes you feel worse, stop and try something else.
You can ask a clinician or therapist to help you find strategies that suit you, especially if dissociation is frequent, frightening or affecting daily life.
When to speak to a healthcare professional
If these experiences are new, changing, causing concern or interfering with daily life, discuss them with your GP or treating clinician. Describe what happens in your own words, including any changes in awareness, movement, sensation or memory.
Do not assume that every new or severe symptom is dissociation or FND. A healthcare professional can help assess whether anything else needs attention.
This article is for general information and support. It does not replace advice or care from a qualified health professional.