Derealization - Wikipedia https://en.wikipedia.

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Derealization
From Wikipedia, the free encyclopedia

Derealization or derealisation (sometimes abbreviated as DR) is an

alteration in the perception or experience of the external world so
that it seems unreal. Other symptoms include feeling as though one's
environment is lacking in spontaneity, emotional colouring, and
depth.[1] It is both a dissociative symptom of many conditions.

Derealization is a subjective experience of unreality of the outside

world, while depersonalization is sense of unreality in one's personal
self, although most authors currently do not regard derealization
(surroundings) and depersonalization (self) as separate constructs.

Chronic derealization may be caused by occipitaltemporal

dysfunction.[2] These symptoms are common in the population, with
For sufferers of derealization the
a lifetime prevalence of up to 5% and 3166% at the time of a
surrounding environments may be
traumatic event.[3]
hard to experience fully.

Contents
1 Description
2 Causes
3 See also
4 References

Description
The detachment of derealization can be described as an immaterial substance that separates a person from
the outside world, such as a sensory fog, pane of glass, or veil. Individuals may report that what they see
lacks vividness and emotional coloring. Emotional response to visual recognition of loved ones may be
significantly reduced. Feelings of dj vu or jamais vu are common. Familiar places may look alien, bizarre,
and surreal. The world as perceived by the individual may feel like it is going through a dolly zoom effect.
Such perceptual abnormalities may also extend to the senses of hearing, taste, and smell. The degree of
familiarity one has with their surroundings is among one's sensory and psychological identity, memory
foundation and history when experiencing a place. When a person is in a state of derealization, they block
this identifying foundation from recall. This "blocking effect" creates a discrepancy of correlation between
one's perception of one's surroundings during a derealization episode, and what that same individual would
perceive in the absence of a derealization episode.

Frequently, derealization occurs in the context of constant worrying or "intrusive thoughts" that one finds
hard to switch off. In such cases it can build unnoticed along with the underlying anxiety attached to these
disturbing thoughts, and be recognized only in the aftermath of a realization of crisis, often a panic attack,
subsequently seeming difficult or impossible to ignore. This type of anxiety can be crippling to the affected

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and may lead to avoidant behavior. Those who experience this phenomenon may feel concern over the cause
of their derealization. It is often difficult to accept that such a disturbing symptom is simply a result of
anxiety, and the individual may often think that the cause must be something more serious. This can, in turn,
cause more anxiety and worsen the derealization. Derealization also affects the learning process. Because
the individual almost sees the events as if in third person, they cannot properly process information.

People experiencing derealization describe feeling as if they are viewing the world through a TV screen.
This, and other similar feelings attendant to derealization, can cause a sensation of alienation and distance
between the person suffering from derealization and others around them.

Partial symptoms would also include the feeling of being an "observer"/an "observer effect" on the planet,
with everything happening or being experienced through their own eyes (similar to a first person camera in a
game).

Causes
Derealization can accompany the neurological conditions of epilepsy (particularly temporal lobe epilepsy),
migraine, and mild head injury.[4] There is a similarity between visual hypo-emotionality, a reduced
emotional response to viewed objects, and derealization. This suggests a disruption of the process by which
perception becomes emotionally coloured. This qualitative change in the experiencing of perception may
lead to reports of anything viewed being unreal or detached.[2]

Derealization can also manifest as an indirect result of certain vestibular disorders such as labyrinthitis. This
is thought to result from the experience of anxiety precipitated by the functional disparity that arises
between the ability to reconcile external stimuli relative to motion and equilibrioception that are
compromised by vestibular dysfunction with the internal perceptions and expectations regarding the
physical environment. An alternative explanation holds that a possible effect of vestibular dysfunction
includes responses in the form of the modulation of noradrenergic and serotonergic activity due to a
misattribution of vestibular symptoms to the presence of imminent physical danger resulting in the
experience of anxiety or panic, which subsequently generate feelings of derealization.[5]

Cannabis,[6] psychedelics, dissociatives, antidepressants, caffeine, nitrous oxide, albuterol, and nicotine can
all produce feelings resembling derealization, particularly when taken in excess. It can result from alcohol
withdrawal or benzodiazepine withdrawal.[7] Opiate withdrawal can also cause feelings of derealization.

Derealization can also be a symptom of severe sleep disorders and mental disorders like depersonalization
disorder, borderline personality disorder, bipolar disorder, schizophrenia, dissociative identity disorder, and
anxiety disorders.[8]

Interoceptive exposure can be used as a means to induce derealization, as well as the related phenomenon
depersonalization.[9]

See also
Depersonalization Post-traumatic stress disorder
nyat Dissociative disorders
Ego death Existential crisis
Temporal lobe epilepsy Mystical psychosis

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Spiritual emergency Spectacle

Solipsism syndrome Falling (sensation)
Fugue state Weltschmerz
Reality

References
1. American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR
(Text Revision). American Psychiatric Association. ISBN 0-89042-024-6.
2. Sierra M, Lopera F, Lambert MV, Phillips ML, David AS (2002). "Separating depersonalisation and
derealisation: the relevance of the "lesion method" " (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737835).
J. Neurol. Neurosurg. Psychiatr. 72 (4): 5302. doi:10.1136/jnnp.72.4.530 (https://doi.org
/10.1136%2Fjnnp.72.4.530). PMC1737835 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1737835) .
PMID11909918 (https://www.ncbi.nlm.nih.gov/pubmed/11909918).
3. Hunter EC, Sierra M, David AS (2004). "The epidemiology of depersonalization and derealisation. A systematic
review". Social psychiatry and psychiatric epidemiology. 39 (1): 918. doi:10.1007/s00127-004-0701-4
(https://doi.org/10.1007%2Fs00127-004-0701-4). PMID15022041 (https://www.ncbi.nlm.nih.gov/pubmed
/15022041).
4. Lambert MV, Sierra M, Phillips ML, David AS (2002). "The spectrum of organic depersonalization: a review
plus four new cases". The Journal of neuropsychiatry and clinical neurosciences. 14 (2): 14154.
doi:10.1176/appi.neuropsych.14.2.141 (https://doi.org/10.1176%2Fappi.neuropsych.14.2.141). PMID11983788
(https://www.ncbi.nlm.nih.gov/pubmed/11983788).
5. Simon, NM; Pollack MH; Tuby KS; Stern TA. (June 1998). "Dizziness and panic disorder: a review of the
association between vestibular dysfunction and anxiety". Ann Clin Psychiatry. 10 (2): 7580.
doi:10.3109/10401239809147746 (https://doi.org/10.3109%2F10401239809147746). PMID9669539
(https://www.ncbi.nlm.nih.gov/pubmed/9669539).
6. Johnson BA (February 1990). "Psychopharmacological effects of cannabis". Br J Hosp Med. 43 (2): 1146,
11820, 122. PMID2178712 (https://www.ncbi.nlm.nih.gov/pubmed/2178712).
7. Mintzer MZ; Stoller KB; Griffiths RR (November 1999). "A controlled study of flumazenil-precipitated
withdrawal in chronic low-dose benzodiazepine users". Psychopharmacology (Berl). 147 (2): 2009.
doi:10.1007/s002130051161 (https://doi.org/10.1007%2Fs002130051161). PMID10591888
(https://www.ncbi.nlm.nih.gov/pubmed/10591888).
8. Simeon D, Knutelska M, Nelson D, Guralnik O (September 2003). "Feeling unreal: a depersonalization disorder
update of 117 cases". J Clin Psychiatry. 64 (9): 9907. doi:10.4088/JCP.v64n0903 (https://doi.org
/10.4088%2FJCP.v64n0903). PMID14628973 (https://www.ncbi.nlm.nih.gov/pubmed/14628973).
9. Lickel J, Nelson E, Lickel AH, Deacon B (2008). "Interoceptive Exposure Exercises for Evoking
Depersonalization and Derealization: A Pilot Study" (http://www.uw-anxietylab.com/uploads/7/6/0/4/7604142
/ie_for_derealization.pdf) (PDF). Journal of Cognitive Psychotherapy. 22 (4): 321330.
doi:10.1891/0889-8391.22.4.321 (https://doi.org/10.1891%2F0889-8391.22.4.321).

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