Derealization is a dissociative experience in which the external world feels unreal, distant, or distorted. For many, this state is temporary and occurs during intense emotional episodes such as panic attacks. However, in some cases, the sensation does not subside when the acute panic ends. Instead, it becomes a chronic condition that can persist for months or even years.
When a person experiences a severe panic attack, the brain may activate a defense mechanism to manage the overwhelming stress. One such mechanism is dissociation, which includes derealization. While intended as a short-term coping response, for some individuals this altered perception becomes ongoing. The result is a persistent detachment from one’s surroundings, often described as feeling like observing life through a fog, screen, or dream.
Common symptoms of chronic derealization include visual distortions, muted or distant sounds, and a sensation that time is passing unusually fast or slow. Environments may feel unfamiliar or artificial, even if they are well-known. This condition can be accompanied by depersonalization, in which individuals feel detached from their own body or thoughts.
This state is often misunderstood. The person is aware that the world hasn’t changed — they know logically that things are real — but the sensation of unreality remains. It is not a psychotic experience or a belief in a false reality, but rather a disconnection from the feeling of reality.
Ongoing derealization can interfere with daily functioning. Individuals may struggle to concentrate, engage socially, or complete routine tasks. This experience often leads to increased anxiety, which in turn reinforces the dissociative state, creating a feedback loop that is difficult to break.
Treatment typically involves psychotherapy, particularly cognitive behavioral therapy (CBT), which focuses on changing thought patterns and behaviors that sustain the condition. Grounding techniques, which help anchor a person in the present moment using physical sensations or environmental cues, are also frequently recommended. In some cases, medication may be used to manage underlying anxiety or depression that contributes to the derealization.
Derealization following a panic attack is a documented phenomenon, and while it can be long-lasting, it is not necessarily permanent. With structured intervention and consistent management, many individuals experience improvement. Understanding that this condition is a response to stress — not a sign of losing touch with reality — is a critical first step toward recovery.
