Have you ever felt as if you were living in a dream? Or felt that you have no control over your life and are just an outside observer? While many people would agree with these statements in a metaphorical sense, people with derealisation experience these feelings literally. What is derealisation and what are its symptoms? Can derealisation be treated? In today’s article, we look at this unusual form of dissociative disorder.
What is derealisation?
It is a mental state in which a person feels detached from their surroundings. The person feels that the people and objects around them are unreal, even though they are fully aware that this state is abnormal. Derealisation is very similar to depersonalisation, in which a person becomes detached in the same way from their own body, thoughts or feelings. In both cases, the person feels like an outside observer of the situation. Statistically, more than half of the population experiences this detachment from reality at least once in their lifetime. However, only 2% of the population experience derealisation so often that it is diagnosed as a dissociative disorder.
Derealisation is often linked to health predispositions such as depression, anxiety attacks, amnesia, dementia or drug addiction. However, the main causes of derealisation are most often severe emotional trauma from the past or stress. Particularly in the case of childhood trauma, a child is likely to seek an escape from their situation by detaching from reality. Forms of trauma that can trigger derealisation include, for example:
- Physical or sexual abuse,
- Domestic violence,
- The unexpected death of a loved one,
- Trauma from an accident or natural disaster,
- Trauma from surviving armed conflict,
- A predisposition from a parent with a serious mental disorder.
Symptoms of derealisation
Derealisation most often appears during adolescence or early adulthood. However, there is no laboratory test that can detect this diagnosis. In this case, doctors’ standard procedure involves testing the patient for toxic substances in the body. If all the results are negative, the patient may be referred to a psychotherapist.
The patient is then diagnosed with derealisation if they see and experience things that are not real, and this significantly interferes with their basic everyday functioning. A patient may also be diagnosed if they have long-term, frequently recurring symptoms of derealisation. These symptoms include:
- The world seems unreal, fake or muted,
- Time passes too slowly, too quickly, or not at all,
- Sounds from the outside world seem muffled, too quiet or too loud,
- The person feels as if they are in a dream or a fog,
- Objects around them seem unrealistic in shape, size or in some other way,
- Sometimes a wall may appear that separates the person from the real world.
Treatment
How do you get rid of derealisation? The good news is that most people with derealisation can recover completely, and some even manage it on their own. Many people with this disorder can also learn to cope calmly with individual episodes. If the symptoms of derealisation persist over the long term, or are accompanied by depression or anxiety, it is advisable to seek medical help.
The most common treatment for derealisation is psychotherapy, which gives the patient the opportunity to learn to talk about their experiences and how they deal with them. Through conversation, the psychotherapist can also guide the patient towards healthy ways of managing these states, which usually differ for each patient and are individual. Psychotherapy can help the patient learn to:
- Talk about their feelings and learn to put them into words,
- Recognise negative emotions and find the causes of their symptoms,
- Not place emphasis on experiences that are not real,
- Distract themselves with leisure activities,
- Learn to stay present in reality by using the five senses, for example through music or holding a calming object.
With derealisation, the patient usually does not need any prescription medication. However, if the disorder is accompanied by anxiety or depression, medication may be prescribed to ease these conditions.
