What Is Derealization and How to Live with It?

Have you ever thought that the world around you is unreal and artificial; that all objects in it seem to be made of cardboard, and people are like programmed robots living in a matrix? If you have, you may be suffering from derealization. What is derealization? Let’s get to know how dangerous it is, and what kind of help you need.

The prevalence of mental illnesses is growing every year, more and more people suffer from borderline disorders, schizophrenia and dementia. According to the WHO, about 264 million people worldwide suffer from depression, 45 million suffer from bipolar disorder, and 20 million suffer from schizophrenia. At the same time, more and more people have symptoms of derealization, and this issue is becoming more relevant.

What is derealization?

Derealization is a psychopathological condition accompanied by impaired perception, in which the world is presented as changed, distant, unreal, devoid of bright colors or properties of objects.

The familiar environment seems “alien”, the world looks “unreal”, “artificial”, “purposely built”. Patients with derealization perceive their surroundings unnaturally: “people look like robots”, “houses look like stage sets”. All surrounding reality is seen as if through a glass wall, fog, or vacuum.

Derealization is quite often accompanied by depersonalization. This is a psychopathological condition characterized by painful experiences of one’s own change, the loss of one’s real self. Patients feel themselves as “having lost their own face”, “having lost the fullness of their feelings”, “stupid”, “empty”.

From the clinical point of view, derealization is similar to psychosensory disorders and is quite often combined with them. Psychosensory disorders include disturbances in the perception of objects, the recognition of which is not disturbed, but their individual qualities are painfully changed: size, shape, color, position in space, angle of inclination, and severity.

Objects seem either too small or too big, and buildings are like houses of cards that may be painted in one color. Distortion of the shape and surface, doubling of objects, rotating the environment by 90 or 180 degrees is also quite characteristic.

One of the variants of psychosensory disorders is a change in the shape of the body – “your arms are swollen and do not shrink”, “your head feels extremely heavy”, “your body is lighter than air”, “long arms hang down to the floor”, “you have two heads”, “your eyes slide off the face.”

When controlling their own changes, patients immediately notice that the internal sensations are not correct: the reflection in the mirror is the same as usual, and there is no visual confirmation of internal sensations.

Time passes too fast or too slow. This also corresponds to psychosensory disorders – this symptomatology is typical of affective disorders: manic or depressive states.

Psychosensory disorders are a manifestation of various organic diseases of the brain and appear either in the form of independent psychosensory episodes, or as part of an aura preceding a larger fit.

What causes derealization?

Derealization and depersonalization are non-specific disorders and can be a manifestation of:

  • acute transient psychoses
  • epileptiform paroxysms
  • persistent personality changes in schizophrenia
  • depressive disorders
  • neuroses

How to treat derealization?

Many people mix up derealization with confusion syndromes, when the environment becomes completely different. For example, a person is in their own apartment, but thinks that they are standing in the middle of a forest, on another planet or in a parallel reality – in hell or in paradise. Such conditions occur with organic brain lesions, intoxication with psychoactive substances, during severe infectious conditions, or with an acute attack caused by schizophrenia. Patients with confusion syndromes can be dangerous to themselves and others, and are subject to involuntary hospitalization.

Mainly, derealization is not a separate diagnosis, it can be one of the symptoms of any mental disorder. If the conditions described above concern you, then you must immediately contact a psychiatrist for examination and further recommendations.

Depending on the severity of the condition, the disorder is treated on an outpatient or inpatient basis with drugs in combination with psychotherapy. The selection of drugs is carried out individually and, as a rule, takes some time.

Treatment options can be different, and drugs from such groups are used – antidepressants, antipsychotics, normotimics and their combinations.

All of the conditions described above are most often chronic and require constant monitoring by the attending physician.