Derealization is a dissociative symptom, where subjects feel as though the external world is not real (e.g., unusual, dreamlike, otherworldly). While derealization is itself not dangerous, it can be distressing to people and often occurs alongside anxiety, depression, trauma, and neurological conditions. It can be present as a symptom of depersonalization-derealization disorder (DPDR) or alongside other psychological disorders.
What Does Derealization Mean?
Derealization is defined as a conscious and subjective change in the perception of the physical world. People with derealization commonly describe the surrounding world as foggy, dreamlike, distant, or artificial. In contrast to psychotic symptoms, such as hallucinations or delusions, people with derealization recognize that they are experiencing an altered perception of reality. Understandably, this factor is important in identifying derealization as a different experience from schizophrenia and similar psychotic experiences.
Causes and Risk Factors
Derealization can occur as a symptom due to a variety of psychological and neurological conditions. Among the most common causes of derealization symptoms are stress and trauma. When a person experiences overwhelming experiences in their life, the brain may utilize dissociation as an adaptive strategy to cope with psychological pain. For instance, individuals with post-traumatic stress disorder (PTSD) will commonly describe episodes of derealization.
Other triggers for derealization include:
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Anxiety and panic attacks: Sudden hyperarousal induces a disconnection between the brain and its environment.
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Substance use: Cannabis, hallucinogens, and other psychoactive drugs can create a temporary state of derealization.
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Neurological conditions: Migraines, seizures, and vestibular issues can also bring forth feelings of unreality.
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Sleep deprivation: Lack of rest disrupts cognitive processing, possibly leading to derealization experiences.
Derealization Symptoms
The experience of derealization can look different for each person but may include the following:
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Feeling like you are in a movie or in a dream
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Your environment looks altered or colorless
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Time may feel slow or out of sync
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A sense of disconnection from everyday surroundings
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Sounds may feel muffled or unusually loud
Derealization can often occur with depersonalization, whereby the continuity of a person or a person’s thoughts or experience feels disconnected from one’s body. Together, these symptoms form Depersonalization-Derealization Disorder.
Psychological and Social Consequences
Derealization itself is not harmful. However, the implications of feeling disconnected from day-to-day life can be significant. A constant state of disconnection lends itself to feeling removed from work, relationships, and an overall sense of functionality. People with chronic derealization may fear going “crazy” or feel overwhelmed by a sense of helplessness in trying to reconnect with reality. The distress accompanying chronic derealization can contribute to depressive symptoms or exacerbate higher levels of generalized anxiety.
Derealization Treatment and Coping Strategies
Treatment for derealization is directed at the underlying issues. The best approaches include:
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Psychotherapy: Cognitive Behavioral Therapy (CBT) helps patients understand their dissociative thoughts and challenge them. Grounding techniques reconnect individuals with the present moment.
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Medication: Although no specific medication targets derealization, SSRIs or anti-anxiety medications may relieve related symptoms.
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Lifestyle changes: Reducing stress, improving sleep quality, and avoiding substances may minimize episodes.
Mindfulness practices—such as breathing exercises and sensory awareness—help individuals feel less disconnected from their bodies and surroundings by fostering present-moment awareness.
Conclusion
Derealization is a complex and often misunderstood symptom that creates emotional and cognitive burdens for those who experience it. It does not indicate psychosis or a permanent mental illness, but the repercussions on quality of life can be significant. Early identification and professional support are essential for managing symptoms and restoring a sense of reality.
With increased clinical and public awareness, individuals suffering from derealization may receive greater recognition, validation, and effective support to reclaim their lives.
References
Simeon, D., & Abugel, J. (2006). Feeling unreal: Depersonalization disorder and the loss of the self. Oxford University Press.
Sierra, M. (2009). Depersonalization: A new look at a neglected syndrome. Cambridge University Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596