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: 09-5-2017

  • 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

  • Riab


    January 2nd, 2018 at 8:46 AM

    Hi I am an MSW student and I am suffering from anxiety. I had depression but that seems to be better. I sometimes do not want to go back to internship. I believe the review that I received for this first quarter which was not that great, triggered it.

  • 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?

  • Michele


    April 3rd, 2018 at 12:32 PM

    Wow, Sharon. I was just doing some research and ran across your post. I hope you found someone who would listen to you and got the help you needed. Best if luck to you!

  • Diane


    February 5th, 2019 at 12:02 PM

    I’m sorry to hear about your issues, I know what it’s like when Doctors don’t listen and they just shove a prescription at u u should research gut brain connection I’m sure this will help u tremendously hope that helps

  • Kathryn Ogle

    Kathryn Ogle

    December 26th, 2019 at 12:58 PM

    I hope you have found some relief by now. My son is suffering from this too. He explains it as you have. Hell on earth. If you are better, please reply what steps you took to get there. Thank you.

  • Raymond


    March 30th, 2020 at 2:52 PM

    I feel the same as you. It all started with a Manic episode 20 years ago. The nightmare lasted for years and one day it just vanished and I was fine for a time. but, just as it left it came back the same. There was one difference, I didn’t have a manic episode first. I had it after. It has now been 6 years stuck in this hell-like state. I’m underwater totally detached from what should be real and I’m crawling out of my skin. It’s there from dusk till dawn every day all day. it never stops. My question to anyone who has experienced this for any length of time. when did it start, what was going on in your life? did it stop, what was going on in your life when it went away? I would sell my soul to live in the world I remember.

  • Richard


    April 13th, 2020 at 12:39 PM

    Just wondering if this is the same experience I am feeling. I had alot of coffee about a week ago and my heart was racing and has shortness of breath. I went to the urgent Care all my vitals were good. Since then about 4 days I am so tired and feel like I am walking In dream. Is this just being exhausted or do I have a condition now because of drinking too much caffeine.

  • lisa


    April 23rd, 2017 at 6:47 PM

    i know what u mean… one knows unless they have been through it …. everything is gonna be ok we are not alone… life doesnt throw us things that we cant handle is a motto i love….. with love from derealization friend lol :)

  • Bl


    June 13th, 2017 at 8:55 AM

    I read today that if you have chronic ONGOING symptoms of derealization, that it’s caused by ‘occipital-temporal dysfunction’
    I’m confused though. I went through a series of emotional events that stressed me out, but afterwards life didn’t feel real, im spacy, with brain fog, and things seem foreign, have head tension too Its felt like this everyday since then all day, wether I’m anxious or not. Bright light makes it far worse.
    I’ve had some cat scans to the brain which show negative. So… I’m not sure what to make of that comment, or why I would continue to feel this way?

  • Amanda


    August 18th, 2019 at 10:12 AM

    I feel the same way most of the time , have you improvised at all ?

  • Brooke


    September 11th, 2019 at 10:06 AM

    My symptoms are exactly like yours. Did this ever go away for you or did you find a way to relieve it?

  • Storm


    July 17th, 2017 at 3:39 AM

    Wow I thought I was the only one that experienced this feeling I feel like I’m not attached to the environment I like I can’t grasp reality what do you guys do about it or what medications do you take I’ve had this feeling every since my late teens. And when trying to explain it to anyone they just don’t get it

  • randa


    July 17th, 2017 at 1:09 PM

    I thought I was alone with this. Dreams seem more real than life. Counselor said “pinch yourself. Do you feel that? Didn’t stay with her. It is depressing to go to anyone, they don’t seem to understand

  • Christina


    October 23rd, 2017 at 5:38 PM

    Since I was about 7 years old I have been able to put myself into and take myself out of a state of derealization intentionally. For those of you who do not bring this on intentionally I apologize. It must be terrible to have it happen unsolicited. Over the years I have tried to explain the experience to others but no one has been able to tell me what it was called. Derealization is the closest I can come to explaining the experience. I have researched if there are others who can bring this on intentionally without trauma but have not been successful in finding any other experiencers. I have even thought of reaching out to a research lab to be a case study but have not to date. Does anyone know who I might contact that can explain this ability more concisely?

  • Laurie


    June 24th, 2018 at 5:17 AM

    Like you, I have been experiencing derealization since childhood. I can’t trigger it, but if I shift (usually due to stress) I can easily come out. I don’t worry about it because it seems to be a way to cope with stress.

  • Sabrina


    November 4th, 2017 at 8:20 AM


  • Chi C

    Chi C

    December 5th, 2017 at 6:30 AM

    Finally found out what’s wrong with me. Trying desperately to make it go away. Knowing what it is and that I’m not alone gives me some comfort.

  • Kyla V

    Kyla V

    December 31st, 2017 at 5:34 AM

    Hi there,
    I’ve been experiencing derealization for about a week now, it’s affecting my work, I can’t concentrate and I’m forgetting that I do certain things. I’ve tried everything but it’s no better. I’m worried that I’ll never feel real. I can’t even go anywhere without feeling fake, dizzy and having constant anxiety and panic attacks,

  • Pauline M.

    Pauline M.

    March 4th, 2018 at 5:30 AM

    Have you tried grounding techniques? I’ve had this for 43 years on and off but past couple of years it’s been really bad. I wear a tight thick band around my wrist to twang hard, taste something very bitter, count and touch different things, have a cold shower, stand in the rain. If I’m outside I imagine I’m in a huge purple bubble with my granny holding her hand. They din’t always work but anything is worth a try. Good luck

  • 70girl


    January 8th, 2018 at 12:37 PM

    Interesting to read comments, I’m 47 have experienced cronic symptoms since I 12 years old. Struggled for a long time, accepted this is my reality, it actually becomes ok!

  • Habsa


    April 8th, 2018 at 5:37 AM

    I’m 14 years old (in yr9) and since year 6 I have been going through derealization. I think it started in our yr6 leavers lunch where there was loud music and everyone was talking. I couldn’t process a thing and I wasn’t aware that I was moving etc. I remember the day very well ( I’m not sure why). As I write this I am drifting in and out of “derealization”. I don’t think i suffer from anxiety or anything like that. I don’t do drugs or drink etc. I’m not suicidal or depressed. Can anybody recommend anything?

    Thanks in advance

  • RoyF


    April 16th, 2018 at 4:43 PM

    Hi, I am new here. My wife is suffering terribly from not only almost daily migraines, but bouts of derealization and depersonalization. I finally got her to agree to seek medical help, but am not sure who to start with. :Psychiatrist, neurologist, primary care doc, etc. We are not sure if they are caused by brain dysfunction or trauma (ptsd). Can anyone point me in the right direction, the help would be greatly appreciated.
    Thank you

  • Kylee D.

    Kylee D.

    May 5th, 2020 at 10:33 AM

    Cognitive Behavioral therapy (CBT) you will want to find a counselor who specializes in CBT, this is a result of high anxiety and trauma, with that being said it might be helpful to also look into EMDR once her derealization starts to get under control.

  • Isaiah M.

    Isaiah M.

    May 30th, 2018 at 1:01 AM

    I have been dealing with derealization since I was about 14, I’m 20 now. it has affected every aspect of my life, its very difficult for me to learn anything because I don’t actually feel here. its hard for me to remember anything I forget a lot of stuff. I just feel like life isn’t even worth living when I don’t even feel here I try to enjoy life but I can’t even enjoy it. everything around me feels unreal like I’m living in a dream or a movie. I’m dealing with many other sicknesses like multiple sclerosis, and patulous Eustachian tube which really makes my life even harder, unbearable almost when all my sicknesses are attacking me at once. There was a time when I thought I was normal, that everyone feels things the way I do, it gives me relief yet saddens me that there is a name for everything that is wrong with me.

  • Laura A.

    Laura A.

    November 3rd, 2019 at 4:36 PM

    Hi Isaiah!
    I have also been living with chronic depersonalization and derealization for almost 8 years now…and I have patulous Eustachian tube in my right ear, as well! I have recently been wondering if they are somehow related? I have had ear issues my whole life, and I had depersonalization/derealization 3 times before it came again 8 years ago. Those three times it always went away within 1-3 days on its own. I would love to connect with you and chat more!!


  • OrangeGirl


    July 1st, 2018 at 8:45 AM

    In the last year was diagnosed w PTSD & derealization. Because I’ve been this way since childhood, I always thought everyone spaced out as a normal state of being. During moments of anxiety it gets worse and it’s scary because sometimes I think I can’t pull myself out of it. Been through several counselors and unfortunately even some of them don’t take this seriously. Currently seeing one who is suggesting I meditate and learn body feeling/awareness. I’ve come up with a trick that might work as I practice it. when I feel myself drifting: close my eyes a minute, touch “third eye” area of forehead and imagine I’m in solitary confinement. Nothing but white walls. Once I’ve fixed that image in mind, I open my eyes and then can see my reality more vividly. If anyone tries this let me know how it works for you. Also helps: SET BOUNDARIES! Do NOT let your world overwhelm you or it will trigger escape mode. Make your home as minimalist and quiet as possible. Ask friends not to call you every day. Get space, sleep, warm showers. Peace to you my fellow-Dereals. xox

  • Privatesoul


    February 7th, 2020 at 9:47 PM

    I am a therapist. I have also felt this way my entire life. I just remind myself that this is me. Life is real. Headspace was a great ap that helped along with attention training exercises really help. Personally battling it just makes it worse. There are med line ups that help too. I used to feel like I watched life from the back of my head if that makes any sense. Almost Luke through binoculars. The right med combo, controlling anxiety, talking to a trusted person, and solid sleep hygiene help. It feels like the end of the world but it doesn’t have to be. I love being a therapist and practicing what I preach. It does it get better by the way. Don’t fight it, go with the flow, it will pass. The more you focus on it and fight the harder it is. Distraction techniques are also helpful. You can still have successful, fulfilling lives. It just take practice, coping skills, and a solid support system.

  • 70girl


    July 2nd, 2018 at 12:34 PM

    Recently I was in almost the exact situation that triggered derealisation over 30 years ago… had a moment of reality, then slipped back into the foggy dream, came to realise that this is my reality… my normal… embrace your life and reality… you are a beautiful soul xx

  • Zakk


    August 24th, 2018 at 12:54 AM

    Hey there everyone!
    So as a dumb teenager i abused a substance known to man as weed. for as well it was fun first time and stuff but then when i stopped (i smoked only 5-7 times all together), i started to feel weird like sometimes i would almost get high by doing nothing. However after 2 months now since i haven’t touched it i still feel im, how to explain…i can’t focus on anything, im constantly thinking that my perception of reality isn’t real at all, specially when i look in the mirror. i think to my self “NO, this is not me..but who is it then?” and sometimes the thoughts can get really deep. as i was “fighting” my own mind in attempt of help, for all the problems i had etc… i really feel like i’m a Camera attached to a fake body, and everything is just subconscious, whatever I do i feel like im programmed to do so…After a small research i found out i had derealization, because at first i was panicking that i had schizophrenia. i’m also emotionally unstable, in a moment i’m happy and in the other i’m sad. sometimes i feel like everything is floaty,and the letters on the keyboard are all unordered. As a joke to a serious condition, its almost like ocd, you can see patterns when you look to the floor, and everthing makes sense but as said, in another moment no. the time is going slow and fast so uncontrollable or predictable. i would try to take ADHD pills so concentrate. Any ideas, should i take ritalin?

  • Karlo


    June 17th, 2019 at 1:09 PM

    Hey man do you feel any better now?

  • 70'sgirl


    August 19th, 2019 at 4:42 PM

    Check out irlen syndrome, the weird pattern thing might be linked to this, wouldn’t be surprised if all of us derealisationers have this to some degree… discovered I do a couple of years ago!!

  • randa


    April 1st, 2020 at 10:26 AM

    I have tried to figure what trauma I had. At. 8 my dad’s cousin committed suicide. Since I ask self is this real or not. Dreams seem more real. Help!

  • Scott


    May 6th, 2020 at 11:35 AM

    I have been in a state of derealization for the past 2 months. It was brought on by a Monumental anxiety Panic condition, which has since stayed with me… Along with the state of derealization. I am still cognizant in present in my day-to-day life, but I feel like I’m looking at the world through some kind of translucent Veil. It’s hard to focus on anything else, and it has deepened my depression. Of course, this all had to happen at the same time as coronavirus. I can’t really go anywhere, I can’t see my friends, and have a hard time distracting myself. When I am able to distract myself, I am able to have fun and focus on whatever it is that I’m doing… But it is always there, either in the front or back of my mind. It has intensified my depression, and I battle with it everyday.
    What two seemed to be the initial trigger of this state was a bad experience with Lexapro, for depression. It was prescribed to me, and after only 4 days I went into an unstoppable continuous panic attack state. although I deal with anxiety daily, I have not had a panic attack since… But the derealization has persisted.
    It makes me feel overwhelmingly sad every time I think about it, which is almost constantly. Like I said, being isolated because of coronavirus hasn’t helped one iota.
    I just feel detached, sleepy, and depressed all of the time. I don’t know what to do with myself anymore.
    For the record, I am a 49 year-old man was two wonderful children who’s been married for 21 years. I love my family, but other than my wife and kids I don’t have much else that me out of bed in the morning.
    I am currently trying to get an appointment with a psychotherapist, but once again because of coronavirus that’s nearly impossible, even over the phone. I am sincerely at the end of my rope.
    Thank you to everyone who is reading this, caring about your own experiences has made me feel a little bit better. All I can hope is that this will pass soon. I have given up caffeine, try to get lots of sleep, take my vitamins, drink a lot of water… Nothing makes it better.
    I don’t know any of you, but I love you for listening to me. Thank you very much.

  • OrangeGirl


    May 7th, 2020 at 5:48 PM

    Hi Scott. In my few years of seeing a counselor for PTSD, SADD I’ve always been told to stay physically active. I know it’s hard to motivate yourself but try to MAKE yourself go outside and put music in your ears and take a long walk. You will feel better even for just a little while. Play your favorite music when you go walk or if you don’t want to go outside…pick a room, shut the door and dance it all away!! Good luck and sending you cyber love too…<3 :) <3

  • Natalie


    June 17th, 2020 at 4:44 AM

    Hi Scott
    I feel for you. I am a mum of an amazing 9 year old, and a bew mum to a 6 month old sweet baby girl. I have an amazing husband and last Wednesday derealisation hitvme like a ton of bricks. Morning OK, afternoon massive panic attack.
    I have a history of GAD, probably some elements of PTSD and have experienced derealisation intermittently since childhood due to trauma.
    I have corrected it on Citalopram 2 years ago, tried this week again, as was off it fir oregnancy. This time round could not take it, physialcal side effects plus absolutely crazy anxiety it brought was unbereable, and this only on 5mg in 3 days…
    I am trying herbs now and meditation, we will see.
    Living with this veil on your eyes, like in a dream, when you have amazing family feels awful… and adds guilt.
    You are right that coronavirus does not help, both with the level of stress and access to services.
    I hope you feel better soon.

  • Coll


    August 29th, 2020 at 7:55 PM

    Have you felt any better? This is an awful feeling😓

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