Health and wellness touch each of us differently. This is one person’s story.
It was like the world was made of wax.
The first time I felt it, I was walking down the streets of New York City. I’d been anxious for months, having panic attacks upon waking, while teaching, while in the back of a cab.
I’d stopped taking the subway and was walking to work when suddenly the buildings around me started to shimmer like their atoms didn’t hold together. They were too bright, immaterial, and shaking like flip-book cartoons.
I didn’t feel real either.
My hand looked garish and it panicked me to clearly feel the thought, move your hand, echo cavernously inside my head — and then see my hand move. The whole process that was supposed to be automatic, instant, and unnoticeable was broken down.
It was as if I were an outside observer of my innermost processes, making me a stranger in my own body and mind. I feared I’d lose my grip on reality, which already felt tenuous and shaky because of a severe flare-up of lifelong anxiety and panic.
I felt reality melt away a week later when I was having one of the biggest panic attacks of my life.
I was on my couch, my hands frozen into claws, the EMTs poised with an oxygen mask and EpiPen above me. I felt as though I were in a dream and everything was hyper-real — colors too bright, people too close, and huge clown-like people.
My skull felt too tight and my hair hurt. I could feel myself seeing out of my own eyes and hear myself talk too loudly inside my brain.
Aside from being deeply uncomfortable and distracting, what made it even scarier was that I had no idea what it was.
I thought it was an indication of total insanity, which caused me more anxiety and panic. It was a devastating cycle.
It would be a decade before I heard the terms derealization and depersonalization.
One reason doctors may be less likely to mention derealization to patients could be because, while associated with panic, it’s not completely clear what causes it. And why it happens for some people with anxiety and not others.
Confronting the scariest symptom of my anxiety
According to the National Alliance on Mental Illness, about half of US adults will experience at least one depersonalization/derealization episode in their lives.
The Mayo Clinic describes the condition as, “observing yourself from outside your body” or “a sense that things around you aren’t real.”
Depersonalization distorts the self: “The sense that your body, legs, or arms appear distorted, enlarged, or shrunken, or that your head is wrapped in cotton.”
Derealization deranges the outside world, causing one to feel, “emotionally disconnected from people you care about.” Your surroundings appear “distorted, blurry, colorless, two-dimensional, or artificial.”
However, the terms are often used interchangeably, and diagnosis and treatment are often the same.
Health Research Funding reports that stress and anxiety are the primary causes of derealization, and that women are twice as likely to experience it as men. Up to 66 percent of people who experience a trauma will have some form of derealization.
A sense of unreality came over me during times of heightened anxiety, but also randomly — while brushing my teeth with the nauseating feeling that the reflection in the mirror wasn’t me. Or eating dessert at a dinner party when suddenly my best friend’s face looked as if it were made out of clay and animated by some foreign spirit.
Waking up with it in the middle of the night was especially scary, shooting up in bed intensely disoriented, too acutely aware of my own consciousness and body.
It was one of the scariest and most tenacious symptoms of my anxiety disorder, lingering months after the acute panic attacks and phobias had eased.
When I first started seeing my therapist, I tearfully described this symptom, concerned about my sanity.
He sat in his overstuffed leather chair, completely calm. He assured me that while bizarre and scary, derealization is not dangerous — and is in fact quite common.
His physiologic explanation eased some of my fear. “Adrenaline from prolonged anxiety redirects blood from the brain to the big muscles — the quads and biceps — so that you can fight or flee. It also sends your blood into your core, so that if your extremities are cut you won’t bleed to death. With the redirection of blood from the brain, many feel a sense of light-headedness and derealization or depersonalization. It’s actually one of the most common complaints of anxiety,” he told me.
“Also, when nervous, people tend to over-breathe, which changes the composition of blood gasses, which affects how the brain works. Because anxious people can be hypervigilant of their bodies, they notice these subtle changes that others wouldn’t and interpret them as dangerous. Because this scares them, they keep hyperventilating and derealization gets worse and worse.”
Returning to reality by accepting my unreality
Depersonalization can be its own disorder, or a symptom of depression, drug use, or psychotropic medications.
But when it occurs as a symptom of severe or prolonged stress and anxiety, experts agree that it’s not dangerous — or a sign of psychosis — like many people fear.
In fact, the quickest way to return the brain to normal functioning is to deescalate anxiety and panic, which often means meeting the dissociative feelings with calm and acceptance, a herculean task at first.
My therapist explained that adrenaline is metabolized in two to three minutes. If one can calm themselves and their fear of the derealization, the production of adrenaline will cease, the body can eliminate it, and the feeling will pass more quickly.
I’ve found that listening to soothing, familiar music, drinking water, practicing deep breathing, and listening to affirmations can help take the focus off the strange zinging awareness and bring me back into my body.
Cognitive behavioral therapy has also shown to be one of the most effective treatments for anxiety-induced depersonalization/derealization. It can help train the mind away from obsessing over the troubling state, and help you build skills and tools to redirect attention where you want it to go.
As intense and all-encompassing as it feels, derealization does abate with time.
I used to have bouts of it several times a day, every day, and it was incredibly distracting, uncomfortable, and scary.
While I was teaching, shopping, driving, or having tea with a friend, it would send a shock through me and I’d have to retreat to bed, to the phone with a friend, or another safe space to deal with the fear it aroused. But as I learned not to react with terror — as I learned to ignore derealization with the confidence that it would not catapult me into insanity — the episodes got shorter, milder, and less frequent.
I still experience unreality sometimes, but now I ignore it and it eventually fades. Sometimes within minutes. Sometimes it takes an hour.
Anxiety is a lie. It tells you you’re in mortal danger when you’re safe.
Derealization is one of anxiety’s lies that we have to see through in order to gain our freedom and comfort. When you feel it coming, speak back to it.
I am myself; the world is here; I am safe.
Gila Lyons’ work has appeared in The New York Times, Cosmopolitan, Salon, Vox, and more. She’s at work on a memoir about seeking a natural cure for anxiety and panic disorder but falling prey to the underbelly of the alternative health movement. Links to published work can be found at www.gilalyons.com. Connect with her on Twitter, Instagram, and LinkedIn.