Derealization and Depersonalization: Feeling Detached from Yourself and the World

Derealization and depersonalization are feelings that the world or the self is unreal. Learn what causes them, how they pass and how therapy approaches them.

One morning you look in the mirror and your face feels familiar and yet strangely unfamiliar. Walking down the street, everything feels as if it is on a film set, the colours are pale or too bright, and the sounds seem to come from far away. As you talk you hear your own voice as if it were someone else's, and you look at your hands and wonder, "Are these really mine?" These experiences are usually called derealization and depersonalization. Derealization is feeling that your surroundings are unreal; depersonalization is a person's sense of being detached from their own body, thoughts or feelings. These feelings can be very frightening, and many people worry, "I am losing my mind." Yet these experiences are often a protective response of the brain to intense stress and anxiety. In this article we look at what derealization and depersonalization are, why they arise, the cycle through which they persist, and what you can do to cope with them.

What Are Derealization and Depersonalization?

Derealization is a change in the perception of the reality of the outside world. The person sees and recognises their surroundings, but everything feels as if it is behind a pane of glass, in a dream, or inside a video game.

Depersonalization is the experience of feeling detached from oneself. The person feels as if they are watching themselves from the outside, as if their body does not belong to them, or as if their emotions have been "switched off".

These two experiences often occur together. An important point is this: a person who has these feelings knows that what they are experiencing is "a feeling of unreality". In other words, their connection with reality has not been broken; they do not believe that the world has really changed, they only feel as if it has. This feature is the key difference that separates derealization from conditions in which the perception of reality is disturbed.

A Passing Experience or a Continuing Condition?

Brief episodes of derealization or depersonalization are quite common. After extreme tiredness, lack of sleep, intense stress, a panic attack or a sudden shock, such feelings lasting a few minutes or a few hours can happen to many people. In some people, however, these experiences recur often, last a long time and noticeably affect daily life. In such a case, a diagnosis of "depersonalization-derealization disorder" may come up after assessment by a professional. A diagnosis can only be made through a detailed clinical assessment.

What Are the Symptoms of Derealization?

Although the experience of derealization and depersonalization differs from person to person, the symptoms most often described are as follows:

Symptoms of derealization

• Perceiving the surroundings as if in a dream, a film or a fog
• Colours, sounds or distances feeling different
• Familiar places and people seeming strange
• Time feeling as if it is passing very slowly or very fast
• The world looking flat, two-dimensional or artificial

Symptoms of depersonalization

• A feeling of watching yourself from the outside, like a spectator
• Your body, hands or face feeling as if they do not belong to you
• Emotions going numb, emotional distance even from loved ones
• Your own voice or thoughts feeling foreign
• Feeling as if you are living on "autopilot"

Accompanying Mental Reactions

Many people are afraid not so much of these experiences themselves as of the meaning they give to them: "Am I going mad?", "Will I never go back to normal?", "Is there something seriously wrong with my brain?" These questions can lead to behaviours such as constantly checking yourself and searching for symptoms on the internet.

What Causes Derealization?

A Protective "Fuse" in the Brain

Derealization and depersonalization can be thought of as a kind of fuse that the brain switches on in the face of an intense emotional load. When threat or stress becomes very intense, the brain puts a distance between the person and their experience in order to reduce the intensity of the emotional experience. This is also the explanation for living through events "in slow motion" or "as if watching from outside" during an accident. This reaction, which is protective in the short term, becomes distressing when it continues after the threat has gone.

Common Triggers

• Intense anxiety and panic attacks: Derealization is one of the most common symptoms experienced during a panic attack.
• Long-term stress: Workload, financial difficulties, relationship problems and burnout.
• Traumatic experiences: In particular emotional neglect or abuse in childhood, or shocking events in adulthood. For details you can look at our article on post-traumatic stress disorder.
• Lack of sleep and extreme tiredness: Sleep deprivation makes it harder to regulate perception and attention.
• Substance use: Some substances, especially drugs such as cannabis, can trigger lasting episodes of derealization even after a single use.
• Depression: Emotional numbness can also be seen together with depression.

The Cycle That Keeps Derealization Going

Derealization often becomes entrenched through the following cycle: the person notices a strange feeling and interprets it as a dangerous sign ("I am losing my mind"). This interpretation increases anxiety, and the rising anxiety intensifies the derealization. This time the person starts constantly checking themselves: "Does it feel real right now?" This constant inward attention makes the feeling even more noticeable. Avoidance is added too: not going to crowded places, not standing in front of mirrors, not being alone. In this way a self-feeding circle forms between derealization, anxiety and attention.

Say that at the end of a busy working week, after a night with little sleep, you are shopping in the supermarket and under the fluorescent lights everything suddenly begins to feel odd and distant. Your heart speeds up, you think "Something is happening to me", and you leave your basket and go home. The next day, the first thing you do on entering the supermarket is to check whether that feeling has come back. This checking directs your attention to the very feeling you are afraid of and makes it easier to bring on. Within a few weeks, the supermarket, crowded places and brightly lit places can be added to the list of places you avoid. The key to breaking the cycle is to notice these links of interpretation, checking and avoidance, more than the feeling itself.

Derealization does not grow because it is dangerous but because it is thought to be dangerous; as the fear lessens, the intensity of the feeling tends to lessen too.

Derealization in Daily Life and in Today's Turkey

People who experience derealization often look "normal" from the outside; they go to work, chat and do their jobs. Inside, however, there is a constant strangeness, difficulty concentrating and a sense of "not being able to live life fully". This invisibility can lead the person to feel misunderstood and to become isolated.

Many people who experienced the 6 February 2023 earthquakes directly, or watched them on screens for days, described in the following weeks the feeling that "everything was unreal". Large-scale disasters on a social scale, economic uncertainty and the ongoing stress created by the high cost of living can cause this protective response to switch on more often in some people. Digital life may also have an effect: spending hours at a screen, watching an endless flow of content late into the night and sleeping little can increase the feeling of being "cut off from the world" in some people. For people who have migrated or live alone in a big city, the scarcity of bonds to hold on to in an unfamiliar environment can deepen the experience of detachment.

Practical Tips for Coping with Derealization

1. Name the Experience Correctly

When the feeling of derealization begins, say to yourself in a calm tone: "This is derealization. My brain is putting distance in place to cope with stress. It is unpleasant but not dangerous." Naming it correctly softens catastrophic interpretations and slows the anxiety cycle.

2. Return to the Present with Grounding Techniques

Use your senses to bring your attention to the present moment. A classic method is the 5-4-3-2-1 exercise: name five objects you can see, four things you can touch, three sounds you can hear, two smells you can detect and one thing you can taste. Holding a cold glass, pressing your feet into the floor or taking ice into your palms can also work by strengthening physical sensations. For more methods, you can look at our article on grounding techniques.

3. Reduce Checking

Constantly asking "Does it feel real right now?" enlarges the feeling. When you want to check yourself, notice it and gently turn your attention back to what you are doing. The aim is not to force the feeling away, but to be able to carry on with your life alongside it.

4. Stop Avoiding and Stay in the Activity

Staying away from social settings, work or hobbies because of derealization turns the mind further inward. Continuing with meaningful activities, even in small steps, directs attention to the outside world and can, over time, reduce the intensity of the feeling.

5. Look After Your Body's Basic Needs

Regular sleep, not skipping meals, limiting caffeine and light exercise help the nervous system find its balance. Long walks can be especially useful, since they both strengthen physical sensations and direct attention to the surroundings.

6. Limit Searching for Symptoms on the Internet

Reading about symptoms for hours often leads you to frightening scenarios and increases your anxiety. After getting the basic information from a reliable source, limiting your searching is an important step in breaking the cycle. Constantly asking AI chat tools about symptoms can also turn into a similar reassurance-seeking behaviour.

7. Share Your Feelings with Someone You Trust

Many people stay silent, afraid that if they describe what they are experiencing they will be thought "mad". Yet sharing this experience with someone you trust can reduce loneliness and shame.

8. Keep a Short Observation Diary

For a week or two, briefly note when the feeling of derealization begins, how much you slept that day, how much caffeine you had, what environment you were in and the thought that was going through your mind at that moment. Also rate the intensity of the feeling from zero to ten. These notes allow you to see that the feeling does not rise and fall at random but in connection with particular conditions. This realisation gives back a sense of control.

When Should You Seek Professional Support?

Brief and rare derealization usually passes by itself. However, it is recommended that you see a professional in the following situations:

• If the feelings last for weeks or recur often,
• If they make it hard for you to do your work, school, relationships or daily tasks,
• If derealization is accompanied by panic attacks, intense anxiety or depressive symptoms,
• If the feelings began after a traumatic event,
• If they appeared after substance use,
• If you are having thoughts of harming yourself. In such an emergency, call 112 (Turkey's emergency services) without delay.

Because some neurological or medical conditions can also lead to similar experiences, a doctor's assessment should come first, particularly if there is fainting, seizure-like symptoms, severe headaches or different symptoms that began suddenly. Where necessary, a psychiatrist's opinion can also be part of the process. Psychotherapy work in the area of anxiety and panic focuses on understanding and breaking the cycle that keeps derealization going.

How Is Derealization Approached in Therapy?

When working with derealization and depersonalization, approaches based on Cognitive Behavioural Therapy (CBT) are often used.

Psychoeducation and Normalisation

The first and often the most reassuring step in therapy is understanding what the experience is. When clients learn that their feelings are a protective response of the brain and that their connection with reality has not been broken, fear can fall markedly.

Working with Catastrophic Interpretations

Thoughts such as "I am going to go mad" or "I will stay like this permanently" are examined in the light of evidence. Together we observe how these thoughts increase anxiety and how anxiety in turn increases derealization.

Attention-Focused Work

Behaviours of constant self-monitoring and checking are identified. Exercises are done to direct attention outwards, to activities and to sensory experience. Gradually returning to avoided situations is also part of this process.

Underlying Causes

If derealization is linked to a trauma, long-term stress or emotional patterns from childhood, these underlying issues are also brought into the focus of therapy. A schema-focused perspective can help in understanding which experiences feed the tendency to "switch off" emotions.

Frequently Asked Questions

Is derealization the start of going mad?

No. A person who experiences derealization is aware that what they feel is unreal; in other words, their connection with reality continues. This experience is mostly a protective response linked to anxiety and stress, and on its own it does not mean the beginning of a serious mental illness.

Does derealization become permanent?

In most people, derealization eases as the underlying anxiety and stress lessen. Even in long-standing cases, marked improvement can be achieved with suitable support. Returning to life, rather than constantly checking whether the feeling has gone, makes recovery easier.

What is the difference between derealization and depersonalization?

Derealization is a feeling of detachment from the outside world, while depersonalization is a feeling of detachment from oneself. One is the feeling that "the world is not real"; the other, that "I am not real". The two often occur together and are approached with similar methods.

Does derealization occur in teenagers?

Yes. Derealization and depersonalization often begin in adolescence and young adulthood. Exam stress, lack of sleep, heavy screen use and experimenting with substances can be triggers. When a teenager describes this experience, it is important to take them seriously and, if necessary, to consult a professional.

• #derealization
• #depersonalization
• #anxiety
• #feeling detached

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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