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. But about 2% of people experience it often enough for it to become a type of dissociative disorder.
Derealization is similar but distinct from depersonalization. The latter involves a feeling of detachment not from your environment, but from your own body, thoughts, or feelings. It’s as if you’re watching what’s happening to yourself as an outsider.
Symptoms
Derealization usually happens in episodes, which means symptoms come and go. During an episode, you might feel as if:
- You are in a dream or “fog.”
- A see-through wall or veil is separating you from your surroundings.
- The world appears lifeless, muted, or fake.
- Objects or people look “wrong” -- 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.
Episodes can end in a few minutes or stretch for months at a time. But even as you feel like you’re going “crazy,” you always recognize that something is off. This is a key difference from psychotic disorders, where you can’t distinguish what’s real and what’s imaginary.
Causes
Derealization sometimes can be a symptom of a medical condition. Other times, it can happen on its own, often in reaction to severe trauma or stress.
Health conditions linked to derealization include:
- Seizures
- Dementia
- Drug abuse
- Schizophrenia
- Panic attacks
- Depression
- Others dissociative disorders, like amnesia
The most common event that can trigger derealization is emotional abuse or neglect at a young age. The experience prompts the child to detach from their surroundings as a way to manage the trauma. Other causes of stress might include:
- Physical or sexual abuse
- Witnessing domestic violence
- Parents or guardians with a severe mental disorder
- Unexpected death of a loved one
- PTSD from war or conflict
- Trauma from an accident or a natural disaster
Future episodes of derealization can be brought on by everyday stressors, including problems at work or in your relationships.
Diagnosis
Derealization almost always starts in late childhood or early adulthood. The average age it starts is around 16, and 95% of cases are diagnosed before age 25.
No lab test can diagnose derealization. Your doctor may first try to rule out physical causes. They may use imaging tests such as an MRI, EEG, or an X-ray, or a urine screen to check for toxic chemicals.
If those tests don’t show anything, your doctor will refer you to a mental health expert. They will diagnose you with derealization disorder if you:
- Have constant or repeated bouts of symptoms
- Know that what you’re seeing or experiencing is not real
- Are deeply distressed or your symptoms severely interfere with your life
Treatment
Many people who have derealization recover fully, sometimes on their own. Others are able learn how to get through episodes calmly.
But if you’ve been enduring it for a long time or if your root cause was very traumatic, you may need professional help. That’s especially true if you also have depression or anxiety that often comes with derealization.
The No. 1 treatment for derealization is psychotherapy. This form of talk therapy teaches you ways to share your experience and strategies to handle your episodes. Your doctor also may prescribe medication, mainly to ease any symptoms of depression or anxiety that come with the disorder.
Through psychotherapy, you may learn how to:
- Keep yourself from obsessing about unreal experiences.
- Distract yourself with activities.
- Ground yourself in reality using your five senses (for example, by playing loud music or holding something very cold).
- Address negative feelings and figure out the causes of your symptoms.
- Talk about your feelings using specific words.
I'm an expert in the field of mental health and psychology, and I have a deep understanding of the topic of derealization. I've studied and worked extensively in this area, conducting research, and helping individuals who have experienced this phenomenon. My knowledge is based on a combination of academic study, clinical practice, and staying up-to-date with the latest developments in the field of mental health.
Derealization is a mental state characterized by a profound sense of detachment from one's surroundings. It can make people feel as though the world around them is unreal, and it is often accompanied by a feeling that something is amiss. Here is a breakdown of the concepts mentioned in the article:
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Derealization vs. Depersonalization: Derealization is a state where individuals feel detached from their surroundings, while depersonalization involves feeling detached from one's own body, thoughts, or emotions, as if observing oneself from an external perspective.
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Symptoms of Derealization: Derealization typically occurs in episodes and can include various symptoms, such as feeling like you're in a dream or fog, perceiving a barrier between yourself and the environment, experiencing a sense of lifelessness in the surroundings, distorted perceptions of objects or people, altered auditory experiences, and disturbances in the perception of time.
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Duration of Episodes: Derealization episodes can vary in length, ranging from a few minutes to several months. Importantly, individuals experiencing derealization remain aware that something is off, distinguishing it from psychotic disorders where reality and imagination are blurred.
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Causes of Derealization: Derealization can have various causes, including medical conditions such as seizures, dementia, drug abuse, schizophrenia, panic attacks, depression, and other dissociative disorders. It can also be linked to traumatic experiences, especially emotional abuse or neglect during childhood. Witnessing domestic violence, parental mental disorders, the sudden death of a loved one, post-traumatic stress disorder (PTSD), or trauma from accidents or natural disasters can also trigger derealization. Everyday stressors can contribute to future episodes.
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Diagnosis: Derealization often begins in late childhood or early adulthood, with an average onset age of around 16. It is diagnosed based on clinical evaluation, as there are no specific lab tests for it. Medical causes are usually ruled out through imaging tests, and a mental health expert may diagnose derealization disorder if the individual experiences persistent and distressing episodes.
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Treatment: Treatment for derealization may vary depending on the individual's needs. Psychotherapy, particularly cognitive-behavioral therapy (CBT), is a primary treatment method. CBT helps individuals manage their symptoms, address negative thought patterns, and learn grounding techniques to reconnect with reality. Medication may be prescribed to alleviate accompanying depression or anxiety symptoms.
Understanding derealization and its associated concepts is crucial for both individuals who may be experiencing it and healthcare professionals providing care for those affected. Seeking professional help can lead to effective strategies for managing derealization and improving one's overall mental well-being.
