Derealization Is a Type of Dissociation That Can Make You Feel Like You Are in a Movie

Does the world ever feel fake to you? You look out and it seems like you’re in a movie or a fog, and things look… off. Maybe the colors are too bright or too dull. You’re aware of where you are, but it might feel like you’re gliding along in a surreal dream. The world just doesn’t feel real somehow.

If this sounds familiar, you might be experiencing a type of dissociation or disconnection called derealization.

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What Is Derealization?

According to Marlene Steinberg, M.D., author of “The Stranger in the Mirror: Dissociation — The Hidden Epidemic,” derealization is one of five types of dissociation. She told The Mighty:

Derealization is characterized by feeling as if one is disconnected or detached from people or from one’s surroundings. Typically a person may report feeling as if friends, relatives, and/or their environment seem strange, unfamiliar and/or unreal. Individuals  who experience derealization are aware that they are not literally disconnected from their environment, but they feel as if they are emotionally disconnected or detached.

The “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), outlined that derealization can happen as an episode, lasting for a defined amount of time, or it can be continuous and never seem to go away. Episodes can be short, such as hours or days, or longer, like months or years. Derealization can also come and go. Don’t be surprised if you experience a combination of all three of these patterns that change over time.

Like other forms of dissociation, many people, regardless of their mental health or trauma history, will experience derealization. According to Dr. Steinberg, “transient, brief episodes of derealization are common and can be triggered by substance use, acute trauma and in transitions to and from a sleeping state.” The DSM reported that an estimated 50% of the U.S. population will have at least one episode of derealization or depersonalization in their lifetime.

No matter how long it lasts, derealization can be more than just feeling like you’re in a movie, fog or bubble. Your vision may seem to go out of focus so things appear blurry or flat. Objects may appear farther away or closer than they are and you may see more or less in your field of vision than usual. Sounds can seem distant or muted even though someone is talking right next to you. Your surroundings can also feel heightened, extra loud or vibrant.  

Having an altered sense of time is also common with derealization, like being in a slow-motion movie or things are speeding around you. When you think about past memories, in a derealized state, you may not be able to recall details or they might feel like they don’t belong to you — there’s no emotion attached to them. Some people have described derealization with sensory signs as well, like feeling your head is full, tingling or feeling light-headed.

None of these vision, hearing, memory or sensory perceptions cause damage to those areas of your brain or body. And though you’re well aware the world is real during derealization, it doesn’t make feeling so disconnected any more comfortable. Some people might not think derealization is a big deal, but when you experience it a lot, Steinberg said it “can cause significant distress and can interfere with work, relationships or daily activities.”

Derealization is different from another symptom or type of dissociation, depersonalization. Depersonalization, which often occurs with conditions like borderline personality disorder, which means you feel disconnected from yourself like you’re not real. Derealization is more how you experience the world around you, where it seems off or distorted.

What Causes Derealization?

Similar to other forms of dissociation, derealization is largely a protective defense to deal with overwhelming emotions or trauma. It’s a strategy your brain uses to keep you safe and regulated during overwhelming situations, which protects you. It might not feel good and it can be scary, but derealization is actually a sign of your resilience and survival.

“Dissociation is an adaptive mechanism promoting survival within a severely stressful, inconsistent or chaotic environment,” said Steinberg. “People who have experienced repeated severe emotional stress or traumas during their childhood or adolescence are most likely to experience recurrent derealization episodes. Derealization can also arise in those who have experienced profound acute trauma.”

Mighty community member Kristen H. described how derealization and dissociation have been part of her trauma journey in the article, “25 Things People Don’t Realize You’re Doing Because of Childhood Trauma.” She said:

I dissociate to protect myself from it all. I have developed depersonalization/derealization disorder because of severe trauma throughout my entire life and it has become my defense mechanism. It has been easier to “shut off” than face all that I have had to deal with in my short lifespan.

The International Society for the Study of Trauma and Dissociation (ISSTD) explained that derealization is considered “effective” during times like a trauma when your emotion regulation skills are completely overwhelmed. However, once the danger has passed, derealization can be triggered by non-threatening events that remind you of past events. At this point, derealization isn’t helpful and it can get in the way of daily life.

While researchers’ understanding of how derealization and other forms of dissociation work, Steinberg said one understanding has been traced to areas of the brain that “have to do with the emotional encoding of memories and on the parts of the brain that are responsible for encoding our sense of self and surroundings.”

According to Steinberg, when you have a history of “emotional or physical maltreatment, [derealization] can be triggered by experiences that in some way harken back or subtly ‘rhyme’ with some circumstance of one’s traumatic past experiences.” You’re also more likely to experience derealization in the present when you’re extra stressed, dealing with anxiety or depression symptoms, or other vulnerabilities like a lack of sleep.

Derealization and Mental Health Conditions

Because of its function as a defense during high stress, derealization is a common symptom if you have dissociative disorders like depersonalization/derealization disorder and dissociative identity disorder (DID), which are often the result of experiencing childhood abuse. Those who live with borderline personality disorder (BPD), post-traumatic stress disorder (PTSD) or complex-PTSD also commonly experience derealization, especially during flashbacks.

Derealization is common among these trauma- and dissociation-related diagnoses, but it’s not just associated with trauma. For example, derealization can be a sign of depression and any kind of anxiety, especially panic attacks. According to the DSM, derealization symptoms may be an early sign of developing panic attacks or panic disorder.

High anxiety or panic and experiencing trauma have a similar effect on your nervous system — they cause you to go into hyperarousal or fight-flight-freeze survival mode. In this state, you have fewer resources to deal with the situation at hand and your brain may switch over to derealization.

Mighty contributor Rachel Gearinger explained how she experienced derealization during panic attacks in her article, “The Panic Attack Symptoms Nobody Talks About.” She wrote:

When I experience [derealization] during panic attacks, everything around me feels unfamiliar. I could be in my bedroom, surrounded by things I’ve seen many times, like my cat, my bed or my clothes. Yet, I feel like I’m in a strange world. I feel like an alien who was beamed down into a random house. Not only this, but things around me appear foggy and fake. Becoming detached like this is terrifying.

How Do You Manage Derealization?

If you experience derealization, you’re not alone and there are things you can do to cope and heal. When derealization happens in the context of a larger mental health condition or as a result of trauma, consider seeking treatment with a knowledgeable therapist or counselor.

“I recommend … assessment and treatment from a dissociation-aware therapist,” Steinberg advised. “Psychotherapy has been shown to affect the ‘wiring and firing’ of the brain, and presumably those who recover from derealization by means of psychotherapy have brain processing changes that underpins their recovery.”

To find a mental health professional in your area who understands derealization, the ISSTD has a database on their website of trauma-informed therapists. The Sidran Institute also provides a help desk to connect you with appropriate therapy resources.

In the meantime, coping skills can anchor you to the present when you experience derealization and lessen your symptoms. Steinberg recommended any coping skill that helps you “identify and distinguish present circumstances from the traumatic events of one’s past.” For example, you might look around the room and identify three objects that are the color purple or sit with your feet flat on the floor and concentrate on what that feels like.

For other coping skills you can try to manage derealization, check out the following resources:

• 15 Grounding Exercises to Manage Stress From Anxiety or Trauma
• 11 Unexpected Ways People ‘Bring Themselves Back’ From Dissociation
• 4 Grounding Techniques I Use to Manage My Anxiety
• 16 Grounding Techniques That Help With My PTSD and Anxiety
• 7 Ways to Bring Yourself Back From Emotional ‘Numbness’ or Dissociation