Derealization: Why You Feel Like Nothing Is Real

Derealization is an altered state of perception in which you feel detached from the reality of your environment. It’s typically temporary and not dangerous, but it can be unsettling to experience.

For example, have you ever been in a familiar environment but felt disconnected from it – like you were observing it, instead of being in it? The world around you might have seemed foggy, dreamlike, or even two-dimensional – flat. 

This feeling could be derealization, a dissociative symptom of poor mental health that alters your perception of reality.

What is derealization?

Derealization is a complex mental health phenomenon characterised by a sense of detachment from your surroundings, often described as feeling as though the world is unreal, feeling as if everything is a dream, or distorted. Derealization is a temporary shift in how your mind processes information about your environment.

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During an episode of derealization, the world may appear muted, blurry, or distorted. Imagine watching a movie scene unfold around you; you are able to observe it, but unable to fully engage with the sights, sounds, events, people, or sensations. You feel detached from everything.

Derealization doesn’t mean you’re going insane

Derealization can be so unsettling it may make you wonder if you’re going insane – you’re not. Derealization is not insanity.

Despite detaching from reality during an episode of derealization, you don’t doubt what is real, as you might if you were hallucinating or delusional; instead, you are simply processing reality in a way that prevents you from fully engaging with it.

And while derealization is not dangerous, the shift in perception can profoundly affect how we perceive and interact with the world, cause significant distress, and impair daily life.

Derealization is different from depersonalization, another dissociative symptom of poor mental health. Depersonalization involves feeling detached from yourself, as if you’re observing your own body, thoughts, feelings, and actions from a distance. While they can co-occur, derealization specifically focuses on your experience of and relationship to the world around you.

Derealization causes

The exact causes of derealization remain unknown, but several factors are believed to contribute:

• Stress and anxiety: When faced with overwhelming stress or worry, the brain may detach or dissociate itself from the situation as a coping mechanism. Derealization may act as a temporary mental pause button, allowing you to detach from emotions that distress you.
• Trauma: Traumatic experiences, like a car accident or emotional abuse, can trigger derealization as a way to manage intense emotional pain and negative memories.
• Panic attacks: The intense physical and emotional sensations of a panic attack can lead to feelings of detachment from the world as the body goes into fight-or-flight mode.
• Depression: Derealization can be a symptom of depression, a condition that can be characterised by a general sense of disconnection from the world and self.
• Substance abuse: Recreational drugs and even certain medications can induce derealization as a side effect.
• Sleep deprivation: Chronic sleep deprivation can disrupt brain function and contribute to feelings of unreality.

What does derealization feel like?

Derealization can be a disturbing experience. Especially when experienced for the first time, derealization can be disorienting and scary. People who have had episodes of dissociating from reality often describe it in the following ways:

• It’s like living in a dream or movie
• The world around you seems foggy, blurry, or distorted
• Noises and voices sound muffled or distant
• Colors seem muted or overly vivid
• Time seems to slow or speed up
• It’s difficult to focus on your surroundings
• It’s like you’re observing yourself from outside your body (out-of-body experience)

Again, while these feelings may be unsettling, they are not a sign of insanity. Derealization doesn’t alter your perception of reality permanently; it’s a temporary shift in how you process information from the world around you.

Derealization symptoms

While the core experience of feeling detached from your surroundings defines derealization, other symptoms can accompany it:

• Feeling emotionally numb: It may be difficult to connect with emotions or feel joy or sadness as intensely as before the derealization episode.
• Out-of-body experiences: It may feel like you’re floating above your body or observing yourself from a distance.
• Dissociation: This broad term encompasses derealization, describing when a person experiences disconnection from their thoughts, feelings, memories, or sense of identity.
• Anxiety: The unsettling nature of derealization can trigger anxiety and panic attacks, creating a vicious cycle the keeps feeding episodes of derealization.

Mental health conditions and derealization

Derealization and anxiety & stress

Stress and anxiety can be a significant contributors to derealization. When faced with overwhelming pressure, worry, or distress, the brain may involuntarily detach from the situation to cope. Imagine being bombarded with deadlines, self-doubt, worry, and demands from a toxic boss – derealization can be a temporary escape, allowing you to distance yourself from further emotional stress. 

Derealization and panic attacks

The intense, heightened physical and emotional sensations of a panic attack can trigger feelings of detachment. As the body goes into fight-or-flight mode (also called survival mode), derealization can kick in as a protective mechanism, allowing us to temporarily disconnect from the overwhelming experience. This dissociation can be frightening, but it’s important to remember it’s a natural response to extreme, all-encompassing distress.

Derealization and depression

Derealization can be a symptom of depression. Depression often causes a general sense of disconnection from the world and self, as an involuntary way of coping with the chronic low mood and hopelessness of the condition.

Derealization disorder

Derealization can also be its own mental health condition. Derealization disorder describes lengthy or recurrent periods of disconnection from reality, lengthy or recurrent periods of depersonalization, i.e. detachment from yourself (your body, identity, emotions, thoughts, and behavior), or lengthy or recurrent bouts of both.

Derealization disorder is rare, but is typically linked to intense trauma such as physical abuse, natural disasters, life-threatening danger, or the sudden death of a loved one.

Does derealization go away?

Derealization can be episodic or chronic, depending on the underlying causes and individual circumstances. Some individuals may experience occasional episodes that resolve on their own, while others may require treatment to manage symptoms effectively. Early professional intervention and appropriate support can lead to better outcomes.

How to get through a derealization episode

Derealization episodes are typically temporary, lasting from minutes to hours. During a derealization episode, grounding techniques can be immensely helpful.

Focus on sensory experiences to anchor yourself in the present moment. For instance, describe out loud what you see, hear, smell, and feel, reinforcing your connection to reality. For example: note the texture of a nearby object or the sound of passing traffic. This sensory inventory brings you back to the physical world.

Distracting yourself and not dwelling on the episode can help it pass sooner. Engage in a simple, stimulating activity – listen to music, read a book, or do some stretches. Distraction takes your mind off the episode and helps it pass more quickly. It’s important to remember that derealization episodes are usually temporary, not dangerous, and do not indicate you’re losing touch with reality.

Derealization treatment options

Treatment for derealization typically focuses on addressing the underlying cause of it and managing symptoms:

• Therapy: Therapy for derealization – whether a digital program or one-on-one sessions – informed by cognitive behavioral therapy (CBT) and mindfulness-based approaches can help you identify triggers, challenge distorted thinking patterns, and develop coping strategies, which can ease derealization and make episodes less frequent.
• Medication: In some cases, medications such as antidepressants or anti-anxiety medications may be prescribed to alleviate derealization episodes and other symptoms of poor mental health.
• Lifestyle changes: Adopting stress-reduction techniques, maintaining a balanced routine, and avoiding substances that can contribute to or worsen derealization are often important steps in curbing episodes.
• Support networks: Connecting with supportive friends, family members, or support groups can provide reassurance and validation during difficult times.

Individualized treatment plans are essential for anyone experiencing derealization, as what works for one person may not be effective for another. Consulting a mental health professional is crucial for determining the most appropriate course of action.

Derealization is a challenging, unsettling experience and mental health symptom characterised by feeling detached from reality. While distressing, understanding the signs of derealization and addressing its causes can go a long way in helping you cope and even recover to the point of not experiencing episodes anymore.

With the right support and interventions, anyone experiencing derealization can regain a sense of stability, maintain their sense of reality, and improve their overall well-being.

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SOURCES:

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• Gentile JP, Snyder M, Marie Gillig P. STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder. Innov Clin Neurosci. 2014 Jul;11
• Loewenstein RJ. Dissociation debates: everything you know is wrong. Dialogues Clin Neurosci. 2018 Sep;20(3):229-242.
• Lyssenko, L., Schmahl, C., Bockhacker, L., Vonderlin, R., Bohus, M., & Kleindienst, N. (2018). Dissociation in Psychiatric Disorders: A Meta-Analysis of Studies Using the Dissociative Experiences Scale. American Journal of Psychiatry, 175(1), 37–46.