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Depersonalization and derealization: a feeling of unreality of oneself and the world

Other names: Деперсонализация, дереализация, чувство нереальности происходящего, как будто смотрю на себя со стороны, мир как в тумане, отстранённость от себя

Depersonalization is a feeling of alienation from oneself: one’s own thoughts, emotions, voice and body are perceived as alien or automatic, as if a person is watching himself from the outside. Derealization is a similar feeling, but turned outward: the world seems flat, artificial, distant, as if behind glass or in fog. These states are almost always accompanied by the fear of going crazy, although they have nothing to do with psychosis: criticism is completely preserved, and the person understands that this is just a feeling. Many people experience short episodes when they are very tired or anxious. If the condition persists for weeks and interferes with life, you need the help of a specialist.

🧾 МКБ-10: F48.1 🏥 Where it is treated: 6 Criticism savedThis is not psychosisMore often associated with anxiety
👨‍⚕️ Which doctor
Psychotherapist, psychiatrist, neurologist
🔬 Diagnostics
Conversation and assessment of the condition, exclusion of epilepsy, thyroid pathology, influence of substances
💊 Treatment
Psychotherapy, treatment of underlying anxiety or depression, withdrawal from cannabis and stimulants
📈 Prognosis
Stress episodes usually resolve; persistent form requires long-term therapy
⚠️ At risk
Anxiety and panic disorders, depression, psychotrauma, cannabis and stimulants, lack of sleep
⏱ When to see a doctor
Planned

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

  • Мысли о нежелании жить — немедленно к врачу, при угрозе жизни 103
  • Состояние появилось после травмы головы
  • Сопровождается судорогами, странными запахами, потерей сознания
  • Есть галлюцинации и убеждённость в нереальности мира как в действительности
  • Появилось после приёма наркотиков или нового лекарства
  • Держится непрерывно дольше нескольких недель и мешает работать

How does a person feel

The descriptions are usually similar: emotions are dulled, as if they were turned off, actions are performed on autopilot, one’s own reflection seems unfamiliar, time flows strangely. With derealization, familiar streets and faces look alien, colors become faded, sounds become muffled. Many people struggle to find words because such experiences are difficult to express, and they are afraid that they will not be understood or considered crazy. It is fear that usually brings more suffering than the sensation itself, and pushes towards constant introspection.

  • The feeling of being watched from the outside
  • Dulling of emotions, “emotional deafness”
  • Feeling of automaticity of actions
  • The world seems flat and unreal
  • Distortion of time perception
  • Difficulty describing your condition
  • Maintaining the understanding that it's only a feeling

Why does this happen?

Most often, depersonalization is a protective reaction of the psyche to overload: with severe anxiety, panic attack, acute stress, severe overwork or sleep deprivation, the brain seems to muffle perception. A significant proportion of cases are associated with the use of cannabis and stimulants, and the condition may persist long after cessation. The symptom occurs in depression, panic and anxiety disorders, after psychological trauma. Less commonly, it is associated with neurological causes, such as temporal lobe epilepsy, so testing is required in unclear cases.

  • Anxiety and panic attacks
  • Acute and chronic stress
  • Lack of sleep and overwork
  • Depression
  • Use of cannabis and stimulants
  • Psychotrauma and violence
  • Rarely - epilepsy, migraine, thyroid disease

What it's not

The most important thing to understand is that depersonalization does not mean the onset of schizophrenia and does not lead to loss of reason. With psychosis, a person is convinced that the world has really changed, and does not doubt it, but with depersonalization, he understands perfectly well that this is only his perception, and that is why he is worried. The condition also does not damage the brain and is not a sign of a tumor, although the frightening sensation causes many to undergo multiple tests. Knowing this in itself reduces anxiety and makes it easier.

  • Not psychosis: criticism saved
  • Not a sign of brain damage
  • Doesn't lead to madness
  • Doesn't mean split personality
  • Occurs occasionally in many people
  • Increased by constant self-observation

Survey

The diagnosis is made by describing the experiences and their duration. The doctor clarifies when the condition appeared, what preceded it, whether there is anxiety, panic attacks, depression, use of substances and medications. Neurological causes are excluded if there are convulsions, loss of consciousness, unusual sensations of smell, headaches with aura; in this case, EEG and MRI are prescribed. Thyroid function and hemoglobin levels are checked, since their disorders lead to similar complaints of detachment and brain fog.

  • Detailed conversation about the nature of sensations
  • Assessing anxiety, depression and panic attacks
  • Clarifying the intake of substances and medications
  • EEG and MRI for neurological symptoms
  • TSH and complete blood count
  • Assessment of sleep patterns and stress

What helps

The key principle is to treat not the sensation itself, but what supports it: anxiety, depression, lack of sleep, substance use. Psychotherapy, primarily cognitive behavioral therapy, is effective: it helps you stop endlessly checking your condition and monitoring your symptoms, because it is introspection that increases detachment. Grounding techniques are useful - switching attention to bodily sensations and surrounding objects. If anxiety or depression is severe, your doctor will prescribe medications. Avoiding cannabis, stimulants and excess caffeine is mandatory.

  • Psychotherapy as the main method
  • Treatment of anxiety and depression
  • Avoiding cannabis, stimulants, and energy drinks
  • Grounding and attention shifting techniques
  • Restoring sleep and daily routine
  • Physical activity and live communication
  • Refusal to constantly control your feelings

Frequently asked questions: Depersonalization and derealization

Is this the beginning of schizophrenia?+
No. With depersonalization, a person understands that only his perception has changed, and that is why he is worried. In psychosis, this understanding is lost. The feeling of unreality does not in itself lead to schizophrenia.
Can this go away on its own?+
Yes, episodes due to overwork, acute stress or a panic attack often pass within days or weeks, especially if you improve your sleep and reduce your workload. If the condition persists for months, you need the help of a specialist.
Is it true that cannabis can cause this condition?+
Yes, this is one of the common reasons. Depersonalization can occur even after a single use and persist long after cessation. Quitting cannabis and stimulants is essential to recovery.
Why does it get worse when I listen to myself?+
Constant self-observation strengthens the symptom: the more carefully a person checks whether “everything around is real,” the more pronounced the feeling of detachment. Psychotherapy helps to shift attention to external affairs and bodily sensations.
Do you need medications?+
Not always. The main method is psychotherapy. Medicines are prescribed by a doctor if the underlying cause is severe anxiety, panic attacks or depression. Self-administration of sedatives does not help and may increase withdrawal.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated depersonalization в Ташкенте

Если чувство нереальности не проходит неделями, стоит обратиться к психотерапевту, а при неврологических симптомах — к неврологу. Clinics Ташкента:

st. Mirzaeva 50, Yunusabad 17, Yunusabad district, Tashkent Landmark: opposite the Nazar M...
M Turkiston 🚶 1.5 km
M Yunusobod 🚶 2.0 km
M Shahriston 🚶 2.8 km
🚌 Nearest bus stop 🚶 100 m · buses: 7
Mon–Fri:09:00–18:00
Open now
Tashkent, Almazar district, st. Chukursay, 149d
🚌 Nearest bus stop 🚶 950 m · buses: 42
Mon–Fri:09:00–17:00
Closed now
Tashkent, Mirabad district, st. Mehrzhon, 35d
M Toshkent 🚶 850 m
M Oybek 🚶 1.8 km
M Mashinasozlar 🚶 2.0 km
🚌 Nearest bus stop 🚶 240 m · buses: 52, 55
Mon–Fri:09:00–17:00
Closed now
Tashkent, Yunusabad district, st. Osiyo, 68d
M Abdulla Qodiriy 🚶 1.2 km
M Minor 🚶 1.3 km
M Yunus Rajabiy 🚶 1.3 km
🚌 Nearest bus stop 🚶 130 m · buses: 2
Mon–Fri:09:00–17:00
Closed now
Tashkent, Sergeli district, Yuldosh-4 massif
M O'zgarish 🚶 950 m
M Sergeli 🚶 1.2 km
M Choshtepa 🚶 2.2 km
🚌 Nearest bus stop 🚶 1000 m · buses: 47
Mon–Fri:09:00–17:00
Closed now
N

NORAX

Private · Yunusabad district

Tashkent, Yunusabad district, массив Кашгар, 30
M Yunus Rajabiy 🚶 200 m
M Ming O'rik 🚶 550 m
M Abdulla Qodiriy 🚶 700 m
🚌 Nearest bus stop 🚶 110 m · buses: 17
Пн–Sat:09:00–16:00
Closed now

ICD-10 code

Official international classification codes — these are used in medical records and statistics.

Other diseases: Psychiatry

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