Some young adults may at one time sense that the world feels unreal or distorted. Everything outside of themselves feels strange, distorted, unreal, or unfamiliar. That is the sensation of derealization. Most people may have mild, transient feelings of derealization when daydreaming or lost in a good book, for example. However, more serious, repeated experiences can benefit from both holistic approaches for grounding as well as therapy.
What is Derealization and What Does it Feel Like?
Depersonalization-Derealization Disorder (DPDR), is a rare dissociative disorder (with chronic cases diagnosed in about 1-2% of the population). It consists of persistent feelings of detachment from oneself and one’s surroundings.
Derealization is one type of dissociation which involves a detachment from the external world, whereas depersonalization is a detachment from the self. However, derealization is not psychosis as you haven’t lost touch with reality. You understand that your perceptions aren’t real, which can be frustrating and cause anxiety [1] [2].
It’s a disorder that inordinately affects young adults. More than 80 percent of people with depersonalization/derealization disorder first experience symptoms before their 20th birthday–most commonly at age 16.
However, chronic incidents of derealization tend to manifest routinely in the lives of people living with the disorder only after they’ve reached their late 20s. You may be diagnosed in high school, but peak symptoms don’t appear until you’re almost 30 [3].
Usually recognizable by the person experiencing it, here are some examples of derealization:
- The world feels dreamlike, foggy, lifeless, or as if looking through a glass wall or a veil.
- Objects may appear blurry, unusually sharp, distorted in size, or two-dimensional.
- Sounds may seem muted or louder than usual.
- A sense of being in a movie or a play; the environment feels staged or artificial.
- Feeling like you’re in a bubble, separated from the world around you.
However, feelings of derealization may last from minutes to hours, days to months, or become chronic and ongoing depending on a variety of co-occurring, underlying conditions. A crucial factor that influences the perceived duration is how long you focus on the feeling.
What Causes Derealization in Young Adults?
Dissociative disorders such as derealization usually develop as a way of dealing with trauma. Although derealization has not been well studied, some research indicates a relationship between childhood trauma, resulting in a fearful, insecure attachment style and dissociative disorder [4]. They most often form in young adults exposed to long-term physical, sexual, or emotional abuse in childhood, causing distress and anxiety or more serious conditions [5].
There are different degrees and durations of symptoms for derealization that a young adult may experience. Each has particular causes:
Brief episodes of short duration
- Acute stress or anxiety
- Panic attacks
- Fatigue or sleep deprivation
- Mild illness or fever
- Substance use such as marijuana
Persistent/recurrent Derealization
- Anxiety disorders
- Major depressive disorder
- Post-traumatic stress disorder
- Unmanaged chronic stress
Chronic Derealization
- Complex PTSD
- Dissociative Identity Disorder
Managing Derealization Symptoms: Practical Ways to Feel Grounded Again
For young adults with milder symptoms, grounding and coping techniques are an important holistic way of managing the effects of derealization. These may include:
- Deep Breathing
- Grounding activities
- Reconnecting with your body
- Music and movement
- Mantras and affirmations
- Regular, quality sleep
- Mindfulness meditation
- Support groups
Professional Diagnostic and Treatment Options
If you have persistent symptoms, it’s important to see a therapist qualified to diagnose your symptoms and ensure it is not something else. Typically, they would be trauma-informed and use an approach based on attachment-based therapy. This usually consists of taking a medical history and asking a series of structured questions to help in the diagnosis. In more severe cases, a brain scan may be used.
There are no medications to directly treat the symptoms of derealization. However, medication may be helpful in treating related conditions or symptoms, such as using antidepressants to treat symptoms of depression or anti-anxiety medications to help with persistent anxiety [3].
Psychotherapy (talk therapy) is the recommended treatment, including Cognitive Behavioral Therapy (CBT) to help with negative or disconnected thoughts. Dialectical Behavioral Therapy (DBT) can also help with this, plus assist with emotion regulation and anxiety. Eye Movement Desensitization and Reprocessing Therapy (EMDR) may also help with those who have experienced trauma.
Finding Stability and Connection at Engage Young Adult Transitions
Engage Young Adult Transitions is a transitional living program and therapeutic community that assists young adults on their path to independence. Using attachment theory, we provide a foundation for forming connections, getting involved with the community, managing mental health, and building life skills for long-term success.
Engage offers structured autonomy—high support without creating dependence. Our therapists and life coaches are here to honor the young adults’ need to gain independence and freely move to a more secure sense of self and their relationships.
Located just steps from Southern Utah University in Cedar City, we offer access to services seven days a week, including academic support, vocational training, career guidance, life skill coaching, mental health therapies, and recreational activities.
Our community offers high levels of therapeutic support that honors autonomy and independence while guiding young adults to a life of freedom, emotional wellness, and success.
Get involved with the Engage Transitions community today!
Sources
[1] Wilkhoo, H. S., et al. (2024). Depersonalization-Derealization Disorder: Etiological Mechanism, Diagnosis and Management. Discoveries (Craiova, Romania), 12(2)
[2] Cleveland Clinic. Depersonalization-Derealization Disorder.
[3] American Psychiatric Association. What Are Dissociative Disorders?
[4] Simeon D., Knutelska M. 2022. The role of fearful attachment in depersonalization disorder. European Journal of Trauma & Dissociation. Volume 6, Issue 3. 2022.
[5] NAMI. National Alliance on Mental Illness. Dissociative Disorders. Nami.org.