Depersonalization and Derealization in Anxiety and Panic
Those people who have never experienced this super unsettling, confusing, and frightening feeling of depersonalization or derealization may think it’s really cool or interesting. But when you look at your hand and it looks like it’s moving under water, or like it’s a video game version of your hand, and you are not on any substances, it’s terrifying. You start to question all of your reality, like what’s real and not, and then the list of existential questions may fill your head, like is anyone real or are we in The Matrix? Am I losing it, going crazy? These are common questions you may ask yourself if you are experiencing depersonalization (DP)- the feeling that you are not part of your body, or derealization (DR)- the environment around you isn’t real, like you are in a movie or in a dream.
DP and DR are not commonly discussed in the general community or in the media. People usually associate them with drugs such as marijuana or LSD, or with psychiatric issues like psychosis. However, they are experienced by some who have anxiety and panic. You may hear a friend talk about anxiety, and may actually go to a doctor or a therapist for this but don’t bring it up. One possibility is because the experience is really hard to describe and articulate. It’s so surreal. So, I’m letting you know that it’s a “thing” with anxiety or panic with or without drug use, and can be experienced more when stressed or anxiety is high. And I’m also going to let you know it can get better, less pervasive, and less unsettling.
Anxiety gets worse when you focus on it and it becomes the center of your attention. This is hard because when you start feeling like reality is slipping away even for a minute, or you think this is a sign of something being very wrong with you, it’s hard not to focus on it.
How can that DP/DR and intense sense of dread and doom decrease do you ask?
Reminding yourself it’s a feeling and a thought that will pass. It may be a very alarming and uncomfortable feeling, but it will go away and you will be able to acknowledge the time when your perception is something you don’t think about. For example, I’m looking at my hands typing on the keyboard and I’m not really giving it a second thought, except maybe I should have taken typing class in high school. And then I’m looking at the computer and right now it’s just what I’m doing, I’m not really paying it any more attention than any other sensation I’m experiencing. Now if the screen started looking all wonky or my hand started feeling disconnected from my body, I’d pay attention to it, and maybe wonder what the heck is going on? So, what I’m asking you to do here is acknowledge there’s that weird feeling, and then continue doing whatever you were doing and know this weird experience will eventually go away in a few minutes.
Averting attention to something other than the physical sensations, emotional feelings and existential questions. This is where mindfulness (focus on the present) and grounding exercises come in. Don’t feed it by worrying about it and googling possible illnesses or conditions. Gently shift focus to another task, like feel your feet on the floor. Replace the “What if’s” with “ok and now what next?”
Managing your stress by maintaining healthy lifestyle choices such as getting enough sleep, eating healthy food choices, moving your body, limiting intake of caffeine and alcohol. When the balance is off with these activities of daily living, it can stress the body and mind and bring on DP/DR.
Be kind and compassionate to yourself. Treat yourself lovingly. Turn down the volume on your inner critic. Do something that you like or that calms you-listen to music, have a nice cool/hot drink of a favorite beverage, go for a walk or run, talk to someone who gives you support, watch a sunset.
DP and DR experiences are scary, confusing, and mess with your reality. But they are just thoughts and are temporary. Remind yourself that you are safe and that these perceptions are skewed.