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Can Derealization Be a Symptom of PTSD?

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Editor's Note

If you’ve experienced sexual abuse or assault, the following post could be potentially triggering. You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673.

Dissociation generally refers to a detachment from reality. In some cases it could be dissociative amnesia, or not remembering parts of your past or even in the present. This isn’t the only type of dissociation, however.

• What is PTSD?

You may also experience depersonalization, where you feel detached from your internal experiences. The third common type of dissociation, derealization, leads you to perceive a disconnect with the outside world or other people.

One of the most common causes of dissociation, depersonalization and derealization is trauma. Dissociation of all types can occur with diagnoses like post-traumatic stress disorder (PTSD). Here’s what you should keep in mind about derealization.

What Is Derealization?

Whereas depersonalization is feeling disconnected from yourself, derealization makes you feel disconnected or detached from other people or your surroundings. People may describe derealization as feeling like the world is unreal, dreamlike or distant. It’s a form of dissociation that serves as a protective measure when you’re unable to escape a dangerous situation.

Marlene Steinberg, M.D., author of “The Stranger in the Mirror: Dissociation — The Hidden Epidemic,” previously told The Mighty:

Dissociation is an adaptive mechanism promoting survival within a severely stressful, inconsistent or chaotic environment. 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.

Derealization may have been an important coping skill to help you survive trauma. But years later when the trauma is in the past, derealization can get in the way of your life.

Is Derealization a Symptom of PTSD?

Technically, derealization isn’t a symptom of post-traumatic stress disorder (PTSD). This means it isn’t factored into whether or not you meet the diagnostic criteria for the condition. Dissociation is one criteria professionals use to diagnose PTSD. But if you experience a more specific type of dissociation like derealization, it may be noted in your diagnosis as a specifier to say you have PTSD “with dissociative features.”

As an umbrella symptom, most types of dissociation are common among those who have survived trauma. Trauma survivors who experience derealization may be diagnosed with PTSD. Depending on your other symptoms and trauma history, your doctor or therapist may opt for another trauma-related diagnosis instead. Some other mental health conditions that may have derealization as a symptom include:

  • Complex PTSD (C-PTSD)
  • Borderline personality disorder
  • Dissociative identity disorder
  • Depersonalization-derealization disorder
  • Bipolar disorder
  • Panic disorder (especially in its early stages)

What Does Derealization Feel Like?

Derealization causes the outside world to seem unreal or far away, which feels different to everyone. Mighty contributor Rachel Gearinger explained how she experiences derealization:

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.

Mighty contributor Anna Lente shared her experience of derealization in poem:

My head is spinning.
I am driving fast,
trying to escape my life.
The world around me blurs,
I become confused.
Am I driving or is the car driving me?
Am I on a movie set?
Are the trees real or are they painted on?
Safe at home,
I touch everything,
convinced it is a movie prop.

Learn More About Derealization

To learn more from others with PTSD who know what it’s like to experience derealization, check out the stories below. And if you want to share your experience with others who get it, post a Thought on The Mighty. Here’s how.

Other Symptoms of PTSD

If you live with PTSD, you know the condition is more than just derealization and dissociation. Here are some other common symptoms of PTSD:

Header image via pawel szvmanski on Unsplash

Originally published: November 26, 2020
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