Derealization and Depersonalization: Types, Symptoms, Causes, Diagnosis and Treatment
I remember the first time I felt it — the sensation that everything around me wasn’t real. I was sitting in my living room, and suddenly it was like I was watching myself from outside my body, like a character in a movie. The colors seemed off, and the room felt unfamiliar, like I was in a dream I couldn’t wake up from. That was the moment I realized I was dealing with something beyond anxiety or stress — it was derealization.
What Is Derealization and Depersonalization?
If you’ve ever felt like you’re detached from reality, like the world seems distant or you’re not fully present, you might be experiencing derealization. On the other hand, depersonalization feels like you’re disconnected from yourself, as if you’re watching your life unfold from a distance. These are two sides of the same coin, often grouped together as derealization and depersonalization disorder.
For me, the hardest part wasn’t just the confusion — it was the fear. I was terrified that I’d never feel “normal” again, that this detachment would last forever. The sense of not being grounded in reality or in my own body was paralyzing. But the more I learned, the more I understood that I wasn’t alone.
Types of Derealization and Depersonalization
Derealization and depersonalization can happen in a few different ways, and they often overlap:
Derealization:
It feels like the world around you isn’t real. Things can appear foggy or distant, and you might feel like you’re stuck in a dream. I remember walking down the street once, and it was like the entire city was a blurry painting.
Depersonalization:
This is when you feel disconnected from yourself. It’s like you’re watching your actions from outside your body, or your limbs don’t feel like they belong to you. There were moments when I would look in the mirror and feel like I was looking at a stranger.
Both of these can feel so isolating, making you question everything — your identity, your reality. I remember questioning if I was going crazy.
Symptoms
The symptoms go far beyond just feeling “off.” They’re overwhelming, and they can really mess with your sense of self:
1. Feeling like you’re detached from your surroundings:
Everything around you may feel like a dream or an illusion.
2. A sense of being an observer of yourself:
You feel like you’re watching your life from a distance, like you’re not in control.
3. Emotional numbness:
You might not feel emotions the way you normally would, almost as if you’re disconnected from your own feelings.
4. Time distortion:
Time can feel fast or slow, or you may not be able to track it at all.
I remember days when I couldn’t even keep track of time. Hours would pass in a haze, and nothing felt real. It’s one of the most disorienting feelings, and it made me question everything — was it just stress, or was I losing my grip on reality?
Causes
There isn’t just one thing that causes derealization or depersonalization. Sometimes it’s triggered by intense stress, anxiety, or trauma. In my case, I think it was a combination of stress and anxiety that I didn’t even realize I was carrying.
1. Trauma:
Emotional or physical trauma can trigger these episodes. It’s like your mind shuts down or disconnects as a defense mechanism.
2. Anxiety and depression:
When your brain is overloaded with stress, it can start to dissociate, leading to feelings of detachment.
3. Substance use:
Certain drugs, especially hallucinogens, can trigger derealization or depersonalization episodes.
4. Sleep deprivation:
Not getting enough sleep can lead to these feelings of detachment and unreality.
I remember the anxiety that led up to my episodes — it built slowly, creeping in until I couldn’t ignore it anymore. But once I experienced derealization, the fear of it happening again only made it worse.
Diagnosis
Getting a diagnosis can be tricky. I didn’t know how to explain what I was feeling to my doctor. How do you describe the sensation of your world not feeling real? It took several appointments before I finally got a name for it — depersonalization-derealization disorder.
The diagnosis is made mostly through talking — explaining your symptoms, your feelings. It was a relief to know that what I was feeling had a name and that I wasn’t alone, but the journey didn’t end there.
Treatment
I thought once I had a diagnosis, everything would magically get better. But treatment for derealization and depersonalization takes time. What helped me the most were:
1. Therapy:
Cognitive-behavioral therapy (CBT) was a lifesaver. It helped me challenge the feelings of detachment and fear. My therapist guided me through grounding techniques to stay present when I felt the dissociation starting.
2. Medication:
For some people, antidepressants or anti-anxiety medications can help. It wasn’t the right route for me, but it’s a valid option for many.
3. Mindfulness and grounding techniques:
When I start to feel disconnected, I focus on grounding myself — feeling the texture of my clothes, smelling something familiar, or even splashing cold water on my face. Anything that brings me back to the present moment.
4. Reducing stress and Anxiety:
This one was huge for me. I had to learn to manage my anxiety through relaxation techniques, deep breathing, and sometimes just stepping away from overwhelming situations.
Living with Derealization and Depersonalization
Living with derealization and depersonalization can be exhausting. It’s not just about feeling disconnected, it’s the anxiety and fear that come with it. But I’ve learned that it’s possible to live with it, to manage it. The key is not to panic when it happens, even though that’s easier said than done. The more I panicked, the worse it got.
The most important thing I’ve realized is that I’m not alone. There are so many people dealing with this, and while it feels isolating, there’s help. Therapy, support groups, and even talking to loved ones made a huge difference for me.
So if you’re going through this — whether it’s occasional or constant — know that you’re not losing your mind. It’s a real disorder, and with time, you can manage it. I still have moments where the world feels distant, but now I know how to bring myself back.
