The experience of feeling detached, lightheaded, or strangely “stoned” without consuming intoxicating substances is a confusing and often unsettling phenomenon. This sensation of unreality or mental fog is far more common than most people realize, ranging from mild wooziness to a profound sense of disconnection from one’s body or environment.
When people describe feeling “high,” they refer to a cluster of neurological and physical symptoms. These often include a sense of floating, visual changes, mental fogginess, or feeling like one is observing life rather than participating in it. This symptom is not a single disorder but a common manifestation of several underlying psychological and physiological processes.
The Role of Dissociation in Altered Reality
One psychological explanation for feeling unreal is dissociation, a mental process causing a lack of connection in a person’s thoughts, memory, and sense of identity. This coping mechanism is often triggered by overwhelming stress, trauma, or an acute sense of danger. The sensation of feeling high or spaced-out frequently results from two specific forms of dissociation: depersonalization and derealization.
Depersonalization involves feeling detached from oneself, as if watching one’s actions, feelings, and thoughts from a distance. People experiencing this may feel numb, robotic, or not in control of their body. Their own voice may sound foreign, or they may feel a profound sense of emotional detachment from loved ones.
Derealization is the feeling that the world around you is unreal, dreamlike, or artificial. The environment may appear distorted, blurry, or flat, and objects might seem to be the wrong size or color. Time may feel like it is speeding up or slowing down, contributing to the sense of being in a fog.
These dissociative states are temporary psychological defenses that allow the mind to retreat from a situation it perceives as too threatening or overwhelming. While these feelings mimic the effects of intoxication, they are not a sign of psychosis. The defining difference is that the person retains a clear awareness that the feelings of unreality are not normal and that their perception is altered.
Vestibular Issues and Physical Disorientation
The body’s inner workings can produce a physical sensation of floating or disorientation often interpreted as being high. The vestibular system, located in the inner ear, is the primary sensory system responsible for balance and spatial orientation. This system sends signals to the brain about head position and movement, allowing us to maintain equilibrium.
Dysfunction in the vestibular system causes a false sense of motion or instability, known as vertigo or dizziness. While vertigo is typically a spinning sensation, subtle dysfunction can create the feeling of being off-balance, woozy, or floating. This occurs when signals from the inner ear conflict with visual information or proprioception, the body’s sense of where it is in space.
Common Vestibular Issues
Common vestibular issues include Benign Paroxysmal Positional Vertigo (BPPV), where tiny calcium crystals in the inner ear become dislodged. Another cause is Vestibular Neuritis, which involves inflammation of the vestibular nerve, often following a viral infection. Persistent Postural-Perceptual Dizziness (PPPD) involves chronic, non-spinning dizziness, unsteadiness, or a floating sensation that can last for months or years.
Anxiety, Panic, and the Acute Stress Response
Anxiety and panic attacks are frequent non-drug-related triggers for feeling intoxicated or disconnected. This occurs due to the activation of the body’s acute stress response, or the fight-or-flight mechanism. When the brain registers a threat, it releases hormones like adrenaline and cortisol, preparing the body for immediate action.
This response causes physical changes such as a rapid heart rate, muscle tension, and shifts in breathing patterns. Intense anxiety often leads to hyperventilation, where a person breathes too quickly or deeply, exhaling more carbon dioxide than the body produces. This rapid exhalation leads to hypocapnia, a low level of carbon dioxide in the bloodstream.
The low carbon dioxide level causes cerebral vasoconstriction, which is the constriction of blood vessels in the brain. This narrowing temporarily reduces blood flow and oxygen delivery to certain brain parts. This transient reduction in cerebral blood flow directly triggers symptoms such as lightheadedness, mental fogginess, visual disturbances, and the feeling of unreality.
The physical symptoms of hyperventilation also include tingling or numbness, particularly in the hands, feet, and around the mouth. These sensations, combined with the cognitive distortion from vasoconstriction, create a physical state that mimics intoxication. These symptoms are a direct physiological consequence of the body’s overreaction to perceived danger.
Specific Medical Triggers and When to Consult a Doctor
A range of other physiological conditions can also produce symptoms of lightheadedness, disorientation, or a sense of floating. Vestibular migraines, for example, can present with dizziness, unsteadiness, and spatial disorientation even without a severe headache. The mechanism involves temporary changes in blood flow and nerve signaling in the brain.
Changes in blood pressure can also cause wooziness. Orthostatic hypotension occurs when blood pressure drops suddenly upon standing up, leading to a brief sensation of lightheadedness or faintness. Similarly, low blood sugar (hypoglycemia) can cause confusion, slurred speech, and disorientation, which may be misinterpreted as intoxication.
Many prescription and over-the-counter medications list dizziness, lightheadedness, or cognitive fog as potential side effects. This includes psychiatric drugs, sedatives, and some allergy medications. These symptoms result from how the medication influences neurotransmitters or blood flow regulation. Consulting a physician is advisable when these symptoms appear after starting a new medication.
It is important to seek medical evaluation for any persistent or recurring feelings of unreality or disorientation to rule out a serious cause. Immediate medical attention is necessary if the feeling is accompanied by severe symptoms:
- A sudden, intense headache.
- Chest pain or a rapid or irregular heartbeat.
- Confusion or slurred speech.
- Loss of feeling or movement in the limbs.
- Difficulty walking.
These severe symptoms may indicate a stroke or other acute neurological event.