We speak of derealization when a person’s perception of reality seems unreal, dreamlike or distorted. Feeling numb, detached from oneself, or having a distorted sense of time are common symptoms of derealization. Derealization is a form of dissociation that can be caused by stress, trauma, severe anxiety, psychosis, or dissociative disorder. Treatment for symptoms of derealization depends on the underlying cause and may involve psychotherapy, medication, or both.

What is derealization?

Derealization is the experience of feeling detached or separated from one’s environment and experiences. It is normal to feel “absent” or disconnected from time to time, but people who suffer from derealization have these episodes more frequently, difficult to stop or control. Dissociative symptoms can make concentrating, interacting with others, and normal functioning quite tricky.

People who suffer from derealization often describe feeling like an “observer” of their life and environment rather than participating in it. They are usually aware of where they are and what is going on around them, but their experience of reality seems unreal during dissociative episodes. They may report that the world seems hazy, artificial, or distant to them.

Symptoms of derealization.

Derealization is a dissociative symptom that can occur during a PTSD flashback, a psychotic episode, or during times of high stress or anxiety. The main symptom of derealization is feeling that your surroundings are unreal or that you feel detached or separate from them.

Here are some of the other signs and symptoms of derealization:

  • Feeling of being “far” or distant from one’s physical environment.
  • Feeling of being stuck in a dream state or feeling that reality is ‘unreal’.
  • Feeling that your surroundings are unfamiliar.
  • Inability to recognize familiar people or faces.
  • Blurred or hazy vision.
  • Sounds are muffled or seem weaker or louder.
  • Numb or altered sensations.
  • Altered sense of time (movement faster or normal than usual).
  • Feeling like being in a movie or watching a movie.

When derealization is caused by another mental illness, it may overlap with other symptoms such as mood changes, anxiety symptoms, or psychotic symptoms.

What are the causes of derealization?

It’s relatively normal to experience occasional symptoms of derealization or dissociation, especially when you’re stressed, sleep deprived, or overstimulated. In fact, about 50% of the population experiences at least one temporary episode of derealization. In most cases, these are isolated episodes that resolve on their own without treatment. Usually these are isolated episodes that go away on their own without treatment. However, frequent or uncontrollable episodes are often a sign of an underlying problem or condition.

The most common cause of derealization is the experience of a traumatic event. Research shows that up to 74% of trauma survivors will experience derealization at some point in their lives.

Childhood trauma, including physical or emotional abuse and neglect, can have lasting effects on a person, such as periodic dissociative symptoms like derealization. Derealization can be triggered by stress, anxiety, PTSD flashbacks, or any other strong emotional reaction.

Other possible causes of derealization are:

Being very ill or seriously injured can lead to dissociation from one’s body and surroundings, complete or partial loss of consciousness, and other symptoms of dissociation and derealization.

  • Brain damage or neurological disorders:

In rare cases, derealization can be triggered by traumatic brain injury or an underlying neurological disorder such as epilepsy. Dementia or cognitive impairment due to long-term drug addiction can also trigger derealization.

  • Anxiety Disorders:

High levels of anxiety or panic attacks can cause chemical changes in the body and brain that alter perception and cause people to temporarily dissociate from their bodies or surroundings.

  • Prescribed or illegal substances:

Derealization is sometimes an adverse effect of a prescribed medication, or the result of taking or withdrawing from a mind-altering or mood-altering drug. Some street drugs like marijuana and psychedelics are more likely to trigger dissociative symptoms.

  • Mood disorders:

Depression or bipolar disorder can also cause symptoms of derealization during manic episodes, depressive episodes, or both.

  • Psychosis or psychotic disorders:

Some people with schizophrenia, brief psychotic disorder, or psychosis experience derealization during times when their symptoms are unmanaged.

  • Personality disorders:

Some personality disorders, such as borderline personality disorder, can cause abnormalities in the way people think and perceive reality, and can lead to derealization in some people.

Dissociative symptoms such as derealization are sometimes a defense mechanism in response to extreme stress or danger. These symptoms almost always resolve on their own.

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