derealisering

Derealisation, or derealisering in Swedish, is a dissociative symptom in which the external world feels unreal, distant, or distorted. People describe surroundings as artificial, dreamlike, or as if they were watching the world through a veil. Derealization can occur alone or as part of depersonalization or other dissociative disorders. It is not a standalone diagnosis in itself, but a symptom that can point to various conditions.

Symptoms include a sense that objects and people are unfamiliar or mechanical, altered perception of time, and emotional detachment from the environment. Sensory input can feel exaggerated or muted, and movements may seem slowed or robotic. These experiences can last from minutes to hours and may recur.

Causes and associated conditions: It can be triggered by severe stress or trauma, anxiety, depression, PTSD, or panic attacks. Substances such as cannabis, alcohol, antidepressants, stimulants, or psychedelics can provoke derealization. It can also accompany medical or neurological conditions and be a feature of dissociative disorders.

Diagnosis and treatment: Evaluation by a clinician is important to rule out medical causes and to assess for underlying mental health conditions. Treatment focuses on the underlying condition. Psychotherapy, especially grounding techniques, cognitive-behavioral therapy, and trauma-focused approaches, can help. Medications may be used for associated symptoms such as anxiety or depression. Sleep, stress management, and avoiding substances that trigger symptoms are advised.

Prognosis and frequency: For many people, episodes are brief and resolve on their own. For others, derealization can be persistent or recurrent, particularly when linked to chronic dissociative disorders or ongoing trauma. Awareness and early treatment can improve outcomes.