Derealization is a psychological phenomenon in which an individual experiences a distorted sense of the world around them. The person may feel detached from their environment, as though the world is unreal, dreamlike, or distorted in some way. People with derealization may feel as if they are observing their surroundings from outside their body or as though everything is somehow “off” or unfamiliar. While it can be a disorienting and unsettling experience, derealization is often a symptom of various mental health conditions and is generally considered a type of dissociation.

In this article, we will explore what derealization is, its causes, symptoms, and potential treatments. By understanding this experience better, individuals who suffer from derealization can feel more equipped to address it and seek appropriate support.

What Is Derealization?

Derealization is a dissociative symptom in which a person’s perception of reality becomes altered. Individuals experiencing derealization may feel as though the world around them is not real, is fake, or has taken on a dreamlike quality. The experience can be fleeting or persistent, depending on the underlying causes. Derealization can affect one’s sense of time, space, and self, and it is often accompanied by feelings of emotional numbness or detachment.

While it might feel as though one’s surroundings are completely altered or unreal, people experiencing derealization typically remain aware that their perception is distorted. For example, they may recognize that the world is not truly changing, but they still experience it as being surreal or distant. This awareness, however, does not always make the experience less distressing.

Symptoms of Derealization

Derealization can manifest in a variety of ways, and the intensity of the experience can vary from person to person. Some common symptoms of derealization include:

1. Feeling Detached from the Environment: People with derealization often describe feeling like they are in a dream or observing the world from a distance. Their surroundings may appear distorted, like a movie set or something artificial.
2. Perceptual Distortions: Individuals may notice changes in the size, shape, or color of objects around them. They may also experience a sense of time slowing down or speeding up.
3. Emotional Numbness: There may be a feeling of emotional disconnection from people or events. It can feel like one is going through the motions without truly experiencing or engaging with life.
4. Depersonalization: While derealization is about feeling detached from the external world, depersonalization is about feeling detached from oneself. The two conditions often occur together. Individuals may feel as if they are watching themselves from outside their body or that their thoughts and actions are not their own.
5. Difficulty Recognizing Familiar Places or People: Familiar environments or people may appear strange or unfamiliar during a derealization episode, even though they are known to the individual.
6. Impaired Sense of Reality: The overall sense of what is real and what isn’t may become blurred. While people experiencing derealization typically know they are not in a dream, the sense of reality may still feel fragile or uncertain.

Causes of Derealization

Derealization is often linked to various psychological and physiological factors. It can occur as a result of trauma, stress, anxiety, or other mental health conditions. Some common causes of derealization include:

1. Stress and Anxiety: High levels of stress or anxiety can trigger derealization episodes. When individuals feel overwhelmed by life’s challenges or by anxiety, their brain may detach from reality as a coping mechanism. It is believed that derealization can act as a protective response to overwhelming emotions or traumatic experiences.
2. Panic Attacks: Derealization is often a symptom of panic attacks, where intense fear and physical symptoms (such as heart palpitations, shortness of breath, and dizziness) can cause a person to feel disconnected from their surroundings.
3. Trauma: Individuals who have experienced traumatic events, such as physical or emotional abuse, accidents, or natural disasters, may develop derealization as a way to disconnect from the overwhelming emotional pain associated with the trauma.
4. Depression: Some people with depression report feeling detached from their environment and experience derealization as part of their depressive symptoms.
5. Substance Use: Certain drugs or substances, including marijuana, hallucinogens, and alcohol, can cause derealization as a side effect. Prolonged or excessive use of these substances may lead to persistent dissociative experiences.
6. Dissociative Disorders: Derealization is a key symptom of dissociative disorders, including Depersonalization-Derealization Disorder (DDD), in which individuals experience persistent or recurrent episodes of derealization and depersonalization.
7. Sleep Deprivation: Lack of sleep can significantly affect cognitive function and lead to dissociative experiences, including derealization.
8. Neurological Conditions: In rare cases, certain neurological conditions, such as epilepsy or migraines, can cause derealization symptoms due to brain activity disruptions.

Diagnosing Derealization

Derealization is typically diagnosed by a mental health professional after a thorough evaluation. The clinician will ask about the individual’s symptoms, medical history, and any potential triggers for derealization episodes. It is important to differentiate derealization from other mental health issues or medical conditions that may cause similar symptoms, such as psychosis, schizophrenia, or neurological disorders.

A diagnosis of Depersonalization-Derealization Disorder (DDD) is considered when derealization episodes are frequent, persistent, and cause significant distress or impairment in the person’s daily functioning. This diagnosis requires that derealization and/or depersonalization occur regularly, often for six months or more.

Treatment for Derealization

Although derealization can be distressing, it is generally treatable. The treatment plan will depend on the underlying cause of the derealization and the severity of the symptoms. Some common treatment options include:

1. Cognitive Behavioral Therapy (CBT): CBT is an effective form of therapy for treating derealization. It helps individuals identify and challenge negative thought patterns and develop healthier coping strategies. For example, CBT can help a person with anxiety learn ways to reduce their stress levels and regain a more grounded sense of reality.
2. Grounding Techniques: Grounding techniques are strategies used to help individuals reconnect with the present moment and the world around them. These can include focusing on sensory experiences, such as touching objects, listening to sounds, or observing the details of one’s environment. Grounding can be particularly useful during an episode of derealization to help bring the person back to reality.
3. Medication: In some cases, medications such as antidepressants or anti-anxiety medications may be prescribed to help manage the underlying conditions (e.g., depression, anxiety, or trauma) that are contributing to derealization. However, medications are generally used in conjunction with therapy rather than as a standalone treatment.
4. Mindfulness and Relaxation Techniques: Mindfulness exercises, such as meditation or deep breathing, can help reduce stress and promote a sense of calm. These practices can be effective for individuals who experience derealization due to anxiety or trauma.
5. Trauma-Focused Therapy: For individuals whose derealization is linked to past trauma, trauma-focused therapies, such as Eye Movement Desensitization and Reprocessing (EMDR), can be helpful in processing and resolving the trauma that may be triggering derealization.
6. Sleep Hygiene: Improving sleep hygiene and addressing any sleep disorders can help reduce episodes of derealization related to sleep deprivation.

Conclusion

Derealization can be a disorienting and unsettling experience, but it is important to understand that it is a symptom that can be managed with the right treatment. Whether caused by anxiety, trauma, or other underlying conditions, derealization can be alleviated with a combination of therapy, coping techniques, and sometimes medication. If you or someone you know is experiencing derealization, it is important to seek professional help to explore the root cause and develop an appropriate treatment plan. With the right support, it is possible to regain a sense of connection to reality and reduce the impact of this challenging experience.