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Derealisation Anxiety

10 Minutes

Edited & clinically reviewed by THE BALANCE Team

Fact checked

Have you ever felt like things around you do not seem real anymore? Like, you are busy doing your thing and living your life as usual, but it feels like a dream? Known as derealisation, this feeling can be an unsettling and jarring experience for anyone, and it is not uncommon to experience it for people battling anxiety.

Derealisation has been identified and accepted as a psychological phenomenon for years, and it might be called unusual but not rare. Sometimes, even the simplest things like standing up too quickly, staring at someone, or hyperventilating can induce this feeling of unreality. Using certain recreational drugs like hallucinogens or marijuana may also bring it on. However, if it starts occurring spontaneously without any apparent reason, consider it the aftermath of anxiety.

Around three-fourths of people worldwide experience derealisation at some point in life. According to some theorists, this dissociation from reality is your body’s way of protecting you from high levels of stress or trauma, and others assume it to be a scar from the trauma itself.

Derealisation anxiety can be a confusing or frightening experience for anyone, and it can interfere with life, making it harder to go about daily activities. Fortunately, educating yourself about its causes and learning a few self-care tools with the help of a mental health professional can make it manageable.

When you’re anxious, the body responds by activating the fight, flight, or stress response. This stress response triggers the release of stress hormones in the bloodstream to prepare the body for immediate action, i.e., to fight or run. As these stress hormones traverse through the body, they induce various psychological, emotional, and physiological changes in the regular body functions to maximise defences. As a result, all the emergency functions are heightened while the non-emergency functions are suppressed.

These emergency changes also affect how the brain interacts with itself and many other parts of the body. For instance, when stress hormones are balanced, the brain’s learning, emotional, and rationalisation areas usually interact. These regular interactions usually allow you to think, experience, and remember emotions and thoughts and feel complete in your reality.

In dangerous situations, however, these interactions undergo significant changes. For example, the high-stress hormones suppress the rationalisation centres of the brain while boosting the activity in the amygdala, the part of the brain regulating fear. All these changes are the brain’s attempt to survive in dangerous situations. Additionally, all functions not required in emergency response are halted so that the body can use its maximum to defend itself or dodge the threat. While the combination of these changes does prepare you better to respond to a threat, it impairs your ability to remember short-term information and think clearly, often triggering derealisation in the way.

An active stress response also induces other changes in the body, such as:

Heightened senses
Pupillary dilatation
Narrowed vision
The rushing of blood to the head
Increased fear detection and reaction

When combined, all the changes mentioned above alter your sense of emotions, reasoning, and perception, further enhancing a sense of derealisation.

When you feel detached from reality, remind yourself that you are okay. Try the following self-care tips to contain the problem before it gets bigger.

Acknowledge your feelings

According to many psychology researchers, depersonalisation may be an adaptive way to cope with stress. Some believe it’s your brain’s way of protecting you from danger. When your body and mind distance you from intense emotional pain, overwhelming feelings may decrease, which may help you feel safe. If your body and mind ignore your feelings for too long, symptoms of depersonalisation may drag on. In these cases, your brain misreads danger, and feelings of depersonalisation increase.

When this happens, you might try to name your feelings. Some research suggests that you can lessen stress by acknowledging certain emotions (in this case, fatigue). It’s possible that this concept may work on other painful emotions as well. This may decrease derealisation symptoms, though more research is needed. Self-compassion exercises may help you accept whatever feelings arise at that moment.

Take deep breaths

Your nervous system fires up the moment your body comes under stress. For people with derealisation anxiety, this can severely disrupt brain functioning, making it difficult to break out of the unreal feelings.

To prevent experiencing derealisation, practice breathing exercises to control the increasing stress levels while you still have time. You may consider downloading a mindfulness app or getting help from an instructor on performing guided meditation to control stress levels.

Listen to relaxing music

Feelings of derealisation become more intense as your brain tends to focus on them. Relying on a grounding technique, such as listening to music, can help control anxious thoughts and consequences. Research has also found that music can reduce the levels of stress hormones in the system. Consider making a playlist including all your favourite songs, and keep the playlist on your phone. As soon as you feel the symptoms of derealisation anxiety kicking in, pop in your earbuds, press the play button and let the relaxing music soothe you.

Read a book

Are you an avid reader? This healthy habit of yours can also help you fight the unreal feeling associated with derealisation anxiety. Pick up an old favourite book that brings you to comfort the moment you feel your anxiety fueling up. You may find that concentrating on the words and their meanings in your favourite book can quieten the intrusive thoughts building up in your head.

Challenge your intrusive thoughts

For many, derealisation involves a lack of intrusive thought, which may pose a real challenge, especially with a coexisting anxiety disorder. Such people can seek help from a cognitive psychologist who can help them use a tool called psychological distancing to fight these intrusive thoughts. Psychological distancing refers to finding space between painful emotions and upsetting thoughts.

Alternatively, consider taking a few deep breaths to fight intrusive thoughts and the consequent derealisation. While it may sound odd to some, talk to yourself out loud as it may make a difference. Ask yourself: “what evidence do I have that my anxiety is real?”

Call a friend

When you feel derealisation anxiety kicking in, you might be tempted to withdraw and isolate yourself socially. However, talking to someone you trust and feel comfortable with can help in times like these. While opening up to someone may make you feel vulnerable, it also gives you a chance to gain empathy from someone who genuinely cares for you. Professional counsellors and therapists are always available to lend an ear if you do not have someone to lean on.

Several self-care tools can provide acute relief from the symptoms of depersonalisation. Psychotherapy, nutrition, exercise, and education must be focused on long-term management.

Talk Therapy

If you are feeling detached from reality due to a traumatic or stressful experience, consider scheduling an appointment with a therapist. A therapist may suggest different types of therapy to control the anxious thoughts to break out of derealisation. These therapies commonly include cognitive behavioural therapy (CBT), which teaches you to identify the intrusive thoughts leading to derealisation anxiety for long-term relief. Trauma-focused therapies such as eye-movement desensitisation and reprocessing (EMDR) may also be provided if your anxiety is secondary to trauma in the past.

Self-Education

Understanding derealisation anxiety and learning about its symptoms, in general, can also contribute to its management. There are many sources to obtain authentic information, such as the NHS website. Moreover, you can always consult your GP to understand the problem. Determining how derealisation affects the brain may make the symptoms less frightening and more manageable.

Healthy Sleep Habits

Going to bed on time can help you manage stress and prevent anxiety. Having an intact sleep routine which involves going to sleep and waking up at a fixed time every day is highly recommended by health regulatory authorities of the UK.

If you feel like a lack of sleep is fueling your anxiety and the consequent derealisation, consider banning all electronic devices, including your mobile phones, from the bedroom. Keep the bedroom as dark as possible as darkness improves sleep quality by regulating the body’s circadian rhythms.

Regular Exercise

Exercise is a proven way to manage stress and keep anxiety under control. Aerobic exercise, in particular, has decreased the psychical and psychological effects of anxiety on the body. Many alternatives are available if you are not fond of spending hours in the gym performing high-intensity workouts. Going for a brisk walk, a simple bike ride, or even a dance class can be a powerful tool to manage chronic anxiety.

Getting Help for Derealisation Anxiety

Either as a symptom of anxiety or any other disorder. At the same time, it is not a life-threatening symptom that cannot be managed. Once help is sought for the underlying anxiety disorder, the symptoms they bring on must no longer arise.

A qualified healthcare professional, who is well within your budget and willing to offer help, can support you with the management of derealisation anxiety. A local mental health referral service or a GP are good places to start looking for a psychiatrist or therapist. Treatment for anxiety mainly involves psychotherapy, medications, or both. Sometimes, it may take a bit of trial and error to curate the perfect treatment plan. However, with patience and dedication, you can start feeling better soon.

FAQs

What can trigger derealisation in a person?

Derealisation may occur as a reaction to severe stress or trauma or might be a symptom of an underlying medical condition. Apart from anxiety, the commonest cause of derealisation, other triggers include:
Seizures
Depression
Schizophrenia
Drug abuse
Panic attacks
Dementia
Dissociative disorders, such as amnesia

What triggers derealisation in panic attacks?

Hyperventilation or over-breathing, one of the most common symptoms of panic attacks, is a major contributor to derealisation. It can interfere with the release of oxygen from the blood to the brain cells. This reduction in oxygen supply often triggers feelings of confusion and unreality and other symptoms of panic attacks, such as increased heart rate, dizziness, and faintness.

Emotional numbing is also another contributor to a derealisation panic attack. This numbing is primarily a consequence of increased activity in the frontal lobe, a part of the brain that inhibits emotions. Moreover, an individual’s attempt to reduce stress during a panic attack can also lead to unwanted feelings of detachment from reality.

What does derealisation feel like?

Derealisation symptoms tend to happen in episodes, meaning they come and go. During an active episode, you may feel like:

You are in a dream
People or objects may look blurry, too big, too small, or unnaturally sharp
Time has sped up, slowed down, or is standing still
Sounds are either too loud, too soft, or distorted
The world seems fake, muted, or lifeless
There is a see-through veil or wall separating you from your surrounding
Each episode of derealisation may last for a few minutes or sometimes extend for months. Even if the symptoms are making you feel like you are going crazy, you are capable of identifying that something is off. This critical difference separates derealisation anxiety from psychotic disorders where you cannot distinguish reality from imagination.

HOW THE BALANCE CAN HELP WITH Anxiety

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