Why Doesn’t Reality Feel Real to Me? Depersonalization Disorder

What is depersonalization (derealization) disorder? Have you ever experienced segments of time when the world around you felt distinctly surreal? Or detached from your surroundings? Maybe you often find yourself “outside of yourself” and “looking in from outside to observe your own life?” You’re not alone; it very well may not be your imagination. This phenomenon really “is a thing.”

Depersonalization disorder is a type of dissociative disorder that characteristically manifests itself through persistent/recurring feelings of detachment (dissociation) from one’s body and/or cognitive processes, not unlike a psychotic episode.

While that may not seem like the worst thing that could happen to you, some patients find the experience nothing short of terrifying. One such notable case is Adam Duritz of the Counting Crows, who deals with depersonalization disorder on a regular, daily basis.

It’s common for those with the disorder to feel as if the world were lifeless, colorless, and even “fake.” They may feel as though they were dreaming, in a fog, or as though a veil or glass wall separated them from their immediate surroundings. A subjective sense of distortion may also occur, e.g. unusually blurry or sharply clear objects, objects that may seem smaller, larger, or visibly “flat.” Often time may seem to be going much slower or faster than usual, and sounds and noises may seem unbearably louder or softer than they actually are.

Such symptoms of depersonalization disorder can typically be distressing, and some patients feel as though they may have irreversible cerebral damage, or even that they are losing their minds. Some patients may obsess over whether or not they really exist, or may compulsively check over and over to verify whether or not their perceptions are for real. Most patients, however, are able to maintain an awareness of the fact that these experiences are unreal, and this is what differentiates the disorder from a psychotic episode, where such awareness is absent. A memory may frequently lapse, and patients may not be able to feel, identify, or express their emotions.

What are the causes of depersonalization disorder? The disorder is typically triggered by acute stress and may be accompanied by depression and/or anxiety. Driving stress factors often involve one or more of the following:

• Losing a close a family member or friend unexpectedly
• Having a severely impaired or mentally ill parent
• Emotional or physical abuse or being neglected as a child (probably the most common cause)
• Exposure to domestic violence

Other triggers include financial, relationship, or job-related stress, and the use of illegal drugs such as hallucinogens, marijuana, and ketamine.

A proper diagnosis is driven by certain symptoms, but only after other possible causes are ruled out.

Three of the dynamics that may lead to a clinical diagnosis include persistent or recurring experiences with depersonalization, an awareness that the depersonalization episodes are only a subjective experience and not real, and symptoms that cause the patient acute distress, or that may greatly impair occupational/social functioning.

If all this seems relatable to you or someone you care about, there is treatment and help. Treatment of depersonalization disorder will typically involve psychotherapy, and possibly medication. Treatment for depression and/or anxiety may also be administered concurrently.

One thing to keep in mind is that depersonalization disorder, though stressful at times, is manageable, and you will still be able to live a normal life.

Are you struggling with feelings of life being surreal? Not to worry, you’re not going crazy, and it is treatable. If you or someone close to you need to talk to someone about mental health issues that seem overwhelming, we can help. Consider reaching out to our expert team at Solara Mental Health at 844-600-9747.