Derealization

What Is Derealization? 

Derealization is a mental state where you feel detached from your surroundings. People and objects around you may seem unreal. Even so, you’re aware that this altered state isn’t normal.

More than half of all people may have this disconnection from reality once in their lifetime. However, about 1% of people have it, and it is often enough for it to become an ongoing issue.

Depersonalization vs. derealization

Derealization is similar to but distinct from depersonalization. 

Derealization causes you to feel disconnected from the world around you.

Derealization Symptoms

Derealization usually happens in episodes, which means your symptoms come and go. During an episode, you might feel as if:

  • You’re in a dream or “fog.”
  • A see-through wall or veil separates you from your surroundings.
  • The world appears lifeless, muted, or fake.
  • Objects or people look “wrong” – for instance, blurry, unnaturally sharp, too big, or too small.
  • Sounds are distorted, too loud, or too soft.
  • Time seems to speed up, slow down, or stand still.
  • The people around you aren’t real. For instance, you might feel like they’re robots, even though you know they’re not.

How long does derealisation last?

Episodes can last a few hours or stretch for months. If your symptoms linger, they may improve or worsen at times. But even if you feel like you’re going “crazy,” you always recognize that something is off and how you think isn’t typical for you. This is a crucial difference from psychotic disorders, where you can’t tell what’s real and what’s imaginary.

Derealization Causes

Derealisation can sometimes be a symptom of a medical condition. Other times, it can happen on its own, often in reaction to severe trauma or stress.

Health issues that are linked to derealization include:

The most common event that can trigger derealisation is emotional abuse or neglect at a young age. As a child, you might have learned to detach from the world around you as a way to manage the trauma. Other sources of stress might include:

  • Physical abuse
  • Sexual abuse
  • Witnessing domestic violence
  • A parent or caregiver with a severe mental disorder
  • Unexpected death of a loved one
  • PTSD from war or conflict
  • Trauma from an accident or a natural disaster

Once you experience derealization, an episode can be triggered by more minor, everyday stressors, like an issue at work or in a relationship.

Derealization panic attack

Between 3.3% and 20% of people who live with an anxiety disorder have dissociative symptoms. If you get panic attacks (episodes of intense fear that cause physical effects, like a racing heart and sweating), it’s common to feel as if the things around you aren’t real. While this can be unsettling, these symptoms won’t lead to serious mental health issues like psychosis or brain damage.

To manage a panic attack,  you may find it helpful to:

Breathe deeply. Close your eyes and focus on breathing. Inhale slowly through your nose. Then, exhale just as slowly out of your mouth.

Tell yourself that this is temporary. You might even remind yourself aloud: “I’m having a panic attack, and this will pass.”

Focus on the present. This can help you feel more grounded when things around you don’t feel real.

Derealization risk factors

Derealisation is more likely to happen because of things like:

  • Your personality. For instance, if you avoid stressful situations or find it hard to talk about your feelings.
  • Trauma or extreme stress. Whether it happened to you as a child or as an adult, your brain may be trying to protect you from overwhelming feelings. 
  • Depression. About half of people with depression have derealization or depersonalization.
  • Anxiety

Derealization from drug use is common, too. For instance, it’s a well-known side effect of marijuana. But some people keep having episodes months or years after they stop using weed.

You can have symptoms of depersonalization-derealization disorder at any age, although it’s most common in teenagers and young adults. Kids and older adults are the least likely to develop it.

When to See a Doctor

Feeling like the world around you suddenly isn’t real can feel scary. You may spend a lot of time wondering if you have a severe mental health issue and trying to check your reality. You may be nervous about telling anyone because your symptoms can feel and sound weird. But any time you have concerns about your mental health, it’s important to get support.

Make an appointment with your doctor if your symptoms:

  • Cause you stress 
  • Make it hard to get through your day
  • Create issues at work, school, or in your relationships
  • Don’t go away or keep returning

Derealization Treatment

Many people who have derealisation recover fully, sometimes on their own. You can also learn how to manage episodes when they happen. Either way, you may find support from a mental health expert beneficial. That’s especially true if you also live with depression or anxiety.

The gold-standard treatment for derealization is talk therapy. A mental health professional like a counselor or psychologist can help you:

  • Learn more about derealisation
  • Keep yourself from obsessing about unreal experiences
  • Ground yourself, in reality, using your five senses (for example, by playing loud music or holding something icy).
  • Address negative feelings and figure out the causes of your symptoms
  • Talk about your feelings using specific words
  • Get better at dealing with stress
  • Explore and improve your mental health

Some kinds of therapy that can improve derealization symptoms include:

Cognitive bbehavioraltherapy (CBT) can help you understand how your thoughts affect your actions and how to unlearn negative thought patterns. You’ll set goals and learn skills.

Psychodynamic therapy explores your past experiences, and how they influence you today. Because you’ll be talking a lot about yourself, finding a therapist you trust and connect with is essential.

Eye movement desensitization reprocessing (EMDR) is a newer therapy that helps you process past traumas by moving your eyes in a particular way. Many clinical trials have shown it to be effective in treating derealisation.

No drug can prevent or stop derealization, but if you’ve been diagnosed with another mental health condition, your doctor may prescribe a treatment to manage those symptoms. That could include:

  • Anti-anxiety medication
  • Antidepressants
  • Mood stabilizers, which can treat conditions like bipolar disorder and borderline personality disorder
  • Antipsychotic medications, which help treat conditions like schizophrenia and mania

How does a person with depersonalization act?

Someone who’s going through this type of dissociation feels detached from themselves. They could:

  • Not recognize themselves in a mirror
  • Feel like they’re floating above their body
  • Worry that their arms and legs aren’t in the right shape
  • Be numb to their senses (what they taste, touch, see, hear, or smell)
  • Have a hard time responding to the world around them
  • Feel like their memories are not their own

If someone you care about is having an episode of depersonalization or derealisation, knowing how to support them can be challenging. They may not be able to put what they’re going through into words or act like their usual selves. You can ask what they need, and listen if they want to talk. If they have techniques to help them manage episodes, you can offer to help them do those. If you can, make a plan ahead of time of who to call for extra support.