Whether you’ve struggled to concentrate, felt lethargic and tired all the time or found yourself overthinking everything, it’s safe to say the last 12 months have been an emotional rollercoaster for all of us, with many people experiencing conditions like anxiety and depression for the first time.
While, in some cases, the symptoms that come with anxiety – such as restlessness, and feelings of dread – and depression – such as low mood, and feeling hopeless – may seem familiar even if you’ve never experienced them before, in other cases, you might find yourself confronted with unfamiliar, lesser-known symptoms – an experience which can feel scary and overwhelming at first.
Two of these lesser-known symptoms that can be caused by mental health problems such as anxiety and depression are depersonalisation and derealisation. They cause an experience known as dissociation or a dissociative episode, where you feel like you’re living in a dreamlike state.
The two differ by the type of experience they refer to. While depersonalisation refers to a feeling of being detached from one’s self, derealisation is when you feel like the world around you isn’t real.
Although these symptoms may feel scary at first, they’re actually surprisingly common. Indeed, most people will experience dissociation at some point in their lives, especially those with a pre-existing mental health condition such as anxiety and depression.
To find out more about depersonalisation and derealisation, including what causes it and how to cope, we asked Pablo Vandenabeele, clinical director for mental health at Bupa UK Insurance, for more information. Here’s what he had to say.
What do depersonalisation and derealisation feel like?
If you’ve experienced depersonalisation or derealisation before, you’ll know how hard it can be to put the experience into words. It’s a sensation stronger than that of lethargy or ‘brain fog’ – almost like you’ve become a little numb to the world and the things going on around you.
According to Vandenabeele, common experiences shared by people with depersonalisation and derealisation include “a sense of detachment, uncertainty, and numbness, both physically and emotionally”.
He continues: “Everyone’s experience with these symptoms can be different. You may feel unfamiliar with your surroundings and struggle to sleep, too.”
Vandenabeele adds that the length of time you might experience depersonalisation will differ from person to person too, from “hours” to “weeks or even months at a time”.
Although depersonalisation and derealisation are typically caused by pre-existing mental health conditions such as anxiety, depression, OCD and post-traumatic stress disorder (PTSD), in more unusual circumstances, they can be a sign of a dissociative disorder (a condition often triggered by a traumatic or extremely stressful life event).
Vandenabeele explains: “The difference between dissociation and a dissociative disorder is the frequency of these episodes. If you suffer from a dissociative disorder, you’ll likely experience symptoms constantly or for long periods at a time, often beginning when you are young.”
What causes depersonalisation and derealisation?
There are still a lot of unknowns when it comes to understanding what causes depersonalisation and derealisation – especially because the experience can vary so much from person to person.
“More research is required to fully understand the causes of depersonalisation and derealisation episodes,” he says. “However, for some, these are a natural response to a traumatic experience. Feelings of depersonalisation or derealisation are our body’s normal defence mechanism that helps us to cope.”
He continues: “Our normal reaction to a stressful event is ‘fight or flight’, but if you’re unable to do either of these things, your body may become numb. This can leave you feeling detached and uncertain of your surroundings.”
In this way, when we’re feeling anxious, stressed or overwhelmed, our body might dissociate as a way to help us cope with the intensity of our feelings. In the long run, however, this can become a problem in and of itself.
As we’ve already mentioned above, in unusual circumstances, depersonalisation and derealisation can both be signs of a dissociative disorder, which are thought to be caused by traumatic events.
According to the mental health charity Mind, you may also experience dissociative symptoms (such as depersonalisation and/or derealisation) as a side effect of alcohol or some medication, or when coming off some medication.
How to cope with depersonalisation and derealisation
Experiencing symptoms like depersonalisation and derealisation for the first time can be scary, but there are things you can do to cope and reduce your risk of it happening in the future.
Stay connected to the present moment
“If you begin to feel detached or uncertain, there are a few ways to keep yourself grounded,” Vandenabeele says. “Breathe slowly and listen to the sounds around you. Touching something can help you stay connected to the present moment.
“Focus on the sensations around you – this can reduce these feelings of detachment and leave you feeling calm.”
Take care of yourself
“It can be difficult to find the motivation to look after our health sometimes, but there’s a lot of physical and mental benefits to taking care of our minds and bodies,” Vandenabeele explains.
“To start with, try to get enough sleep – aim for a minimum of seven hours each night. These experiences can impact your sleep; if you begin to feel restless, write down your thoughts and relax with a warm bath or read your favourite book.
“Eating well and regularly has some surprising benefits for your mood. If your blood sugar drops, you may begin to feel irritable and fatigued. Make sure you’re eating plenty of healthy snacks during the day, like nuts or fresh fruit.
“Regular exercise can release mood-boosting hormones into our body – take time out of every day to head out for a walk or do an activity you enjoy.”
Start a diary
“If your dissociative episodes are linked to a traumatic event in your life, one way of easing your symptoms is to keep a journal,” Vandenabeele says. “Writing down your experiences can help you to understand and process events and how you’re feeling right now.”
“Short, passing feelings of depersonalisation or derealisation are common and you may not require any medical support,” Vandenabeele explains. “However, if you’ve experienced on-going or severe feelings of detachment, uncertainty, and numbness, it’s important to seek support. Make sure you reach out if these feelings are interfering with your daily life or relationships, too.
“Your doctor is a good starting point – speak to them about how you’re feeling and how long you’ve experienced your symptoms. You may also find it useful to talk to a loved one about this – it can feel a huge relief to confide in and open-up to someone you trust.
“Experiences of depersonalisation or derealisation can be a sign of a mental health condition. It’s important to first understand the condition that is causing these symptoms. So, working out what is causing you to experience these symptoms will help guide you to the right treatment.”
If you, or someone you know, is struggling with their mental health, you can find support and resources on the mental health charity Mind’s website and NHS Every Mind Matters or access the NHS’ list of mental health helplines and organisations here.
If you are struggling with your mental health, you can also ask your GP for a referral to NHS Talking Therapies, or you can self-refer.
For confidential support, you can also call the Samaritans in the UK on 116 123 or email firstname.lastname@example.org.