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Depersonalization and Derealization: Symptoms of Severe Anxiety

Meloncauli is a former nurse and anxiety management therapist. She hopes everyone can take something away from her articles.

Learn about depersonalization disorder

Learn about depersonalization disorder

Do You Suffer From Depression or an Anxiety Disorder?

When you suffer from an anxiety disorder or depression for a long time, you can become so sensitized or over-sensitive that you almost feel scared of your very own shadow. The nervous system takes a battering, and many wild and not-so-wonderful sensations and thoughts can occur. Rumination and mind chatter can take over.

Questioning our very selves, our reality, and our place in the world can become persistent. It is not uncommon to begin to suffer from a state of depersonalization and/or derealization, which can be very alarming. These perceptual distortions can most certainly directly result from prolonged stress, anxiety, and depression.

What Is Depersonalization and Derealization?

Depersonalization is a state of being hyper-aware, like an onlooker outside the body. Most people who suffer from panic attacks will encounter this feeling. The perception of being unreal can even make us wonder if we are really alive and here in the present.

Derealization is a state where everything around you seems unreal. This can make you question if you are the only thing that is real. These states of mind can thus produce a feeling of either I am real and the world is not or the world is real, and I am not! It can be very disturbing and has the effect of producing yet more fear which in turn releases more adrenaline creating further sensitization. It seems to be a never-ending cycle of fear/adrenaline/fear/adrenaline helping to maintain the symptoms of unreality.

If you have experienced life’s anomaly of déjà vu, you have had a minor taste of what depersonalization and derealization can feel like. Déjà vu is a fleeting feeling of having experienced a situation or place before. Likewise, people with epilepsy or migraine sufferers can experience an aura that can also be sudden and unsettling but of a very short duration. All of these things have a dreamlike quality about them but with depersonalization and derealization, the experience can sit around for a long time and be experienced every day. Imagine having déjà vu constantly for hours, days, weeks or months on end. For chronic generalized anxiety or panic sufferers, these symptoms can be the most frightening of all.

Take a Depersonalization Test

Anxiety can cause strange thoughts, feelings, and behaviors. Often, people fail to believe that anxiety could be the cause; after all, doesn’t everyone have some anxiety in their lives? We are not talking about healthy anxiety here but unhealthy anxiety that is chronic and debilitating. It is the fearful reaction to the symptoms brought on by the chronic anxious state that helps it to build and keep it alive.

Will I Lose My Mind?

First, it is important to understand that these states are not harmful, either mentally or physically. They may feel very alarming, but you are not going insane. Many people are afraid the symptoms are an indication of the onset of psychosis, but when you have been diagnosed with an anxiety disorder and/or depression, it will be highly likely to be associated with that diagnosis.

There is a condition called depersonalization disorder which is listed in the DSM (statistical diagnostic manual) as a dissociative state and can be a result of a past traumatic experience, although this is usually found with accompanying anxiety also. Some sufferers may begin to have these symptoms after taking illicit drugs, perhaps after having had a bad trip. The good news is that both depersonalization and derealization can completely go away once a person is no longer sensitized. Desensitization takes time and is subject to how much a person addresses their general anxious state.

Smoking cannabis can start up  panic attacks particularly with feelings of unreality

Smoking cannabis can start up panic attacks particularly with feelings of unreality

Treatment Options

In most cases, the treatment for depersonalization and derealization would be the same as that for the underlying anxiety and depression. SSRIs used as anti-anxiety pills are the most common medication, and in some cases, benzodiazepines may be prescribed, such as Xanax or valium, though these may be discouraged due to dependence issues. If the actual anxiety issues are not addressed, one may be subject to a return of symptoms after these medications are stopped. Ideally, therapy or self-help should be encouraged.

One must remember that these feelings of unreality are, for the most part, usually a direct symptom of having suffered intense anxiety. The longer you suffer, the more likely it will be that you may experience unreality. That said, people who use substances such as cannabis may have a sudden onset of unreality after they have used the substances. It is my opinion that in the case of anxiety disorders, treating the underlying anxiety is key. The unreality tends to dissolve once this is addressed.

There are some things you may try to alleviate the symptoms. When we feel a sense of detachment, life can become difficult, so difficult that we may avoid social activities, leave the home, and become further isolated. It is important to maintain as much normality as possible despite the unreality. Easier said than done, but the undoing of unreality is to face the reality of it. It will not harm you; it is a frightening experience, but it seeks your fearful reaction, and you must work to resist this. Without reaction, it loses power somewhat. Here are some things I suggest:

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Read More From Healthproadvice

Suggestions to Cope with Unreality

  • Wear a rubber band or elasticated bracelet on the wrist. Each time an unreal feeling begins, snap the band hard on your wrist to remind you not to react with fear. It might be a good idea to have a little statement you can say to yourself at the same time, such as "I am here; this feeling is a product of my anxiety only. I will be okay."
  • Look in the mirror. Go look in the mirror and touch your face or any parts of your body. Smile at yourself. Tell that statement to the mirror.
  • If you are around other people, make a point of striking up a conversation and, most of all, encourage eye contact with the person you are talking to. This reminds us that we are real and everything around us is real.
  • If you are alone and the feelings come, go and phone someone. It is amazing how, when we divert our attention away from our own thoughts and feelings, some respite is gleaned.
  • Keep a notebook with positive affirmations in it. Write down realistic statements, one on each page in bold capital letters. Read these in times of doubt and uncertainty. It may seem silly, but you need to reinforce over and over the explanation for your suffering, the truth – the reality!
Phoning someone will redirect your focus and attention.

Phoning someone will redirect your focus and attention.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


David on June 09, 2017:

I loved reading this post and knowing you're a nurse with personal experience dealing with this. I've been horribly anxious and depersonalized since taking Zoloft and I've since been recovering for 2+ months. I'm doing better and better and this post really helped. Thank you so much for your insight and encouragement :D

Robin on January 25, 2017:

I am so lost in cry all the time and can't keep a job lost my family, my 3 ex husbands and friend (who I thought was in love with me), for 5 years, is not but verbally and a couple of times physically abusive, my last ex-husband was mean all alcoholics, dieing of cancer has both of our children, supported by his parents. I have lost the myself and my family and I have social anxiety disorder and major depression, haven't been able to to work since I fell and I am lost finding out that my psychiatrist said that my prognosis is poor and doesn't want me to work. I have not filed for disability benefits or workman's compensation when I should have. So I talk to representatives about this topic and I get paperwork but don't follow up. I don't want to be disabled. I want to find myself and pay for my car and phone, rent and bills, I am afraid on medical insurance through the state. I just wanted to be happy and healthy. Enjoy my family, my 15 year old son won't talk to me. There is so much more, but I don't have any money, ashamed of my self,and life and don't know what to do. I get up do my chores go on interviews and, no call backs, I am just wanting to be me, and I need help, but now just lost, I don't want it to be true that the doctors say my prognosis is poor. Any suggestions on self help or something

Richard J ONeill from Bangkok, Thailand on June 27, 2016:

Great hub, well written, and some useful information there.

I think I may have suffered from both depersonalization and derealization before, and I know I most definitely suffer from anxiety.

As you say, the root cause is trauma from childhood.

I would sit and cover my ears in my room upstairs as my mum and dad screamed the house down, and then there was always the fear of the door opening and more abuse raining down on me.

I still suffer today because of that.

Great tips. Thank you. :)


Ashley Ferguson from Indiana/Chicagoland on February 06, 2016:

Interesting topic. Hoping there is an end one day to depression and anxiety. :(

HaddieHope on February 06, 2016:

Thank you for this article! I always wondered why I felt calmer looking in the mirror.

Lisa VanVorst from New Jersey on February 06, 2016:

This was a very educational hub. I believe we all at one time or another suffer from anxiety, however for some it is severe. I do not believe that society should all be placed on medications as you said these medications can be very addictive and going off them is dangerous and can increase one's anxiety. I do suffer from anxiety and need to take medication. However I take a very low dose and none of which you mentioned above. I also have recently been diagnosed with seizures and for the remainder of my life will have to take medication. Some people I know have Post Traumatic Stresss Disorder and are on anxiety medications as well. Doctors need to find ways to decrease symptoms of anxiety without medication. However I also know people who do not take any type of medication and their anxiety is out of control. So I feel the care our doctors give up should be personalized, not generalized. Thank you for this hub. I am sure it will guide people with anxiety in the right direction.

Nigel789 on February 05, 2016:

Just like some countries have Suicide Hotlines, wouldn't it be nice (but probably totally unrealistic) to have Depression Hotlines.

I have no one to talk to when depressed, DP, DR or anything else.

Andrei Andreescu from Seattle, Washington on December 06, 2015:

Well done.I think this hub might help many people with anxiety.I did not suffer from anxiety but I had been through neuro-gastric eating disorders such as bulimia and binge eating disorder.

Shannon on August 26, 2015:

Thank you for this articlethese coping skillsI have been dealing with this dp for about 4 weeks and im praying it gos away ... I am also very sensitive to light and everything looks so unreal when I go outside it really scares me or from bipolar 2 general anxiety disorder and post traumatic stress disorder .....i just want it to end

Susan Trump from San Diego, California on May 22, 2015:

Nice article. Many deserved comments. Sounds like you are reaching an audience that needed hearing from you. I'm curious to know how you include the references in blue back to your other articles.

meloncauli (author) from UK on October 12, 2012:

Thanks for your comment time2rite! I shall look out for your articles with interest :)

Kathryne Waller from Knoxville, TN USA on October 11, 2012:

Wow, wow, wow! You have hit the nail on the head with this one.

I am a sufferer of panic disorder, OCD, and depression. I have experienced the derealization and depersonalization, and it is quite scary and unsettling.

I began a hub tonight called "My Trip Through Grief." This is but a first of many installments I will be posting which will chronicle how I am coping with this disorder along with becoming divorced.

I'm glad you chose this topic and you have explained quite clearly just how bizarre these feelings can be. Your tips to cope I have found myself doing, especially the night of my final hearing...I stood before the mirror touching my face and hair while looking at my reflection; subconscious way of coping I had no idea was the very thing I needed to do.

Great hub!

meloncauli (author) from UK on October 08, 2012:

Thanks for your comment Tara. I can vouch for how artificial lighting can affect a person with anxiety and DP/DR. The supermarkets were my worst nightmare with both crowds and lighting as precursors to me becoming very disorientated and adding to the unreality. The lighting seemed to make my head spin!

It is easy to become reliant on medication especially when you have a job to do.(Congratulations on the job!).

The good news is that you are not going insane and this will go away eventually. Remember that the worst thing you can do is question it over and over; also recoil away from it in horror it (tensing to it).

Have some meaningful reality memos at your disposal to remind you that it is a bluff of anxiety. I assume you are addressing the core anxiety problem head on?

Thanks again for your comment.

Tara on October 07, 2012:

Thank you for this article. I have suffered with severe anxiety for over 6 years. I had a row of traumatic events happen in a 6 months time period. I did seek psychological help one time, but after a few months I found that it didn't help. I am also very sensitive to lights. Fluorescent lighting makes me almost instantly become in a DR state. Usually I stay away, and my husband does the shopping. Recently I got a new job, (I love this job, and am very happy), but the DR has gotten 10x worse. It's almost a 24/7 feeling now. I do not want to quit this new job because I do enjoy it. There are florscent lights in my office, and I am trying to adjust. I take xanax when needed but I really try not to. I rather calm myself down, but it's not helping anymore and I am starting to rely on the medication. (This is not typical of me and I have been on and off xanax for the past 6 years. Maybe 3-6 pills per year in total). Now with the DP/DR being almost 24/7 I am not sure where I go from here. It is very frustrating. And I do feel like I am going insane/losing my mind. Thank you for the article. I have tried a lot of what you suggest, but there are a few I have not thought of and am going to try.

meloncauli (author) from UK on October 07, 2012:

Glad you are finding them useful LadyLola. Thanks for your comment.

Lanie Robinson from Canada on October 06, 2012:

I've been reading through your Hubs, and been learning a lot.

Jodi Buck from Guthrie, Oklahoma on September 27, 2012:

Okay. Thank you for all of your advice.

meloncauli (author) from UK on September 27, 2012:

You may be looking for it..i.e analyzing it. If you dwell long enough on your feelings after starting meds like this , you can believe you actually feel worse than you do. Give it a few days and if you feel distinctly worse I would have a word with your doctor, but as I said, increased agitation/anxiety can increase for a while.

Jodi Buck from Guthrie, Oklahoma on September 27, 2012:

Thank you. I'm not sure how I'll handle even more anxiety, or a spike in depression for that matter. I just went from being so hyper I felt like I was tweaking, to feeling like I'm going to cry as well as anxious. Are these mood swings normal?

meloncauli (author) from UK on September 27, 2012:

After 2-3 weeks you should start getting used to it but it may be longer. Most SSRIs tend to make you more anxious for the few weeks. This is often why people stop taking them but I do hope you find some relief with them.

Jodi Buck from Guthrie, Oklahoma on September 27, 2012:

Mine is also for panic disorder. Right now--roughly two hours after my first dose--I feel hyper and restless, but sluggish at the same time. Its strange.

meloncauli (author) from UK on September 27, 2012:

I took Celexa on and off for about six years and have to admit that it was one of the better SSRIs I took. It did make me drowsy at times, especially at first and when my dose was increased. I took it for panic disorder and it was quite effective.

Jodi Buck from Guthrie, Oklahoma on September 27, 2012:

Do you know anything about Celexa, meloncauli? I started taking it today. I'm somewhat nervous.

meloncauli (author) from UK on September 26, 2012:

Hi and thanks for your comment. This is not a type of anxiety. DP and DR happen as a result of a build up of chronic anxiety. People can also get these symptoms from illicit drug use, though they may be more susceptible sensitive people generally to begin with. The treatment is for the underlying cause i.e. anxiety . If you have an anxiety disorder for a long time and then use either medications or self help to recover from the problem, it is possible to be left with DP or DR for some time. Once the sensitized nervous system has fully recovered these kinds of symptoms tend to disappear without the use of medication.

KellyMediaBest from Tampa, Florida on September 26, 2012:

Wow, deja vu is the most bizarre feeling ever- I can't imagine having it for more than a couple of seconds. This seems like a really interesting subject to research within anxiety. I would never want to feel as though I am not real, or the things happening around me were not real- it would be incredibly frightening! These disorders seem to be incredibly difficult to cope with, are there medications specifically for these types of anxiety?

Jodi Buck from Guthrie, Oklahoma on September 25, 2012:

Thank you. :)

meloncauli (author) from UK on September 25, 2012:

That's a very realistic goal so good luck with it.

Jodi Buck from Guthrie, Oklahoma on September 25, 2012:

I would say 'yes', but I've had bipolar for all of my life and I've had GAD symptoms since elementary school and panic disorder symptoms since middle school. It has kind of become my normal. The best case scenario with the medication would be to create a healthier normal for myself.

meloncauli (author) from UK on September 25, 2012:

I do hope you get some relief from the medications. It's amazing how so many of the anxiety disorders are suffered alongside each other. This must be very difficult for you suffering with bipolar too.

Jodi Buck from Guthrie, Oklahoma on September 25, 2012:

GAD, panic disorder, OCD, ADHD, Bipolar II, and Seasonal Affective Disorder (SAD). Yeah, I've tried a lot of different things. Breathing exercises and meditation help some with my panic attacks, but not enough. If the medication does more harm than good, I'll ask to be taken off of it.

meloncauli (author) from UK on September 25, 2012:

That's really good to know, thanks. Have you tried any self-help ideas? I don't know what exactly your problems are but if they are anxiety related, so much can be overcome through self-help.

Jodi Buck from Guthrie, Oklahoma on September 25, 2012:

I'm starting a regimen of antidepressants and Buspirone (BuSpar) sometime this week. As I've never been on medications like these before, I've been trawling about for good information. Many of your hubs have been useful so far.

meloncauli (author) from UK on September 25, 2012:

Thanks so much for dropping by and reading my article. Yes, doctors don't use these terms very often when discussing symptoms with their patients.

Jodi Buck from Guthrie, Oklahoma on September 25, 2012:

I have panic attacks frequently and never knew the exact terminology for this specific symptom. Great article.

meloncauli (author) from UK on September 24, 2012:

Thanks KCap. I suffered with post partum depression too.

Kelly Capozzi on September 22, 2012:

Very interesting article. I suffered from post partum depression and anxiety but thankfully it did not escalate into depersonalization. I like that put tips for how to cope with it.

HubTub on September 04, 2012:

You are most welcome! Looking forward to your next hub (smile).

meloncauli (author) from UK on September 04, 2012:

Thanks HubTub. I suffered with panic disorder for decades and now I do not. There are ways to completely recover from panic disorder but equally important are the skills you can learn to prevent it happening again.....I feel another hub coming on ha ha!

Thanks again.

HubTub on September 04, 2012:

I suffer from severe anxiety and panic attacks and wouldn't wish either of these on my worst enemy. I don't think society, in general, understands just how debilitating anxiety can actually be. Unfortunately, I can personally relate to much of the information you have so beautifully written in this hub.

Over the years I have learned techniques to "quiet" the attacks; however, I don't believe I will ever return to the person I was, before anxiety quietly slipped into my life, wreaking complete havoc.

Thank you for writing this most interesting article. I thoroughly enjoyed the read!

meloncauli (author) from UK on June 23, 2012:

Sorry for the late reply. I do hope they have gone away for good now.

Rick Maselli from Akron, Ohio on May 02, 2012:

Another great article. You sure cover a lot of information in your articles. Wow!

Having had two panic attacks some years back, I was caught off guard with the first one. I really felt as if I was dying. My breathing became very labored, and my body tightened up all over. All I could do was curl up on my bed and hoped it would go away. I did not understand, at the time, what was happening. My wife jumped into action. She told me to get up and she was taking me to the park down the street to walk.

I felt as if that was never going to happen. So she helped me up, got me into the car and took me to the park and we did start walking. As we did my labored breathing began to stop and body became more relaxed and soon it was over.

Later after researching panic attacks, I realized that I could catch them and stop them within a few minutes by using deep breathing techniques, which I had some training in. And, breathing into a paper bag does work too.

Deep breathing can slow your anxiety down, relax you and prevent it from turning into a full blown panic attack. Also, recognizing what triggers you and removing your self from the situation or the person who is the trigger when you first start getting the anxiety, is one of the best things you can do to help prevent future attack onsets.

meloncauli (author) from UK on April 09, 2012:

I would imagine the instant physical state of shock caused you to instinctively scream. In lots of ways, shock has a lot to answer for in panic issues also. A panic attack is shocking. Feeling shocked by your, what appears to be at the time, alien sensations, your reaction kicks in immediately. That's why it's so hard to address often. It seems instinctual and indeed the flight or fight response is. Dissociation was once described to me as a way of your mind coping with something when it is overwhelmed. Thanks for your comment, it was much appreciated.

Lori Colbo from United States on April 08, 2012:

I'm glad you mentioned it being a dissociative disorder because as you were explaining it that is what I was connecting it to. One time I broke my ankle quite severely, and I was on the ground writhing and screaming. And yet, I was having this out of body experience and thinking to myself, why am I on the floor screaming, I don't feel anything. I later shared my experience with a mental health professional (I was there for other reasons) and she told me that it was a dissociative episode. The psychological dissociation is very unsettling as I have experienced them that way as well. It's a fascinating topic but very unpleasant to experience. Thanks for a very informative hub.

meloncauli (author) from UK on April 05, 2012:

Many thanks for your comment tsmog and for adding the extra information.

Tim Mitchell from Escondido, CA on April 04, 2012:

A very informative and helpful article. Ordered logically and written with warmth and familiarity.

Adding to, yet not taking away is that both of those are symptoms of dissasociative disorder. Now, that can be confusing. Anti-psychotics may be persribed too, like resperdal or the generic resperdone.

Persons who meditate 'lightly' may experience the definition(s) or depersonalization. Persons who meditate 'deeply' may experience the definition(s) of derealization more so than depersonalization, in my view or experience.

RJ Castillo Department of Anthropology, Harvard University has published a few articles on this including PubMed. Carlos Castenada's books have been included in discussions of these as well.

The therapeutic solutions this hob suggests are very wise too. Overall I found this hub to be spot on. Thank You for the contribution. :)

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