Derealization and depersonalization

How it works

In derealization, your surroundings feel unreal, dreamlike, foggy, or far away. Colours look flat. Sounds seem muffled. Familiar places feel like a stage set². In depersonalization, you feel detached from your own body, thoughts, or feelings. It is like watching yourself act from a distance³. In both, you know that the feeling is not literally true. That knowledge is what separates it from psychosis¹.

Both are forms of dissociation, a state in which the brain reduces the link between its parts⁴. The leading idea is that this is protective. When the brain is overwhelmed, it turns down the emotional response to the outside world and to the self. Turning down the feeling also turns down the sense of realness¹. Common triggers are a panic attack, severe stress, lack of sleep, extreme tiredness, migraine, and cannabis¹.

Between 50% and 75% of people have at least one brief episode in their lifetime¹. An episode usually lasts minutes to hours. About 1% to 2% of people have it as a persistent disorder¹. The disorder usually starts in the teenage years¹.

Is it a problem?

A brief episode is not. It is not psychosis and it does not mean you are losing your mind. Fear of the feeling makes it stronger, and naming it makes it weaker. Sleep, food, and calm reduce it.

When the feeling lasts for weeks, keeps coming back, or gets in the way of school or friendships, talk to a doctor or counsellor. Persistent depersonalization is well recognised and it responds to therapy¹. Also see a doctor if it starts after a head injury, comes with seizures, or begins after starting a new medicine.

History and culture

Many people with the persistent form spend years thinking they are alone with it. Communities such as r/dpdr exist to show them they are not⁵.