Derealization (DR) is a psychiatric condition in which a person’s perception of reality is altered in such a way that everything feels unfamiliar or unreal. DR is typically not a stand-alone disorder, but a side effect of severe anxiety, panic or certain types of drug use or withdrawal. It may also occur with some neurological disorders, such as epilepsy, head injury or migraine.

DR is a dissociative symptom, meaning that it produces feelings of detachment from the self or the environment. The feelings of detachment that come with derealization are said to be like an invisible veil or fog has been placed between oneself and the outside world. Some sufferers say it feels like the external world is just a TV show, as if one is simply an observer of an unfamiliar world. A person who is experiencing derealization will often say there is a lack of emotional connection to familiar people, places and things. Feelings of deja vu are also common.

The symptoms of DR tend to be very frightening and disturbing, and the sufferer often has a hard time believing that they are only the result of anxiety and not something much more serious. This anxiety intensifies the derealization, which in turn intensifies the anxiety, often resulting in a vicious cycle.

Another closely related dissociative disorder is called depersonalization — feelings of unreality in one’s own self rather than the external world. Although derealization and depersonalization often occur together, they are considered distinct symptoms. While most people who experience derealization or depersonalization recover fairly quickly, there are some individuals who continue to have symptoms long-term, typically after a major trauma. When this happens, it is called depersonalization-derealization disorder.

Example: One month after his panic attacks began, Jeff started to have episodes in which he would feel as if nothing was real.