Experiencing a persistent sensation of feeling “high” or detached, even without substance use, can be disorienting. This common phenomenon often has explainable origins. Understanding these sensations can help alleviate distress and provide a path toward feeling more grounded. This article explores the nature of these feelings and their potential causes.
Defining the Sensation
The feeling of being “high” in a non-substance context often involves two distinct but related sensations: depersonalization and derealization. Depersonalization refers to a feeling of detachment or unreality concerning oneself. Individuals might feel like an outside observer of their own thoughts, feelings, body, or actions, including feeling emotionally numb, robot-like, or as if memories lack emotional connection.
Derealization, on the other hand, involves feeling detached from one’s surroundings, where the external world appears unreal, foggy, dreamlike, or distorted. Objects and people might seem blurred, unnaturally sharp, or appear the wrong size or color. Time might also seem to speed up, slow down, or stand still. Both depersonalization and derealization are forms of dissociation. While these experiences can be frightening, individuals usually remain aware that these altered perceptions are not actual reality.
Common Psychological and Lifestyle Triggers
Various non-medical factors can trigger feelings of depersonalization and derealization, often stemming from psychological states and daily habits. Chronic stress is a common trigger, as prolonged exposure to stress hormones can disrupt normal brain functioning and lead to feelings of detachment. Severe stress, including emotional or physical abuse or witnessing domestic violence, can also contribute to these dissociative symptoms.
Anxiety, especially during panic attacks or generalized anxiety disorder, is another trigger. During intense anxiety, the body’s “fight-or-flight” response can redirect blood flow away from the brain’s higher processes responsible for interpreting reality. This physiological shift can result in light-headedness and an “out-of-body” sensation. Some theories suggest that depersonalization and derealization may serve as a protective mechanism, buffering the mind from overwhelming stress during a panic attack.
Lack of sleep and fatigue can blur the lines between reality and unreality, contributing to dissociative symptoms. Even a single night of severe sleep deprivation can induce depersonalization, which typically resolves once adequate sleep is restored. Hyperventilation, or rapid, shallow breathing, often accompanies anxiety and can further reduce blood flow to the brain, intensifying feelings of detachment. This can worsen existing depersonalization symptoms.
Underlying Medical Conditions and Medications
Beyond psychological and lifestyle factors, certain medical conditions and prescription medications can induce sensations resembling a “high” or detachment. Neurological conditions like migraines with aura can present with symptoms including depersonalization or derealization. Inner ear disorders, which affect balance and spatial orientation, might also contribute to feelings of unreality or disorientation.
Epilepsy, particularly temporal lobe epilepsy, is another neurological condition that can cause dissociative symptoms as part of its seizure activity. Traumatic brain injuries can also lead to similar experiences of detachment or altered perception. These feelings of unreality result from physical or electrical changes within the brain.
Certain prescription medications can have depersonalization or derealization as a side effect. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can induce these feelings in some individuals. Anxiety medications, while often used to manage anxiety, can also, in rare instances, exacerbate feelings of depersonalization. Other medications, such as the antibiotic minocycline, have been reported to cause transient depersonalization symptoms, which typically resolve once discontinued.
When to Seek Professional Guidance and Support
If feelings of depersonalization or derealization are persistent, severe, or interfere with daily life, seeking professional guidance is advisable. Consulting a doctor for a proper diagnosis is an important first step, especially if symptoms are accompanied by other concerning signs. A medical evaluation can help rule out underlying physical health problems, medication side effects, or other medical issues.
Diagnostic steps may include a physical examination, lab tests, and a mental health evaluation. During the mental health evaluation, discussing symptoms, thoughts, feelings, and behavioral patterns can help determine if the sensations are part of a recognized condition like depersonalization-derealization disorder or another mental health concern. Early detection and intervention can lead to a more positive outcome.
Beyond diagnosis, various strategies can help manage these sensations:
- Psychotherapy, particularly cognitive-behavioral therapy (CBT), is a primary treatment approach, helping individuals identify triggers, reframe distressing thoughts, and develop coping mechanisms.
- Grounding techniques involve engaging the senses to reconnect with the present moment, such as touching an object, listening to music, or focusing on breathing patterns.
- Mindfulness practices and regular exercise can reduce stress and improve emotional regulation.
- Maintaining social connections and talking with trusted friends or family can provide support and reduce feelings of isolation.