Imagine feeling like you’re stuck in a dream you can’t wake up from. Or like you’re watching your own life unfold from the outside. Maybe you have a sense that life is a simulation or that people around you are not real. For many people, this isn’t just a fleeting moment, but rather a regular experience of living with Depersonalization/ Derealization Disorder. These symptoms, often tied to stress or trauma, can feel unsettling, scary, and anxiety-provoking. If you or someone you know is experiencing symptoms of Depersonalization/Derealization Disorder, it can help to understand more about this condition and how to cope with it. 

Jasmine’s Story

Jasmine (not her real name) was an 18-year-old senior at a private high school. She had been coping with anxiety since middle school. Lately, though, something felt kind of off. Jasmine would find herself staring at her hands during class, feeling like they didn’t belong to her. Other times, she felt like she was floating just behind her own body, watching herself laugh or talk without feeling real.

Additionally, when these experiences happened, Jasmine felt like the world around her was hazy, like she was watching everything through a screen. This would then trigger feelings of fear and anxiety. 

Jasmine thought that no one would understand what she was experiencing or think she was crazy. However, when she finally talked to her school counselor, she learned about depersonalization and derealization, and felt relief. For the first time, there was a name for what she was feeling, and more importantly, a path forward.

What is Depersonalization/ Derealization Disorder?

Depersonalization/ Derealization Disorder is a mental health condition where a person feels detached from themselves (depersonalization) and/or disconnected from their environment (derealization). These feelings can come and go, but in Depersonalization/ Derealization Disorder, they tend to last a long time (that is, persist) or recur.

• Depersonalization: Someone might feel like they’re watching themselves from the outside, as if they’re in a movie. Their thoughts, feelings, body, or body parts may seem unfamiliar.
• Derealization: The world around a person may feel unreal, foggy, or distorted, like they’re looking through a clouded window or mirror.

Frequently, when people are experiencing Depersonalization/Derealization Disorder, they report feeling crazy or that they’re going crazy. They understand logically that what they’re feeling isn’t real, but the sensations can be intense and scary. These experiences can interfere with the ability to focus on school or work, lead to isolation or avoidance, and cause symptoms of anxiety or depression.

How Common is Depersonalization/ Derealization Disorder?

It’s common for people to feel disconnected from time to time. But Depersonalization/ Derealization Disorder is different; it’s more persistent and intense, affecting about 1-2% of people, mostly adolescents and young adults. It presents equally often in men and women.

Symptoms

People with Depersonalization/ Derealization Disorder often struggle to describe their experiences. Common symptoms include:

• A sense of disconnection from their thoughts, emotions, or body
• Perceiving the world around them as unreal, dreamlike, like a movie, or like a “simulation”
• Experiencing themselves as robotic, or seeing others as emotionless or artificial—like robots or AI
• Emotional or physical numbness
• Observing themselves as if from outside their body (for example, hovering above themself)
• Increased anxiety, sadness, or feelings of isolation

These symptoms can cause distress and make people question what’s happening to them. Thinking about the symptoms or checking in regularly about whether symptoms are happening can increase anxiety, which then may make symptoms worse.

Causes

We aren’t sure exactly what causes Depersonalization/ Derealization Disorder, but research suggests that it’s often linked to stress or childhood trauma. Examples include:

• Neglect
• Physical or emotional abuse
• Witnessing or experiencing domestic violence
• Accidents or natural disasters
• Life-threatening danger
• The sudden loss of a loved one
• Growing up in a chaotic or unpredictable environment
• A parent with severe mental illness

Who is at Risk?

Some factors that may increase the likelihood of developing this disorder include:

• The presence of other mental health conditions, such as anxiety, panic, or depression
• Experiencing high stress levels
• Using certain substances (especially cannabis and hallucinogens)
• Certain physical conditions, like seizure disorders
• Difficulties identifying or describing one’s emotions

How to Cope with Depersonalization/ Derealization Disorder

Skills and a healthy lifestyle can help manage and reduce the frequency of episodes. Some examples are:

1. Grounding Techniques: Engage your senses by holding an ice cube, playing with a fidget toy, going for a walk, smelling an essential oil, or focusing on deep breathing.
2. Distraction Skills: Creating a list of things that help distract you from what you’re experiencing in the moment can be helpful: Listen to your favorite songs, watch a favorite TV show, do a crossword puzzle, or text a friend.
3. Mindfulness & Relaxation: Practicing meditation or relaxation techniques can help bring you back to the present moment.
4. Talking About It: Talk with someone you trust, like a family member, friend, school counselor, or therapist.
5. Healthy Lifestyle: Getting enough sleep, eating well, drinking water, and exercising regularly can help your mental health.
6. Limit Triggers: Avoid stressors that may worsen symptoms, such as:
   • Substance Use: Drugs and alcohol can make symptoms worse and interfere with medications an individual might be taking.
   • High Stress: Finding ways to manage stress effectively can help prevent episodes of depersonalization or derealization.
   • Sleep Deprivation: Severe sleep deprivation or exhaustion can trigger or worsen episodes of depersonalization or derealization. 
   • Excessive Caffeine: Caffeine may trigger physical symptoms that may feel like anxiety, which can trigger episodes in some people. 

If You or Someone You Know is Struggling with Depersonalization or Derealization

In closing, if you or someone you know is struggling with symptoms of depersonalization or derealization, you’re not alone, and you’re not “crazy.” These experiences can feel deeply unsettling, but they are real and treatable. Talking to your doctor or a therapist can help you better understand what’s happening, identify a plan for treatment, and begin the process of healing. Like Jasmine, finding a name for your experience can bring relief and the first step toward getting the support you need to feel grounded and in control again.

Megan Vogels, MA, LPC, NCC (she/her) is a Licensed Professional Counselor and National Board Certified Counselor in private practice in Greenwood Village, Colorado. With over 20 years of experience in the mental health field, Megan is well-versed in treating conditions like anxiety, depression, dissociative disorders, and trauma. For more about Megan, click here.