Derealization & Understanding the Disconnection from Reality

Derealization Symptoms, Causes, and Coping Strategies

Derealization is a psychological phenomenon characterized by a profound sense of detachment from one’s surroundings, often accompanied by feelings of unreality or distortion of the external world. While it can occur as a fleeting experience during periods of stress or anxiety, for some individuals, derealization becomes a chronic and distressing condition. 

Research suggests that derealization is closely linked to other dissociative disorders, such as depersonalization, and often arises as a coping mechanism in response to trauma or overwhelming stress. Studies have also implicated abnormalities in brain function and neurotransmitter imbalances in the development of derealization, shedding light on the complex interplay between psychological and neurobiological factors underlying this condition. 

Understanding the basics of derealization and its underlying mechanisms is crucial for effective diagnosis and treatment strategies.

What is Derealization?

Derealization refers to a psychological experience marked by a profound sense of detachment from one’s surroundings and reality. It is characterized by a feeling that the world is surreal, dreamlike, or somehow distorted, leading individuals to question the authenticity of their experiences. 

People experiencing derealization may describe feeling as though they are watching the world through a foggy lens or that their surroundings lack the usual vividness and clarity. 

This dissociative phenomenon can vary in intensity and duration, ranging from fleeting episodes triggered by stress to persistent and distressing states that significantly impact daily functioning. 

What Does Derealization Look Like?

Derealization manifests differently from person to person, but common features include a sense of detachment from reality, visual distortions, and a feeling of unreality. Individuals experiencing derealization may describe their surroundings as appearing foggy, blurry, or somehow artificial, leading to a pervasive feeling of disconnection. 

Some may feel as though they are observing the world through a veil or experiencing life as if in a dream. The experience can be distressing and disruptive, impacting various aspects of daily life. Key points to note about derealization:

  • Profound detachment from surroundings.
  • Visual distortions such as foggy or blurry vision.
  • Feeling of experiencing reality as dreamlike or artificial.

Derealization Panic Attack

Experiencing derealization during a panic attack can intensify feelings of fear and confusion, compounding the distress already associated with panic disorder. In these episodes, individuals may feel an overwhelming sense of detachment from their surroundings, as if the world around them is unreal or surreal. 

It’s crucial for those experiencing derealization panic attacks to seek support and implement coping strategies to manage both the panic symptoms and the dissociative experiences. Key points:

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Symptoms of Derealization

Experiencing derealization can be distressing and disorienting, often accompanied by a range of symptoms that affect one’s perception of reality. Common symptoms include:

Symptoms of Derealization

Visual Distortions:

  • Objects appear blurry or distorted.
  • A sense of visual unreality, as if viewing the world through a foggy lens.

Emotional Numbness:

  • Feeling detached from emotions or experiencing them as muted.
  • Difficulty connecting emotionally with oneself or others.

Disconnection from Surroundings:

  • Feeling as though the environment is unfamiliar or artificial.
  • Sensation of being detached from one’s surroundings or the people within them.

Altered Time Perception:

  • Distorted perception of time, with moments feeling elongated or condensed.
  • Difficulty gauging the passage of time accurately.

Cognitive Impairment:

  • Difficulty concentrating or focusing on tasks.
  • Memory problems, including difficulty recalling recent events or experiences.

These symptoms can vary in intensity and duration, with some individuals experiencing brief episodes of derealization during times of stress, while others may struggle with persistent symptoms that significantly impact daily functioning. Understanding the range of symptoms associated with derealization is essential for accurate diagnosis and effective treatment planning.

Derealization Causes

The causes of derealization are multifaceted and can vary widely among individuals. While the exact etiology remains unclear, several factors have been implicated in the development of this dissociative phenomenon. 

Common causes include:

Derealization Causes
  • Psychological Factors:

Trauma or stress: Exposure to traumatic events, such as abuse, accidents, or combat, can trigger derealization as a coping mechanism to dissociate from overwhelming emotions.

Anxiety disorders: Derealization often occurs in conjunction with anxiety disorders, such as panic disorder or post-traumatic stress disorder (PTSD), especially during periods of heightened stress or anxiety.

Depression: Derealization may also occur in individuals with depression, particularly in severe cases where emotional numbness and disconnection from reality are prevalent.

  • Neurobiological Factors:

Imbalance in neurotransmitters: Dysregulation of neurotransmitters, such as serotonin and glutamate, has been associated with derealization, suggesting a neurochemical basis for the condition.

Abnormal brain activity: Neuroimaging studies have revealed alterations in brain regions involved in sensory processing and self-awareness among individuals experiencing derealization, indicating potential neurological abnormalities underlying the disorder.

  • Other Factors:

Substance use: Certain substances, including hallucinogens, cannabis, and dissociative drugs, can induce derealization as a side effect or exacerbate existing symptoms.

Medical conditions: Derealization may occur secondary to medical conditions affecting the brain or sensory processing, such as epilepsy, migraine, or temporal lobe lesions.

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How to Stop Derealization?

Managing derealization especially when triggered by factors like depersonalization from weed, requires a multifaceted approach that addresses both the underlying causes and the immediate symptoms. 

Cognitive-behavioral therapy (CBT): CBT helps individuals identify and challenge distorted thoughts and beliefs contributing to derealization. It also teaches coping skills to manage anxiety and stress triggers effectively.

Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) may be prescribed to alleviate symptoms of anxiety and depression, which often co-occur with derealization.

Anti-anxiety medications: Benzodiazepines or buspirone may provide short-term relief from anxiety symptoms associated with derealization.

Mindfulness meditation: Practicing mindfulness techniques can help individuals ground themselves in the present moment, reducing feelings of detachment and promoting a sense of connection to reality.

Progressive muscle relaxation: This technique involves tensing and relaxing different muscle groups to alleviate physical tension and promote relaxation, which can help counteract the dissociative symptoms of derealization.

Avoiding substance use: Avoiding substances known to exacerbate derealization, such as cannabis and hallucinogens, can help prevent further episodes of depersonalization triggered by substance-induced dissociation.

Establishing a healthy routine: Prioritizing regular sleep, nutritious diet, exercise, and stress management techniques can support overall mental health and reduce the likelihood of experiencing derealization episodes.

Support Groups: Joining support groups or online communities for individuals experiencing derealization can provide validation, understanding, and practical coping strategies from others who have shared similar experiences.

Self-Care Practices: Engaging in activities that promote relaxation and self-care, such as spending time in nature, practicing creative expression, or engaging in hobbies, can help individuals reconnect with themselves and their surroundings, reducing feelings of detachment and unreality.

Difference Between Depersonalization and Derealization

Depersonalization involves a sense of detachment from oneself, leading individuals to feel disconnected from their own thoughts, emotions, and identity. On the other hand, derealization entails a feeling of detachment from the external world, causing individuals to perceive their surroundings as unreal, distorted, or unfamiliar. 

While these experiences often co-occur and share similarities, they represent distinct manifestations of dissociation. Differentiating between depersonalization and derealization is essential for effective diagnosis and targeted treatment approaches.





Feeling detached from oneself and identity.

Feeling detached from the external world.


Disconnection from thoughts, emotions, and identity.

Perception of the world as unreal or distorted.


Sense of watching oneself from outside the body.

Sensation of the world being dreamlike or artificial.

Common Triggers

Stress, trauma, anxiety disorders.

Stress, anxiety, substance use.

Coping Strategies

Grounding techniques, therapy, relaxation exercises.

Grounding techniques, therapy, mindfulness.

Why Do I Feel Disconnected from Reality?

Feeling disconnected from reality or out of touch with reality can be a distressing and bewildering experience, often leaving individuals questioning the authenticity of their surroundings and experiences. 

This sensation may arise from various psychological factors, including anxiety disorders, trauma, or depression, which can disrupt the brain’s perception and processing of sensory information. Stressful life events or overwhelming emotions may trigger a dissociative response, leading to feelings of detachment and unreality as a coping mechanism. 

Additionally, substance use, particularly hallucinogenic drugs, can induce transient episodes of feeling disconnected from reality. Understanding the underlying causes of feeling out of touch with reality is essential for addressing and managing these distressing symptoms effectively.

Depersonalization Schizophrenia Relationship

Depersonalization and schizophrenia are two distinct mental health conditions, but they can sometimes co-occur or share overlapping symptoms, leading to confusion in diagnosis and treatment. While depersonalization involves a sense of detachment from oneself and identity, schizophrenia is a complex psychotic disorder characterized by hallucinations, delusions, and disorganized thinking. 

Understanding the relationship between depersonalization and schizophrenia is essential for accurate diagnosis and appropriate management strategies.





Feelings of detachment from oneself and identity.

Hallucinations, delusions, disorganized thinking.


Can occur in response to stress, trauma, or anxiety disorders.

Typically emerges in late adolescence or early adulthood.


Therapy, grounding techniques, addressing underlying psychological factors.

Antipsychotic medication, therapy, supportive services.

Ending Note

Derealization and depersonalization are complex dissociative experiences that can profoundly impact individuals’ perceptions of reality and self. Understanding the symptoms, causes, and potential relationships with other mental health conditions like schizophrenia is essential for accurate diagnosis and effective treatment. While these experiences can be distressing and disruptive, there is hope for recovery through a combination of therapy, medication, lifestyle modifications, and support networks. 

By fostering awareness and empathy, we can create a more inclusive and understanding environment for those navigating the challenges of derealization and depersonalization. 

Dr. Lubna Siddiki MD
About Author

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Dr. Lubna Siddiki MD
Dr. Lubna Siddiki is a board-certified Adult Psychiatrist. She specializes in treating adults struggling with various mental health disorders, including depression, anxiety, bipolar disorder, and more. Dr. Siddiki believes in a holistic approach to mental health treatment and works closely with her patients to develop personalized treatment plans that focus on their overall well-being. She is dedicated to helping individuals improve their behavioral health and lead fulfilling lives.