Depersonalization:
Strange but Harmless

Depersonalization, (also called derealization), is one of the many symptoms of a panic attack. Of all the panic symptoms, it's probably the hardest to describe, or even recognize as a symptom. For this reason, it can be quite disturbing to people who experience it, even though it is completely harmless.

Depersonalization is a combination of physical sensations, emotions, and thoughts which lead you to feel so disengaged from your surroundings that you wonder whether or not you're actually in your body. People experiencing this symptom may fear that they're actually someplace else, watching their body sleepwalk through life while they float around in some kind of spirit world.

A patient of mine once described an experience she had while riding in the back seat of a car with several friends. She had become detached from the conversation, felt more and more removed from what was going on, and was stricken with a panic attack during which she wondered if she were still in the car, or if she had somehow left her body and was watching from the sidewalk. She knew the thought was ludicrous, but continued to think about it anyway, and feared that she might never get reconnected to herself again.

People have a variety of reactions to depersonalization, but a common theme is that they are losing touch with reality, and they fear they will lose it for good. Here are some descriptions of the derealization experience I have received from readers and patients.

How People Describe Depersonalization

Sally:
If I have to interact with people for too long, especially when I have to defend an issue, this is what starts to happen:

I start to get tunnel vision. My ears start burning. My face gets hot. The world seems to drop away - I am solely in this situation. I lose track of what I'm saying. I am in complete "unreal" mode and don't know where I am.

Elaine:
In situations where I don't feel part of the group, I feel isolated. It's a feeling of not being in control, or of not feeling like I'm part of the situation. I tend to feel like I need to have control of all situations, so when I feel like I don't have control, I feel uncomfortable. I actually feel like I'm not there.

John:
For me, depersonalization means that I suddenly feel as though I am "not real" - that feeling of "Is this me? Am I myself? Or, is this all a dream?" It is a bizarre feeling. Sometimes I am looking at myself from the outside, other times I get confused as to whether or not I am really thinking the thoughts that I am thinking...if I really keep concentrating on something that has been bothering me, or am worrying about things that are not happening at the present time, I tend to suddenly slip into this mode. I usually try to snap out of it and do something - make a phone call, take a walk, anything to "bring me back" to reality.

Margaret:
If I'm with friends, I find my vision altering suddenly. They will seem almost flat and two-dimensional, as do my surroundings. I feel like a "spectator", as if there is a definite distance between me and my surroundings. I often feel as if I'm in a dream...on autopilot. I find it a lot easier to deal with my physical symptoms.

Suzanne:
I always feel like I am not 100% here. I have developed a persona on top of this which allows me to interact, but in my basic self I am very aloof. I have spent the majority of my life disconnected...and keep waiting for the moment when I will be part of the world again.

I think there are three useful questions to ask about depersonalization.

What Does it Mean?

It means the same thing as any other panic symptom. It means "I'm afraid! I'm having a panic attack!"

However weird it feels, it has nothing to do with "losing control".

All panic symptoms mean the same thing, even though the symptoms differ from each other. Some are physical sensations; some are emotions; some are thoughts. But in the end, they all mean the same thing: I'm scared. They're different ways of experiencing the same reaction.

Why Does it Happen?

Depersonalization seems to occur when you have become less involved with what's going on around you, especially the people around you, and become preoccupied with your own thoughts. These are typically not thoughts about your immediate surroundings, but thoughts of other people, times and places. The less energy and attention you bring to your immediate circumstances, the more your thoughts wander toward ideas that can only happen in your imagination.

What Should I Do?

First and foremost, remember that the experience of depersonalization is all discomfort, not danger. Your job, while experiencing derealization, is to see if you can make yourself a little more comfortable while waiting for it to end. If you just ride it out, nothing terrible will happen.

The best way to relieve the discomfort of depersonalization is to follow the AWARE sequence of coping steps for a panic attack.

You can specifically address the symptom of depersonalization as you follow the AWARE steps by emphasizing the following points:

1. Acknowledge and accept the symptom. Remind yourself that it is a source of discomfort, but not danger.

2. Return your attention to the immediate environment, rather than your thoughts of other times and places. Don't argue with your thoughts, just refocus your attention.

3. Become more actively engaged with the people, activities, and objects immediately around you. Get back into the conversation and activities that the others are involved in. I think you'll find that the odd feelings lessen as you get more involved in your present surroundings.

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