Alcohol consumption can trigger feelings of detachment and unreality in some people, linking the substance’s use to the experience of derealization. This psychological phenomenon is a type of dissociation, where the mind separates itself from reality, leading to a profound sense of disconnection. The experience can range from a transient, unsettling feeling to a more intense episode that severely impacts well-being. This article will explain the mechanism behind alcohol-induced derealization and clarify the difference between an acute effect and a symptom of withdrawal.
Understanding Derealization and Depersonalization
Derealization is a dissociative experience characterized by detachment from one’s surroundings, making the external world seem unreal or dreamlike. Individuals often report that objects appear visually distorted, blurry, or lifeless, as if a glass wall separates them from the world. Time perception can also become skewed, feeling either significantly sped up or slowed down. This state is a way the mind sometimes copes with overwhelming stress or chemical disruption.
Derealization is closely related to, but distinct from, depersonalization, which involves detachment from oneself. Depersonalization is the feeling of being disconnected from one’s own body, thoughts, or emotions, often described as observing oneself from outside, like watching a character in a movie. Both are categorized as dissociative symptoms and frequently occur together, creating a general sense of unreality.
How Alcohol Disrupts Perception and Brain Chemistry
The ability of alcohol to induce these feelings stems from its action as a central nervous system depressant, profoundly altering the brain’s neurochemical balance. Alcohol primarily targets two major neurotransmitter systems: Gamma-aminobutyric acid (GABA) and Glutamate. GABA is the principal inhibitory neurotransmitter, acting as the brain’s natural brake pedal to slow down neural activity.
Alcohol acts on the GABA-A receptor, boosting the inhibitory effects of GABA, which leads to sedation and reduced anxiety. Simultaneously, alcohol suppresses the activity of Glutamate, the brain’s main excitatory neurotransmitter, especially at the N-methyl-D-aspartate (NMDA) receptors. This dual action—increasing inhibition while decreasing excitation—results in a significant dampening of overall brain function.
The brain regions responsible for processing sensory input and integrating it into a cohesive sense of reality are highly susceptible to this chemical disruption. By suppressing the brain’s ability to process information accurately, alcohol can cause a temporary failure in the circuits that create a normal sense of self and surroundings. This alteration in neural signaling, where sensory input is incorrectly integrated, manifests as derealization.
Acute Derealization vs. Alcohol Withdrawal Symptoms
Derealization related to alcohol occurs at two distinct points: during acute intoxication or as a symptom of withdrawal. Acute derealization happens while a person is actively drinking, particularly during heavy consumption. This is a direct consequence of alcohol’s depressive effect on the central nervous system, as the brain struggles to function under the chemical imbalance. The feeling of unreality typically subsides as the alcohol is metabolized and the person becomes sober.
A different mechanism is at work when derealization occurs hours or days after drinking has stopped. Chronic heavy alcohol use causes the brain to adapt by downregulating its inhibitory (GABA) system and upregulating the excitatory (Glutamate) system to counteract the constant presence of alcohol. When alcohol is suddenly removed, the brain is left in a state of hyperexcitability, lacking the depressive influence to keep the overactive excitatory system in check.
This condition, known as rebound hyperexcitability, is a hallmark of alcohol withdrawal syndrome. The resulting surge of uncontrolled neural activity leads to symptoms like anxiety, tremors, and, in severe cases, seizures. Derealization in this context is a psychological manifestation of this neurological rebound, as the overstimulated brain struggles to process reality.
When to Consult a Medical Professional
While transient feelings of unreality during or after drinking may resolve on their own, specific situations warrant medical attention. If derealization is prolonged, recurrent, or causes significant distress that interferes with daily functioning, seek a professional evaluation. A medical doctor can help rule out other potential causes, as derealization can be a symptom of underlying anxiety disorders, panic attacks, or other medical conditions exacerbated by alcohol.
Immediate medical assistance is necessary if symptoms are accompanied by signs of severe alcohol withdrawal. These warning signs include persistent tremors, hallucinations, severe confusion, or any indication of a seizure. Attempting to manage severe alcohol withdrawal without medical supervision can be dangerous due to the risk of life-threatening complications. Consulting a healthcare provider ensures a safe assessment and the development of an appropriate treatment plan.