Do you ever feel like you’re outside your body, looking at yourself – as though your actions aren’t really yours? Do you ever have the sensation that you are living in a dream, and nothing around you feels real? If the answer is yes, does it make you feel a little bit crazy sometimes?
When Nothing Feels Real: Derealization, Depersonalization, and Anxiety
These are phenomena called depersonalization and derealization, and you may be surprised to learn that it’s actually quite common in psychological disorders such as anxiety and depression. They are especially common during panic attacks, but depersonalization and/or derealization (DP/DR) can happen at any time. For instance, derealization is something I’ve experienced throughout most of my life, and strangely enough, it has never occurred while I was actually having a panic attack.
DP/DR can be incredibly distressing. These experiences tend to fuel further anxiety and panic attacks, and perpetuate the feelings of DP/DR. It can become a vicious cycle that feels impossible to break, and this is often very frightening for those who don’t fully understand what’s going on.
If it’s happening to you, I hope you can take some comfort in knowing that it happens to many of us, and it does not mean you’re crazy, or that you’re going crazy! Despite feeling uncomfortable or scary, it’s actually not dangerous and will not cause lasting damage.
Disassociation through Derealization and Depersonalization
Depersonalization and derealization are considered to be dissociative symptoms, which can occur on their own, or alongside other disorders. It is often a result of past trauma, but can also come about after experiencing prolonged stress and anxiety.
Essentially, depersonalization is feeling divorced from your sense of self – that feeling that you’re watching yourself do things, or that you’re not in your body. Derealization is a state in which the things — or even people — around you do not feel real.
Chronic DP/DR is classified as a dissociative disorder, which can occur on its own, but is often comorbid with other conditions, such as anxiety, depression, and bipolar disorder. It often comes about from severe traumatic events, but can also be a result of prolonged stress and anxiety. DP/DR — when not induced by drugs, alcohol, or another health condition — is thought to be a coping mechanism of the brain that gets “switched on” in order to allow to brain to experience stress or trauma less intensely. (This is why it’s a common occurrence during panic attacks.)
However, it’s important to note that DP/DR can happen even when you do not feel particularly stressed or upset. Sometimes, when it comes on unexpectedly like this, it can feel even more disturbing.
Common DP/DR experiences include:
- Feeling disconnected from your body, or that your actions aren’t your own (depersonalization).
- Being in a dreamlike state, or feeling as though you’re looking at everything through a haze or fog (derealization).
- Feeling like an alien or a stranger, even in familiar places; in severe instances, you may not recognize people or things you know.
- Questioning everything, even things that you once felt certain of – your faith, the reality of everything around you, and even your purpose and what it means to be alive.
- Feeling that the things are lacking in significance, as though they are lacking in depth and meaning.
- A sense of hyper-awareness, as though you cannot stop over-thinking or over-analyzing everything.
- Feeling totally absorbed in your own thoughts, or even feeling that you are in your own world or dimension; sometimes finding yourself in a place and not remembering how you got there
- Not remembering what happened during the dissociative state (though this is certainly not always the case)
Managing Depersonalization and Derealization
The good news is that depersonalization and derealization caused by anxiety are not actually dangerous, even if it feels particularly distressing. For most people who do not have a chronic dissociative disorder, these states eventually pass. The best thing to do is not fight it, since this can cause more stress or panic and feed the cycle of anxiety and DP/DR.
Here’s what’s been helpful for me and others I know who experience DP/DR:
- Take a deep breath or practice breathing exercises.
- Focus on mindfulness and whatever’s going on in the present moment – this can help keep you “grounded.”
- Practice regular meditation and yoga. These activities increase your awareness of your own body and mind, which can help to prevent that disconnected feeling. Additionally, over time, yoga and meditation can greatly aid in emotional healing and recovery from anxiety disorders.
- Try to keep busy. Many people report that they don’t struggle with DP/DR as much when they’re busy. It tends to be more common when you’re alone or not doing anything in particular.
- Find a helpful distraction, such as a funny video or an absorbing book. Distractions don’t work for everyone, but for some, they help pull them back down to reality.
- Avoid alcohol and other drugs, as they typically intensify the feelings of DP/DR.
- Make sleep a priority – fatigue also intensifies dissociative states.
- Reach out to someone you trust. We are often hesitant to talk about these feelings because we don’t want people to think we’re “crazy,” but maintaining a connection with others is important to prevent further withdrawal from reality.
- Explore these issues with a therapist
- My personal favorite strategy: Accept what is happening, remind yourself that it’s just a little “glitch” in the brain, and even try to embrace it if possible. When derealization kicks in for me, I like to go for a long walk, preferably in the woods or someplace with a lot of natural beauty. I may feel like I’m walking in a dream, but usually by the time I get home, things feel real to me again. However, any physical activity can potentially have this effect – go to the gym, dance, take a yoga class. These are all great options.
An Important Note on DP/DR and Benzodiazepines
Benzodiazepines such as Ativan, Xanax and Klonopin are commonly prescribed to anxiety patients, but ironically, they can induce DP/DR in people, especially after long-term use. This is the case even if you always take your medication exactly as prescribed and keep a consistent dose. In fact, the most intense period of derealization I’ve ever felt was during the months when I was prescribed Klonopin twice a day.
Additionally, stopping benzodiazepine use is also known to cause depersonalization and derealization. This can last even after other withdrawal symptoms have subsided.
Therefore, anxiety sufferers who experience DP/DR should consider whether these drugs may do more harm than good for them, and explore other medication-free coping strategies.