foggy-streetDerealization is an altered mental state in which the surrounding environment seems foggy, unreal, or disconnected. It is similar to depersonalization in that it alters a person’s perception of reality. However, while depersonalization results in a feeling that one is robotic or detached from one’s environment, derealization causes the environment itself to seem unreal.

Symptoms of Derealization

Derealization can be experienced differently by different people. Some people describe it as a hazy, dreamlike state where details of the environment may seem fuzzy or detached. Other people may experience changes in their perception of the environment. For example, sights and sounds may be muted and seem unreal.

Causes of Derealization

Derealization is characteristic of several mental health disorders. Severe anxiety and depression may cause periods of derealization. People having panic attacks due to anxiety disorders or flashbacks due to posttraumatic stress may also experience episodes of derealization. Derealization commonly occurs with dissociative disorders and may also occur with some forms of schizophrenia.

The symptom may also occur during or immediately after a person experiences a traumatic event. Brain damage to the occipital or temporal lobes may also cause both depersonalization and derealization. Drugs such as marijuana, hallucinogens, pain medication, and even large quantities of caffeine may contribute to derealization.

Treatment for Derealization

When people present with symptoms of derealization, clinicians typically first rule out physiological causes such as brain damage or substance use and abuse. Thereafter, treatment depends on what specific mental condition is causing derealization. Because derealization is associated with anxiety, panic, and trauma, people often benefit from learning self-soothing skills and may practice meditation, deep breathing, and other relaxation exercises. Medication can also help ease anxiety, and people may be prescribed antidepressants and/or anti-anxiety medications. When derealization occurs as a part of schizophrenia or dissociative disorders, psychiatrists may prescribe antipsychotic medications. When derealization is caused by a mental health condition, treatment almost always involves some form of psychotherapy. Therapy can address underlying causes of derealization, help with groundedness, and provide new coping skills.


  1. Cox, B. J., & Swinson, R. P. (2002). Instrument to assess depersonalization-derealization in panic disorder. Depression and Anxiety, 15(4), 172-175. doi: 10.1002/da.10051
  2. Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Abnormal psychology. Hoboken, NJ: John Wiley & Sons.

Last Updated: 08-5-2015

  • Leave a Comment
  • Claire

    June 24th, 2016 at 11:54 PM

    Excellent summaries.

  • Claire

    June 24th, 2016 at 11:55 PM

    I am a social worker therapist and found these summaries excellent. I can see using them with some of my clients and also for my own reference. Thanks. Claire

  • Randa

    June 28th, 2016 at 4:42 PM

    This applies to me.derealization for years no idea why. Thinking about it depresses me. I need help. When I say how I feel, people look at me like I must be crazy.

  • Sharon

    December 12th, 2016 at 10:45 PM

    Derealisation for me is when i actively cant do anything as im not sure what my reality is. I feel dreadful – aware that what im experiencing is too horrid and i go to hermit mode looking at bed. I think my emotionally traumatic childhood has a lot to answer for and ive been alone looking for help to remove me from the hell within my brain. Think i need hospitalisation soon to feel better. This is hell on earth and i cant find a way out. Just went and got valium from dr as im seriously unwell and yet do t feel i get talen seriously when i say my head is fighting myself

  • Kofi

    March 14th, 2017 at 10:52 AM

    Hi Sharon, How do you feel three months after, what have you done to improve the condition?

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