Out of nowhere, as if someone had turned down the volume on reality. You look at your hands and they seem foreign, you hear your own voice as if it came from far away, or the world around you turns flat and strange, like being behind glass or inside a dream. It doesn't hurt, but it's very frightening, and the thought 'am I going mad?' shows up straight away. The answer is no: what's happening to you has a name and an explanation, and it's called depersonalization (along with its sibling, derealization).
Depersonalization is the feeling of being disconnected from yourself, as if you were watching yourself from the outside; derealization is feeling that your surroundings aren't real. They're far more common experiences than they seem and, however distressing, they aren't dangerous. In this article I'll explain what they are, why they appear and how to overcome them.
What depersonalization and derealization are
Both are forms of dissociation, a temporary disconnection between consciousness and experience. The American Psychological Association defines depersonalization as a state in which one feels strange or unreal in relation to oneself. It isn't about losing touch with reality, but about living it as if it were filtered, muffled or dimmed. The person still knows who they are and where they are; what changes is the sense of connection with it all.
Depersonalization vs derealization: the difference
They often go hand in hand, but they look in opposite directions. Depersonalization points inward: 'I don't feel like me', 'I see myself from the outside', 'my body doesn't seem mine'. Derealization points outward: 'the world doesn't seem real', 'everything is flat or foggy', 'it looks like a stage set'. One is about the self; the other, about the world. You can have one, the other or both at once, and it's common for them to appear during or after a spike of anxiety.
How it's experienced: symptoms
Depersonalization is hard to put into words, and that's part of what makes it distressing: it's difficult to explain and it feels like no one will understand you.
Signs of depersonalization and derealization
- Feeling outside your body, like a spectator of your own life.
- Noticing your hands, face or voice as if they weren't yours.
- Seeing your surroundings flat, foggy or unreal, as if behind glass.
- A sense of living 'on autopilot', without connecting to what you're doing.
- Muffled emotions: as if you weren't feeling anything with the usual intensity.
- The added fear of the sensation itself: 'what if I don't go back to normal?'.
Why it happens: a defence mechanism
Even though it seems the opposite, depersonalization is, deep down, a way the brain protects us. Faced with anxiety or stress that overwhelm it, and which it can neither fight nor flee, the brain hits a kind of 'emergency button': it partially disconnects the experience to cushion the blow. It's the same thing the body does in extreme situations so that pain doesn't paralyse us. The problem isn't the disconnection itself, which is usually fleeting, but the fright it gives us, which feeds the very anxiety that had set it off.
Depersonalization, anxiety and panic attacks
By far the most common cause is anxiety. Depersonalization often appears during a panic attack —in fact, it's one of its symptoms— or in people with generalized anxiety and a very high, sustained level of arousal. When the body has been on alert for too long, disconnection is almost a release valve. That's why working on the underlying anxiety with good strategies to manage it is usually the most direct route to making depersonalization go away.
Depersonalization and trauma
Dissociation is also a very typical response to trauma. Faced with overwhelming experiences, especially if they repeat or come from childhood, disconnecting is a way to survive them: if I can't escape what's happening, I 'leave' inward. When this strategy is learned as a child, it can later switch on in adulthood in situations that echo, however faintly, that original distress. In these cases, treating the underlying trauma is key for depersonalization to stop appearing.
When it's normal and when it's a disorder
Experiencing depersonalization occasionally is surprisingly common: many people have felt it at some point through extreme tiredness, lack of sleep, a scare or alcohol or cannabis use. That's fleeting and isn't a disorder. It's another matter when the sensations are very frequent, intense and persistent, and affect daily life: then we talk about depersonalization-derealization disorder. The line is set by the impact and the duration, not by feeling it now and then.
The fear cycle: how it's maintained
Here's the key to understanding why it doesn't go away. Depersonalization appears because of anxiety, but then the person gets so frightened by the sensation —'what's happening to me?', 'what if I stay like this forever?'— that this fear triggers more anxiety, which in turn maintains the depersonalization. It's a trap that feeds itself: the more you watch it and the harder you fight to make it go, the more present it becomes. Breaking this cycle means, paradoxically, ceasing to be so afraid of it.
How to overcome depersonalization and derealization
The good news is that depersonalization is very treatable and, in the vast majority of cases, reversible. The underlying idea is simple, though hard to put into practice: it isn't something to be 'fought', but to stop fearing. When the person understands that the sensation is harmless and stops giving it importance, anxiety comes down and the disconnection fades on its own. At the same time, the cause (anxiety, stress, trauma) is worked on so it doesn't set it off again.
Grounding techniques
When the sensation appears, grounding helps you return to the present and to your body. It isn't about forcing depersonalization to go away, but about reconnecting with what's real here and now.
Grounding exercises that help
- The 5-4-3-2-1 technique: name 5 things you see, 4 you touch, 3 you hear, 2 you smell and 1 you taste.
- Activate your senses: hold an ice cube, smell something intense, walk barefoot and feel the floor.
- Breathe slowly: lengthening the out-breath lowers the body's arousal and helps you come out of the anxiety spike.
- Come back to your body through movement: stretching, moving your hands or doing some exercise reconnects you with physical sensations.
- Practising mindfulness and looking after your emotional regulation trains, over time, the ability to return to the present.
When to seek professional help
It's worth seeking help when depersonalization is frequent or persistent, causes you a lot of distress or stops you living normally, and especially if it's linked to anxiety, panic attacks or trauma. The UK National Health Service (NHS) notes that dissociative experiences are treatable and that you don't have to live with them resigned. Asking for help isn't overreacting: it's the fastest way to understand what's happening and to take away the power it has gained.
How therapy helps
In therapy we work on depersonalization first by explaining it well, because understanding it already lowers the fear a lot. Then you learn not to feed the cycle (to stop constantly watching and checking yourself), we practise grounding techniques and, above all, we treat the underlying cause: the anxiety, stress or trauma that set it off. I do this through therapy for anxiety and, if it suits you, with online therapy, in English, Spanish or Catalan.
If you've recognised yourself here, get in touch for a first assessment with no obligation. And hold on to an idea that's usually a huge relief: depersonalization is very frightening, but it isn't dangerous or permanent; it's the brain protecting itself, and when you stop being afraid of it, it goes.