Depersonalization and Derealization

Have you ever felt kind of foggy, out of place, or like you are living in a dream? Have you felt detached from your surroundings or your own body and mind?  Maybe you felt like you had fallen out of your body or like your every move seemed mechanical or on autopilot. Fear not because you’re not alone, and you’re not going insane.

If you ever felt something among those terrible feelings, you probably asked yourself: “Am I going mad?”, “Am I schizophrenic?”, “Will my old self ever come back?”. Those are the typical questions people usually ask themselves after suffering some of the aforementioned symptoms. I was also one of those individuals, and my goal is to tell you my story and do the best I can to help you understand, heal, or at least cope with it and ease your suffering.

The important thing to note is that I am not a psychiatrist, I am Not Your Doctor nor do I claim that my methods work, but I can assure you that you will not be forever stuck in this derealising torment of yours and that eventually, you will find a way to be an even better person than you were before those symptoms occurred.

Technical terms

With that said, what is derealisation, and what is the difference between derealisation and depersonalization?

Derealisation is the term described as a feeling that one's surroundings are not real, while depersonalization is a state in which one's thoughts and feelings seem unreal or do not belong to oneself. The depersonalization-derealization disorder occurs when you persistently or repeatedly have the feeling that you're observing yourself from outside your body or you have a sense that things around you aren't real, or both.

Derealization usually occurs with other neurological conditions like epilepsy (particularly temporal lobe epilepsy), migraine, and head injury. Derealization can also be a symptom of severe sleep disorders and mental disorders like depersonalization disorder, borderline personality disorder, bipolar disorder, and other mental conditions. Cannabis, psychedelics, dissociatives, caffeine, and nicotine can all produce feelings of derealization, or sensations mimicking them, particularly when taken in excess. It can also result from alcohol withdrawal or benzodiazepine withdrawal.

Depersonalization is usually a symptom of anxiety disorders, such as panic disorder, sleep deprivation, migraine, epilepsy, obsessive-compulsive disorder, severe stress or trauma, and anxiety, but can also occur after the use of recreational drugs, especially cannabis, hallucinogens, ketamine, and MDMA.

Depersonalization-derealization disorder is thought to be caused largely by interpersonal trauma, such as childhood abuse. 

The first step in helping yourself is understanding what happens in your brain during derealisation. As a famous Polish physicist and chemist, Marie Curie said:

“Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.”

In a nutshell, this is the: 

Neuroscience behind it

Prefrontal cortex: part of the brain that is involved in planning, managing emotional reactions, and adjusting complex behaviors.

Limbic system: part of the brain involved in our behavioral and emotional responses.

It is not fully understood what all of the brain circuits are responsible for feelings of derealisation, depersonalization, or both. However, there is evidence that the prefrontal cortex may inhibit neural circuits that normally form the basis of emotional experience. Circuits likely to cause emotional and cognitive disruption in these disorders might be prefrontal and limbic regions involved in cognitive-emotional regulation. In other words, the part of your brain that normally causes your emotional response can, in these disorders, paradoxically inhibit or stop normal or increased emotional response.

Indeed, functional magnetic resonance imaging studies of patients suffering from depersonalization-derealization disorder have demonstrated decreases in activity in regions involved in affective processing (limbic regions). Also, there may be increased recruitment of inhibitory prefrontal regions to emotional stimuli. In other words, your prefrontal cortex inhibits your emotional part of the brain.

But what is the reason your brain would play such tricks on you and/ or work against you?

One hypothesis is that the brain is trying to protect itself from severe emotional trauma, and as a coping mechanism, it detaches itself from external stimuli to prevent further damage.

This hypothesis is pretty logical considering that DPDR and other dissociative disorders usually have roots in certain traumatic events. Our brains are capable of protecting us through detachment. However, there is the collateral damage of falling into something I would like to call an anxiety loop.

The key thing is to understand that you might not suffer from the depersonalization-derealization disorder, but that your persistent anxiety is causing you to feel detached. In that case, your depersonalization and/or derealisation is a symptom of your anxiety. 

Anxiety and derealization

We all feel anxious at times, and we all have different symptoms and mechanisms to cope with our irrational fears. However, some of us deal better with them, and some worse. Prolonged anxiety has detrimental effects on our minds, bodies, social capabilities, and inevitably our lives. Such long-term anxiety is the root of the possible symptoms we explained earlier. 

One of the first things that comes to our mind when experiencing these symptoms is: “Why me?”, or “I was perfectly healthy before this!”, “Did last night’s bad trip or one shot too many ruin my life!?” 

The thing is, probably not. Whatever the trigger for your derealisation might be, there is a significant chance you have had unresolved trauma or long-term anxiety. Many drugs I mentioned before can mess up your brain’s chemistry (especially in the still-developing brain), but triggers cannot be the only topic when it comes to derealization. We have all heard a thousand times how drugs are bad for you, but the inescapable stress and anxiety that we deal with in our everyday lives are the true roots that cause all that mess. Sadly, not enough is talked about anxiety and its permanent damage to our brains. 

With that said, anxiety is closely related to derealization and depersonalization.

Long-term anxiety is the root of possible episodes of detachment, and that detachment itself can cause severe anxiety, thus falling into a vicious cycle that is, at first, hard to break out of. This is the anxiety loop:

Once you successfully stop the anxiety loop, there is a significant chance your symptoms will get better. It might take some time, but with proper psychotherapy and determination, you could be on the right path to recovery. 

Summary:

DPDR is a mental health condition where individuals feel detached either from themselves (depersonalization) or their surroundings (derealization), often describing the experience as feeling like they are in a dream or watching life from outside their body. These sensations can be terrifying, but they are more common than people think and not a sign of going insane.

Key Points:

• Depersonalization: Feeling detached from your body or thoughts.
• Derealization: Feeling like the world around you isn’t real.
• DPDR Disorder: Persistent or recurrent episodes of both depersonalization and derealization.

Causes & Triggers:

• Trauma, especially in childhood
• Severe stress or anxiety
• Sleep deprivation, migraines, and epilepsy
• Drug use (e.g., cannabis, psychedelics, ketamine, MDMA)
• Neurological or mental health conditions

Brain Mechanism:

• The prefrontal cortex may suppress emotional responses from the limbic system as a defense against trauma.
• This can create emotional numbness and a sense of unreality.
• Functional brain scans show decreased limbic activity and increased prefrontal inhibition during episodes.

Anxiety Connection:

• DPDR is often linked to prolonged anxiety, creating a vicious cycle—anxiety causes detachment, which in turn increases anxiety.
• Breaking the “anxiety loop” is key to recovery.

Hope & Recovery:

• You’re not alone and not permanently broken.
• Understanding the condition is the first step.
• Therapy and personal resilience can help overcome or manage symptoms.