Depersonalization vs derealization: what’s the difference?

“I don’t feel like me.” “Nothing around me feels real.” These two experiences sound similar, and they often show up together, but they’re slightly different. One is about you, the other is about the world.

Here’s how to tell depersonalization from derealization, and why, in the end, the same things help both.

The short answer

Depersonalization is feeling detached from yourself: your body, your thoughts, your feelings or your actions. It can feel like watching yourself from outside, or like being on autopilot.

Derealization is feeling detached from the world around you. Places, objects and people can seem unreal, foggy, flat or dreamlike.

Many people have both. Doctors group them together as one condition, depersonalization-derealization disorder, when the feelings keep coming back or won’t go away and cause distress. You can read about the condition in Depersonalization-derealization disorder, explained.

Side by side

	Depersonalization	Derealization
What feels unreal	You	The world around you
Common words	“I’m watching myself”, “I’m a robot”, “my hands aren’t mine”	“It’s like a dream”, “everything’s behind glass”, “it looks fake”
Body	Feeling numb, floaty, weightless or cut off from your body	Objects looking flat, too far, too close, or the wrong size
Emotions	Feeling emotionally blunted, even towards people you love	Familiar places and people feeling strange or distant
Senses	Your own voice sounding odd	Sounds muffled or echoey, colours dull or too bright

What depersonalization feels like

People describe depersonalization as:

• watching their life like a film, from slightly behind or above themselves
• doing things on autopilot, as if someone else is moving their body
• looking in the mirror and not feeling like the face is theirs
• feeling emotions from a distance, or not at all
• memories feeling like they happened to someone else

What derealization feels like

People describe derealization as:

• the world looking like a film set, a video game or a painting
• seeing everything through fog, glass or a veil
• familiar places suddenly looking strange or new
• people seeming like actors, or not quite real
• time speeding up, slowing down or feeling disjointed

We go into more detail in What does derealization feel like?

Why they happen together

Both are forms of dissociation: the mind turning down the volume on experience. When your brain senses overwhelming stress or threat, it can dial down feelings, which can make you feel detached from yourself, the world, or both. That’s why they often appear during or after panic attacks, intense anxiety, trauma, exhaustion or drug use, especially cannabis.

Neither one is psychosis

This is the most important thing to know, because it’s one of the biggest fears. With both depersonalization and derealization, you know that you are real and the world is real. It just doesn’t feel that way. People with psychosis lose that awareness. The fact that you’re worried about it is a good sign that you haven’t.

Does it matter which one I have?

Not much, when it comes to getting better. The same things help both:

• Ground yourself through your senses: hold something cold, smell something strong, or name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell and 1 you can taste.
• Lower your anxiety: slow breathing with a longer out-breath helps here.
• Check less: constantly testing whether you feel real keeps your attention locked on the feeling.
• Keep doing things you value, even if they feel unreal for now. The feeling tends to fade when it gets less attention.
• Look after the basics: sleep, regular meals and avoiding cannabis.

If the feelings keep coming back or won’t go away, talking therapy, particularly cognitive behavioural therapy (CBT) adapted for depersonalization, helps many people.

How Breatheasy can help

Whichever you’re feeling, Breatheasy can help you ground yourself. Tap “I’m feeling anxious” and Luma walks you through it: rate how strong it feels from 1 to 10, breathe slowly as your phone pulses gently, ground yourself with 5-4-3-2-1, then see how far the anxiety came down. It works without internet, and it’s always free. Breatheasy is coming soon to iPhone and Android.

When to get help

See a doctor if depersonalization or derealization keeps coming back, lasts a long time, or is getting in the way of your life. Get checked straight away if the feelings started suddenly after a head injury, or come with other new symptoms like severe headaches, confusion, seizures or changes in your vision.

Sources

• Depersonalization-derealization disorder, Cleveland Clinic
• Dissociative disorders, NHS
• Hunter, Phillips, Chalder, Sierra and David (2003). Depersonalisation disorder: a cognitive–behavioural conceptualisation. Behaviour Research and Therapy.