Understanding Depersonalization & Derealization: What They Are, How They Show Up, and How to Find Relief
These days, terms like depersonalization and derealization are showing up more in social media conversations about mental health. Unfortunately, there’s often confusion or inaccurate information. Many people are left wondering: What exactly are these experiences? Why do they happen? How do I know if I’m going through them?
If you’ve ever felt like you were outside of your body or as if the world around you looked dreamlike or unreal, you may have experienced depersonalization or derealization. Let’s explore what these terms mean, how they can show up, and what can be done to manage them.
What Are Depersonalization and Derealization?
Depersonalization: Feeling detached from yourself. Some people describe it as watching themselves from outside their body, or feeling disconnected from their own thoughts, feelings, or actions.
Derealization: Feeling detached from your surroundings. Things may seem foggy, dreamlike, or distorted, as if the world has lost its color or feels “unreal.”
It’s possible to experience one or both of these. Sometimes they last only a few moments, and sometimes they become more persistent.
Depersonalization/Derealization Disorder (DPDR)
When these experiences are persistent or keep returning, and they cause distress or interfere with daily life, they may meet criteria for Depersonalization/Derealization Disorder (DPDR) as defined in the DSM-5-TR (the main manual that clinicians use to diagnose mental health conditions).
In plain language, DPDR means:
A person repeatedly feels detached either from themselves (depersonalization), their surroundings (derealization), or both.
Even though the experiences feel very real and unsettling, they know what’s happening around them is real(unlike psychosis).
These symptoms cause significant distress or make it harder to function at school, work, or in relationships.
The experiences are not explained by substances (like drugs or medication), medical conditions (like seizures), or another mental health condition.
There’s no required time frame (like six months), but the key is that the experiences are recurrent or ongoing and significantly affect daily life.
How Depersonalization and Derealization Relate to Anxiety and Panic
For many people, these experiences show up in the context of high anxiety or panic. When stress builds without release, the nervous system may “check out” as a way of protecting itself. This can look like:
During high anxiety: depersonalization/derealization can appear as the mind and body disconnect to shield against overwhelming stress.
During panic attacks: the detachment can feel even stronger — a sudden sense of being unreal or disconnected, often alongside racing heart, chest tightness, or fear of losing control.
Outside of panic: some people experience these sensations more chronically, especially if stress or trauma is ongoing.
What It Feels Like
People who go through depersonalization or derealization often describe:
Feeling like they’re watching themselves from outside their body.
Emotional numbness or a sense of being disconnected from their feelings.
The world looking dreamlike, foggy, or “off.”
Time moving too slowly, too quickly, or feeling distorted.
Familiar places, people, or objects suddenly seeming strange or unreal.
Anxiety or fear that something is “wrong” or that they’re “losing their mind.”
While the symptoms can be frightening, it’s important to remember that many people experience these sensations and that they do not mean you’re “going crazy.” They are responses of the nervous system, often tied to stress or trauma.
Why DPDR Can Feel So Difficult
Psychiatrists and therapists often note that depersonalization/derealization can be particularly challenging when it becomes a disorder. Here’s why:
Pervasive and unsettling: When the symptoms persist, they can affect daily life, making it difficult to focus, enjoy relationships, or feel connected.
Awareness without relief: Because reality testing stays intact, people know something feels wrong, but they can’t “snap out of it.” This awareness can increase distress.
Commonly connected with other conditions: DPDR often appears alongside anxiety, depression, or trauma, which can complicate how it shows up.
Unpredictable course: Some people experience short episodes, while for others the symptoms can last weeks, months, or even longer.
How DPDR Is Managed
Although DPDR can feel overwhelming, there are ways to reduce its intensity and regain a sense of control. Treatment often includes a combination of:
Psychoeducation – Understanding what’s happening reduces fear and helps normalize the experience. Knowing it’s a recognized condition — and not a sign of “going crazy” — can ease anxiety.
Grounding techniques – Strategies to reconnect with the present moment, such as the 5-4-3-2-1 sensory exercise, deep breathing, or noticing the physical feeling of your feet on the ground.
Therapy – Trauma-informed therapy, cognitive behavioral therapy (CBT) adapted for dissociation, or somatic approaches can help address both symptoms and underlying stress.
Lifestyle and self-care – Consistent sleep, movement, and reducing overstimulation (caffeine, screens, constant stress) can lessen triggers.
Medical support – While there isn’t a single medication proven to cure DPDR, doctors may prescribe treatments that address co-occurring anxiety or depression. Always consult with your physician to rule out medical causes before assuming symptoms are psychological.
A Message of Hope
While depersonalization and derealization can feel overwhelming, the good news is that they are treatable. Therapy provides tools to reduce the distress, understand what’s happening in your body and mind, and reconnect with yourself and the world around you.
You don’t have to navigate this alone. With the right support, many people find their symptoms lessen, their sense of connection returns, and life feels more real and balanced again.
At The Child & Family Therapy Place, Inc., I offer therapy in both English and Spanish, with a compassionate, culturally sensitive approach. I work with clients in Salinas and throughout California through safe online sessions.
If you’ve been struggling with depersonalization, derealization, or anxiety, please call me at 831-272-2041.Together, we can explore tools and strategies to help you feel grounded, present, and at peace.
To learn more, visit my Services page.
