What is Depersonalisation?

Understanding Depersonalisation

Depersonalisation is a dissociative experience where you feel detached or disconnected from yourself—your thoughts, feelings, body, or sense of identity. It’s like watching yourself from the outside, as if you’re an observer of your own life rather than actively living it.

People experiencing depersonalisation often describe feeling like they’re “not themselves,” living in a dream, or like their body doesn’t belong to them. Despite these unsettling feelings, they typically maintain awareness that these sensations aren’t actually real—they know intellectually that they are themselves, even though it doesn’t feel that way.

Depersonalisation is one of the most common dissociative experiences, affecting millions of people worldwide. It can range from brief, mild episodes that many people experience occasionally to persistent, distressing symptoms that significantly impact daily life. Understanding depersonalisation is crucial because it helps normalise these frightening experiences and provides a foundation for healing.

This experience represents your brain’s attempt to protect you from overwhelming emotions, stress, or trauma. Rather than being a sign of mental illness or “going crazy,” depersonalisation is actually an adaptive response that has helped humans survive difficult situations throughout history.

What Depersonalisation Feels Like

Common Descriptions

People experiencing depersonalisation often struggle to articulate their experiences because the sensations are so unusual and deeply personal. Here are some common ways people describe depersonalisation:

Observing Yourself:

• “I feel like I’m watching myself from outside my body”
• “It’s like I’m an actor playing the role of myself”
• “I feel like I’m behind glass, looking at my own life”
• “I’m present but not really there”
• “Like watching a movie of my own life”

Body Disconnection:

• “My hands don’t feel like they belong to me”
• “When I look in the mirror, I don’t recognise myself”
• “My body feels foreign or unfamiliar”
• “I feel like I’m floating or not quite in my body”
• “My limbs feel mechanical or robotic”

Emotional Detachment:

• “I can’t feel my emotions, like they’re behind a wall”
• “I know I should be sad/happy/angry, but I can’t access the feeling”
• “My emotions feel muffled or distant”
• “I feel emotionally numb or empty”
• “Like my feelings are happening to someone else”

Identity Confusion:

• “I don’t feel like myself”
• “I’m not sure who I am anymore”
• “I feel like a stranger to myself”
• “My personality feels fake or artificial”
• “I don’t recognise my own thoughts or voice”

Physical Sensations

Depersonalisation often includes specific physical experiences:

Visual Changes: Feeling like you’re looking through a fog or haze, vision may seem flat or two-dimensional, colours might appear dull or overly bright, and difficulty recognising your own reflection.

Sensory Alterations: Reduced sensitivity to touch, pain, or temperature, sounds may seem distant or muffled, taste and smell might be diminished, and feeling disconnected from physical sensations.

Spatial Disorientation: Feeling like your head is detached from your body, sense of floating or being lighter than usual, confusion about your body’s position in space, and feeling larger or smaller than usual.

Types and Patterns of Depersonalisation

Acute vs. Chronic Depersonalisation

Acute Depersonalisation: Sudden onset, often triggered by specific events. Intense but typically shorter duration (minutes to hours). May be accompanied by panic or severe anxiety. Often occurs during times of high stress and may resolve on its own once stressor passes.

Chronic Depersonalisation: Persistent, ongoing experiences lasting weeks, months, or years. May be constant or fluctuate in intensity. Often less intense than acute episodes but more persistent. May become the person’s baseline experience and usually requires professional intervention.

Severity Levels

Mild Depersonalisation: Subtle sense of disconnection that may be dismissed as stress or fatigue, with minimal interference with daily functioning and often brief and self-resolving.

Moderate Depersonalisation: Clear sense of detachment from self with noticeable impact on relationships and activities, causes distress or concern, and may interfere with work or social functioning.

Severe Depersonalisation: Overwhelming sense of disconnection with significant functional impairment, high levels of distress and anxiety, and may be accompanied by other dissociative symptoms.

Causes and Risk Factors

Trauma-Related Causes

Depersonalisation often develops as a protective response to traumatic experiences:

Childhood Trauma: Physical, sexual, or emotional abuse; severe neglect or emotional unavailability of caregivers; witnessing domestic violence or family conflict; medical trauma or prolonged hospitalisations; loss of parent or primary caregiver.

Adult Trauma: Physical or sexual assault; accidents or life-threatening experiences; combat exposure or war trauma; medical emergencies or serious illness; sudden loss or bereavement.

Attachment Trauma: Inconsistent or frightening caregiving in childhood; emotional neglect or invalidation; role reversal (becoming caregiver to parent); repeated abandonment or rejection experiences; disorganised attachment patterns.

Mental Health Factors

Depersonalisation is often associated with other mental health conditions including anxiety disorders (panic disorder, social anxiety, generalised anxiety), mood disorders (depression, bipolar disorder), and other conditions like PTSD, dissociative disorders, eating disorders, and obsessive-compulsive disorder.

Biological and Medical Factors

Various physical factors can contribute to depersonalisation including medical conditions (epilepsy, migraines, thyroid disorders), medications (antidepressants, anti-anxiety medications), substances (marijuana, alcohol, hallucinogens), and hormonal changes (puberty, menstrual cycle, pregnancy, menopause).

The Neuroscience of Depersonalisation

Brain Regions Involved

Research has identified specific brain areas that show altered activity during depersonalisation:

Prefrontal Cortex: Hyperactivity in areas responsible for self-monitoring may create the “observing self” experience and is involved in emotional regulation and self-awareness. Changes may contribute to emotional numbing.

Insula: Reduced activity in this body-awareness centre normally integrates bodily sensations with emotions. Decreased function may explain physical disconnection and is important for sense of embodied self.

Anterior Cingulate Cortex: Altered activity in areas monitoring internal states, involved in emotional processing and self-awareness. Changes may contribute to emotional detachment and are important for integrating thoughts and feelings.

Protective Brain Function

Depersonalisation appears to serve important protective functions: emotional protection (shields consciousness from overwhelming emotions), trauma buffer (allows psychological survival during overwhelming experiences), stress response (provides distance from intolerable stress), and survival mechanism (may have evolutionary advantages in life-threatening situations).

Impact on Daily Life

Cognitive and Mental Functioning

Depersonalisation can significantly affect thinking and mental processes through concentration difficulties (attention drawn to unusual internal experience), memory problems (difficulty forming memories during episodes), decision-making challenges (uncertainty about own thoughts and feelings), and creativity issues (feeling disconnected from creative impulses).

Relationships and Social Connection

Depersonalisation can create significant challenges in relationships including emotional intimacy difficulties (trouble accessing and expressing emotions), social interaction problems (feeling like going through motions socially), communication issues (difficulty explaining experiences to others), and parenting concerns (feeling disconnected from parenting role).

Safety Considerations

While depersonalisation itself isn’t dangerous, it can create risks through impaired judgement (taking unnecessary risks due to feeling “unreal”) and self-harm risk (some people may harm themselves to “feel real”). Important to develop alternative coping strategies and may need professional support for safety planning.

Coping Strategies and Management

Immediate Grounding Techniques

When experiencing depersonalisation, these strategies can help reconnect with yourself:

Physical Grounding: Hold ice cubes or splash cold water on face; press feet firmly into ground and feel the contact; pinch or gently slap arms (safely) to increase awareness; do physical exercise or movement; focus on breathing and make it intentional.

Sensory Reconnection: Listen to music and focus on different instruments; look at photos that have emotional meaning; smell strong scents like peppermint or coffee; eat something with intense flavour; touch different textures mindfully.

Cognitive Strategies: Remind yourself: “This is depersonalisation, it will pass”; list facts about yourself and your life; describe your surroundings in detail out loud; use affirmations: “I am real, I am here, I am me”; connect with your personal history and memories.

Emotional Reconnection: Try to identify any emotions you can access; look at photos that usually evoke emotion; listen to music that typically moves you; think about people you love; practice self-compassion and patience.

Long-Term Management Strategies

Daily Grounding Practice: Incorporate grounding exercises into daily routine; practice body awareness through yoga or stretching; maintain regular exercise and physical activity; spend time in nature when possible.

Stress Management: Identify and address stress triggers; develop healthy coping mechanisms; practice relaxation techniques regularly; maintain good sleep hygiene and regular schedule.

Emotional Awareness: Keep an emotion journal to track patterns; practice mindfulness to increase awareness; work on identifying and naming emotions; develop emotional vocabulary and expression skills.

Professional Treatment Options

Therapy Approaches: Cognitive Behavioural Therapy (CBT) for symptom management; Dialectical Behaviour Therapy (DBT) for emotional regulation; trauma-focused therapy if trauma is involved; mindfulness-based interventions; Acceptance and Commitment Therapy (ACT).

Medication Considerations: Antidepressants may help with associated depression/anxiety; anti-anxiety medications for acute episodes; some people benefit from mood stabilisers; important to work with psychiatrists familiar with dissociation.

Living with Depersonalisation

Building Self-Awareness and Acceptance

Learning to live with depersonalisation often involves understanding your patterns (notice what triggers episodes, track intensity and duration), developing self-compassion (remember that depersonalisation is not your fault, treat yourself with kindness), and finding meaning (some people develop greater self-awareness through their experience).

Communication and Relationships

Explaining Depersonalisation: Use simple, concrete language; help others understand it’s not about them; explain that you’re not choosing to be disconnected; share resources that explain the condition.

Maintaining Connections: Make effort to stay connected even when symptoms are present; communicate your needs and limitations clearly; ask for patience and understanding; express appreciation for support received.

Hope and Recovery

Many people with depersonalisation experience significant improvement. Recovery possibilities include symptoms often decreasing with appropriate treatment, many people learning effective management strategies, quality of life improving substantially, and some people recovering completely over time.

Grounding Exercise

Take a moment now to reconnect with yourself. Place both hands on your chest and feel your heartbeat. Say your name out loud. Look around and name three objects you can see. Take five deep breaths and remind yourself: “I am here, I am real, I am me.” Even if it doesn’t feel completely true right now, these things are true, and the feeling of connection will return.

Crisis Resources

If you’re in immediate crisis:

• Emergency Services: 999 (UK)
• Samaritans: 116 123 (free, 24/7)
• Crisis Text Line: Text SHOUT to 85258
• NHS 111: For urgent but non-emergency support

Remember: This article is for educational purposes and doesn’t replace professional medical advice. If you’re experiencing persistent depersonalisation, please consult with a qualified mental health professional who understands dissociative experiences.

Recommended Reading

For Understanding Depersonalisation:

• “Feeling Unreal: Depersonalization Disorder and the Loss of the Self” by Daphne Simeon – Comprehensive guide by leading expert
• “The Stranger in the Mirror” by Marlene Steinberg – Understanding dissociative experiences including depersonalisation
• “Overcoming Depersonalization and Feelings of Unreality” by Anthony David – Practical guide to managing symptoms

For Healing and Recovery:

• “Coping with Trauma-Related Dissociation” by Suzette Boon, Kathy Steele, and Onno van der Hart – Practical skills for reconnection
• “The Body Keeps the Score” by Bessel van der Kolk – Understanding trauma’s impact on sense of self
• “Complex PTSD: From Surviving to Thriving” by Pete Walker – Healing from trauma that often includes depersonalisation

References

1. Briere, J., & Scott, C. (2015). Principles of Trauma Therapy. Sage Publications.
2. Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalisation and derealisation: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 39(1), 9-18.
3. Sierra, M., & David, A. S. (2011). Depersonalization: A selective impairment of self-awareness. Consciousness and Cognition, 20(1), 99-108.
4. Simeon, D., & Abugel, J. (2006). Feeling Unreal: Depersonalization Disorder and the Loss of the Self. Oxford University Press.
5. Simeon, D., Guralnik, O., Hazlett, E. A., Spiegel-Cohen, J., Hollander, E., & Buchsbaum, M. S. (2000). Feeling unreal: A PET study of depersonalization disorder. American Journal of Psychiatry, 157(11), 1782-1788.
6. Steinberg, M., & Schnall, M. (2000). The Stranger in the Mirror. HarperCollins.

Frequently Asked Questions