Nothing feels real. You feel foggy, like everything is a dream. Your senses feel fuzzy, and it almost feels like you're having an out-of-body experience. You feel detached from yourself and the world around you. There's a word for this feeling: derealization.
This feeling can be normal. Research shows that up to 3 in 4 people experience passing feelings of detachment. But if the feeling is persistent, it could be a sign of an underlying mental health condition, including a condition called depersonalization-derealization disorder. Trauma, depression, and panic attacks can also cause it.
Here's how to cope with and snap out of derealization.
Our mental health IOP in Glendale, AZ is open and welcoming new clients! If you live with depersonalization related to anxiety, depression, or trauma, our IOP provides structured, intensive support designed specifically for mental health needs. Get in touch to learn more!
Derealization: When nothing feels real
There's a clinical term for that feeling that nothing is real: derealization. Derealization is a type of dissociation that makes you feel disconnected from the world around you. You typically still know that your surroundings are real, even though they don't feel that way.
Derealization is closely related to depersonalization, but they're slightly different experiences. Derealization is about feeling disconnected from your surroundings, while depersonalization is about feeling disconnected from yourself.
You can experience one without the other, but they often happen together. Neither is a mental health diagnosis in itself, but both can be symptoms of one.
Here's what derealization and depersonalization can feel like.
- Numbness or disconnection, like you can't really feel your emotions
- Feeling like you're watching yourself from outside of your body
- Feeling like you're not "you," or that your thoughts and feelings don't really belong to you
- Your senses feeling dulled; for example, it feels like when you touch things, you're not really feeling them, or you can't hear as well as usual
- Feeling like the world around you looks foggy or strangely artificial
- A sense that you're living in a dream
- Changes in how you experience time, like everything is moving too quickly or slowly
- Feeling like familiar places or people suddenly look strange or unfamiliar
- Having trouble remembering parts of what happened while you were feeling disconnected
What is depersonalization-derealization disorder?
One possible cause for this feeling is a mental health condition called depersonalization-derealization disorder, or DPDR. It's recognized in the DSM as a type of dissociative disorder.
DPDR is often linked to trauma and severe stress. But there's no single, direct cause. Its symptoms include:
- Repeated or ongoing experiences of derealization, depersonalization, or both
- Feeling detached from your body, thoughts, or emotions
- Feeling like the world around you isn't real
- Knowing that these experiences are feelings rather than believing that reality has actually changed
- Symptoms that cause significant distress or interfere with your everyday life
That fourth point is important. People with DPDR maintain what's called "reality testing," which means you understand that the strange feeling you're experiencing isn't really accurate. The world around you doesn't feel real, but you know, logically, that it is.
This is different from psychosis, which can involve difficulty distinguishing between what is real and what isn't. The difference can look like feeling like you're in a dream (DPDR) vs. believing that you're literally in a dream (potential psychosis).
If you're hearing or seeing things that other people don't, or you truly believe that the world around you has changed in a way other people say it hasn't, it's important to seek a professional mental health evaluation.
Other mental health conditions that can cause a disconnect from reality
DPDR is far from the only condition that can cause you to feel that nothing is real. Here are some other possible explanations.
Other dissociative disorders
Dissociation is broader than just DPDR. It's an experience that involves feeling disconnected from your thoughts, memories, identity, or surroundings. DPDR is only one type of dissociative disorder that can cause things to feel unreal.
Other examples include dissociative amnesia, which can cause gaps in your memory that can't be explained by ordinary forgetfulness. Dissociative identity disorder (formerly known as multiple personality disorder) can involve significant disruptions in your identity along with memory gaps.
Trauma-related disorders
Dissociation, as a symptom, is also common among people who have experienced trauma. It can be a protective strategy. During an overwhelming or frightening experience, dissociation may be one way your brain distances itself from what's happening.
Some people continue to experience dissociation long after the traumatic event is over. For example, people with post-traumatic stress disorder (PTSD) may experience derealization or depersonalization when they're reminded of what happened. It might also be difficult to truly connect to the emotions of what happened.
Panic and anxiety attacks
Derealization can happen during periods of severe anxiety, especially during a panic attack. You might suddenly feel detached from your surroundings. At the same time, you're experiencing intense physical symptoms like a racing heart or dizziness.
The experience can be frightening, especially if you've never felt it before. You might start worrying that you're losing control or "going crazy," which can make your anxiety even worse
Depression
Some people with depression describe feeling emotionally numb or disconnected from their own lives. You might feel like you're simply watching the days pass rather than actually participating in them.
Severe depression can also affect concentration and memory, which may add to the feeling that you're not completely present. This can overlap with dissociation, although emotional numbness doesn't necessarily mean you're experiencing derealization.
Substance use disorder
Some substances can cause depersonalization or derealization, both while you're intoxicated or during withdrawal. Cannabis, hallucinogens, and some other drugs have been associated with these experiences. While you're under the influence, you might feel like you're floating outside of your body. This can be uncomfortable for some people.
For some people, feelings of derealization continue even after the immediate effects of a substance have worn off. If your symptoms started after using a drug or changing how much you use, tell your healthcare provider.
Sleep disorders
Severe sleep deprivation can make the world feel strange or unreal. When you're extremely tired, you might also have trouble concentrating or processing what's happening around you.
Certain sleep disorders can also cause unusual experiences around the time you fall asleep or wake up. For example, sleep paralysis can cause you to feel like you're completely disconnected from your body. If your derealization seems closely connected to poor sleep, addressing the underlying sleep problem may help.
Coping strategies and how to snap out of derealization
If derealization is temporary and only happens occasionally, then you might be able to cope with it on your own. When you're feeling disconnected from yourself, try:
- Ground yourself through your senses. Pay attention to something you can physically feel, like your feet against the floor or the temperature of an object in your hand. This can remind you that you are really here in this world, even if it feels like everything is a dream.
- Name what's happening. You might try literally saying it out loud: "I'm experiencing derealization." Remind yourself that derealization can feel frightening, but the sensation itself doesn't mean that you've actually lost touch with reality.
- Slow down your breathing. If anxiety or a panic attack is contributing to the episode, taking slower breaths may help your nervous system settle.
- Move your body. Walking around the room or gently stretching can help you reconnect with physical sensations. Use movements to pull yourself back into your body.
- Describe your surroundings. Focus closely on where you are and describe what you see in concrete terms. Not just "I'm in my room," but "I see the colorful art on my wall, my laptop on my desk, and my dog laying in my bed."
- Limit drugs and alcohol. Pay attention to whether cannabis, alcohol, caffeine, or other substances seem to trigger your episodes. Even if you don't think they do, it's a good idea to stay away from drugs and alcohol while you feel this way.
- Get some sleep. Derealization can become more intense when you're severely sleep-deprived. If you haven't slept, prioritize getting some sleep right away. You might find the feeling gets better once you're rested.
Try not to panic if the feeling doesn't disappear immediately. Focusing intensely on whether you "feel real yet" can sometimes keep your attention locked onto the sensation.
Instead, continue doing ordinary activities as much as you're able to. Reminding your brain that you're safe and continuing with your day can sometimes help the feeling gradually pass.
Treatment options
It's normal to have a passing moment of derealization, especially if you're under the influence of substances or are sleep-deprived. But if this is an ongoing experience for you, then it's important to seek professional support.
A mental health professional can help you figure out what's going on and what treatments might help. They'll ask about when the symptoms started and what else you're experiencing. This will help them determine whether your symptoms are related to DPDR, another mental health condition, or something that should be evaluated by a medical provider.
Therapy is one of the best treatments for dissociation and derealization, as well as the many mental health conditions that can contribute to it. A therapist can teach you grounding skills that you can use when you're feeling outside of your body. They can also help you process trauma in a safe way.
Mental health IOP in Glendale, AZ & Phoenix, AZ
Feeling like nothing is real can be unsettling and scary. But depersonalization and derealization can happen for many different reasons. Sometimes, these experiences are temporary and connected to stress or anxiety. If they keep happening or start getting in the way of your life, getting professional mental health support can help you understand what’s going on and find ways to feel more grounded.
Thrive Therapy offers a unique mental health IOP in Glendale and Phoenix for people who need more support than weekly therapy can provide. If dissociation, trauma, depression, or anxiety is holding you back from the life you want to live, contact us to learn more about our intensive outpatient programs.
Colter is a licensed psychotherapist and the owner and Executive Director of Thrive Therapy. He specializes in the treatment of anxiety, OCD, identity issues, and more.
