Derealization, Depersonalization, and Anxiety
Have you ever felt disconnected from your thoughts, feelings, or surroundings? Like you're in a dream or watching yourself from outside your body? These experiences, known as dissociation, derealization, and depersonalization, can be extremely unsettling and often go hand in hand with anxiety and trauma. In this blog post, we'll dive into what these experiences are all about, how they're related to anxiety and your nervous system, and what you can do to find relief.
What Do Dissociation, Derealization, and Depersonalization Feel Like?
Dissociation is basically a disconnect between your thoughts, memories, feelings, actions, or sense of self (American Psychiatric Association, 2013). It can be anything from mild daydreaming to more severe forms like dissociative disorders.
Derealization is when the world around you seems unreal, distant, or distorted - like you're in a fog or a dream (Hunter et al., 2004). Depersonalization, on the other hand, is when you feel detached from your own thoughts, feelings, or body, almost like you're an outside observer of yourself (Simeon et al., 2008).
The Link Between Dissociation, Anxiety, and Your Nervous System
Dissociation, derealization, and depersonalization often show up alongside anxiety disorders (Armour et al., 2014). In fact, research suggests that dissociation might be a way for your mind to protect itself from overwhelming anxiety or intense emotions (Briere et al., 2005). Dissociation symptoms can emerge after a traumatic or overwhelming experience, or can show up as part of an anxiety disorder.
When you're faced with a scary or overwhelming situation, your nervous system kicks into high gear, getting your body ready to fight, flee, or freeze (Porges, 2011). But sometimes, when your nervous system is totally overwhelmed and can't effectively respond, it might resort to a "freeze" state where you feel emotionally numb, detached, and dissociated.
It’s important to note that it’s normal to have some amount of dissociation from time to time. Many of us have had the experience of driving somewhere and not remembering most of the drive when we get to our destination, for instance.
Why Does Dissociation Keep Happening? Am I Stuck With This?
If you've been struggling with dissociation, derealization, or depersonalization for a while, you might be frustrated that these experiences keep popping up even when you feel like your anxiety is under control. It's like your mind and body are stuck in a loop, and you can't seem to break free.
Here's the thing: dissociation can become a learned response to stress, even if the original stressor is no longer present. Your nervous system may have become so used to resorting to dissociation as a coping mechanism that it continues to do so out of habit. It's like a well-worn path - even if you don't need to take that route anymore, your brain might automatically steer you there.
With the right treatment and support, you can learn to retrain your brain and body to respond differently to stress. It takes time and practice, but it is possible to break free from the cycle of dissociation. Therapy can help you develop new coping strategies, process any underlying traumas, and learn to ground yourself in the present moment.
Remember, your symptoms are not a sign of weakness or failure, and they’re not a sign that you’ve changed permanently. They're a reflection of your nervous system's attempt to protect you from overwhelming experiences. With patience, self-compassion, and the right tools, you can gradually restore a sense of safety and connection within yourself and your environment.
How Can I Find Relief From Constant Feelings of Unreality?
Dealing with derealization disorder, where you constantly feel like the world isn't real, can be really tough and get in the way of your daily life. But the good news is that there are effective treatments out there.
Treatment for derealization disorder also often focuses on helping you develop skills to regulate your nervous system and feel safe in your own body (Fisher, 2017). This can include things like deep breathing, progressive muscle relaxation, and mindfulness practices to help you feel calm and present.
It also can be helpful to look at your relationship with anxiety. For many people, derealization symptoms become less severe as you begin to fight with them less. It can sound like a chicken-or-the-egg problem: how can I relax and accept the thing that I most want to go away? But one of the challenges in derealization disorder is that you are constantly on the lookout for a process that is a normal human experience. Therapy may help you to accept that a moment of derealization does not need to be met with anxiety and resistance; if you can accept it in that moment, you can often move on quickly.
Many therapeutic approaches can help with derealization symptoms. Cognitive-behavioral therapy (CBT) has shown a lot of promise in treating derealization disorder (Hunter et al., 2003). In CBT, you work on identifying and challenging the thoughts and beliefs that fuel your dissociation. You also learn grounding techniques and coping strategies to help manage your symptoms. Other approaches, such as IFS and EMDR, may also help.
You’re Not Alone, and Recovery is Possible
Dissociation, derealization, and depersonalization can be really distressing and disorienting, especially when they happen alongside anxiety. These experiences can be seen as your nervous system's response to feeling overwhelmed or threatened. By understanding your symptoms, seeking the right treatment, and learning skills to manage overwhelming emotions and feel safe, you can find relief and improve your quality of life. If you're struggling with persistent or distressing symptoms of dissociation, derealization, or depersonalization, I'm here to help. Feel free to reach out to me to discuss how we can work together to help you find relief and reclaim your sense of well-being.
Frequently Asked Questions About Dissociation Symptoms
Can dissociation, derealization, and depersonalization happen even if I don't have a history of trauma?
While these experiences are often associated with trauma, they can also occur in people who don't have a history of trauma. Chronic stress, anxiety, experiences with certain drugs, and other mental health conditions can also trigger dissociative symptoms.
Is it possible to fully recover from dissociation, derealization, and depersonalization?
Yes, with the right treatment and support, it is possible to significantly reduce and even eliminate these symptoms. Recovery is a gradual process that involves learning new coping strategies, processing underlying issues, and building a stronger sense of self and connection to the present moment.
Can lifestyle changes help reduce dissociation, derealization, and depersonalization?
Yes. In addition to therapy, certain lifestyle changes can help manage dissociative symptoms. Regular exercise, a balanced diet, good sleep hygiene, and stress-reduction techniques like yoga or meditation can all contribute to better mental health and emotional regulation. Having experiences that make you feel present and aware of your body can be helpful, such as sports or massage. Some find it helpful to avoid drugs and alcohol while recovering, as substance use can worsen dissociative symptoms.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Armour, C., Karstoft, K. I., & Richardson, J. D. (2014). The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD. Social Psychiatry and Psychiatric Epidemiology, 49(8), 1297-1306. https://doi.org/10.1007/s00127-014-0819-y
Briere, J., Scott, C., & Weathers, F. (2005). Peritraumatic and persistent dissociation in the presumed etiology of PTSD. American Journal of Psychiatry, 162(12), 2295-2301. https://doi.org/10.1176/appi.ajp.162.12.2295
Fisher, J. (2017). Healing the fragmented selves of trauma survivors: Overcoming internal self-alienation. Routledge.
Hunter, E. C., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: a cognitive–behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451-1467. https://doi.org/10.1016/S0005-7967(03)00066-4
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