Have you ever felt that something strange was happening to you, as if you could observe yourself from outside your body being a spectator of yourself, or that reality became strange and unreal, as if everything happened in slow motion or on a set?

Depersonalization and de-realization are experiences in which one’s self or one’s surroundings appear strange, as in a dream or a movie. In this article we will talk about them.

Depersonalization and unrealization: what are they?

Depersonalization is a distressing and disturbing experience in which the person experiences a sense of strangeness about him/herself, a feeling of being separate, or outside of one’s body. It often coexists with unrealization, which is an altered perception of the environment that produces a sense of unreality.

The person experiences the world as if it were strange or unreal, as if they were inside a dream. In both there is an altered perception of reality, but while in depersonalization that sensation refers to one’s body, in de-realization it is the environment that seems altered.

Often, affected patients have great difficulty describing these episodes and may believe they are going crazy. They may perceive alterations in the shape and size of objects and people may seem strange. There may also be an alteration in the subjective feeling of the passage of time. These experiences are not considered serious or dangerous, however, they are disturbing and quite confusing, causing great concern and discomfort, and fear of a future episode.

Unlike in psychotic disorders, where the person believes that the altered perceptions are real, as in the case of hallucinations, in depersonalization or de-realization the sense of reality remains intact, i.e. the person is aware that his or her perception is not real and is a product of his or her mind.

When do they show up?

Depersonalization and de-realization have been observed during states of fatigue, sleep deprivation, during infectious diseases such as the flu, or after the use of alcohol or drugs such as LSD, mescaline or marijuana, in the withdrawal syndrome after the withdrawal of anxiolytics and induced by certain antidepressants such as fluoxetine. It is usually triggered by a high degree of anxiety and stress and is common in panic disorder. It can also appear in post-traumatic stress disorder, depression, or schizophrenia.

Despite being a little known, and relatively little researched phenomenon, approximately half of adults have experienced at least one episode of depersonalization or de-realization in isolation throughout their lives. However, depersonalization/disrealization disorder is much less frequent, with an estimated 2% of the population.

A dissociative disorder

Depersonalisation and de-realisation disorder is one of the dissociative disorders within the current diagnostic classifications.

The term “dissociation” is used to describe the disconnection between things generally associated with each other. In this case, it is perceptions that are considered dissociated, specifically the integration of perceptual experiences. Dissociation is a defence mechanism that normally serves to mitigate intense emotional pain caused by very painful experiences or trauma.

In the context of severe childhood trauma such as sexual abuse, dissociation can be considered adaptive because it reduces intense emotional pain. However, if dissociation continues into adulthood, when the original danger does not exist, it can be dysfunctional and lead to associated problems.

Your diagnosis

The diagnosis of depersonalization/deprealization disorder consists of persistent or recurrent experiences of depersonalization, unrealization, or both that cause significant distress in the individual’s life.

These episodes are not caused by medical illness, other mental disorders, drugs or medication. Although, as we have seen, episodes of depersonalisation or de-realisation do not involve any risk, and are relatively frequent in isolated cases, when repeated they can greatly limit life and cause great suffering in the affected individual. In these cases, it is advisable to consult a professional, who will provide the necessary tools to be able to understand, manage and master this confusing and little known disorder.