The sensation of feeling “high” or “out of it” without consuming substances is a common, yet unsettling, experience. People describe this state using terms like altered reality, lightheadedness, emotional numbness, or detachment from their surroundings. This phenomenon, which can range from fleeting moments to persistent feelings of unreality, is a symptom arising from underlying psychological or physical processes. Exploring these non-intoxication-related causes helps clarify how the body and mind react to stress, metabolic changes, and neurological factors.
Psychological Contributors: Dissociation and Anxiety
One frequent explanation for feeling “not quite real” is the psychological response known as dissociation. Dissociation is a mental process where a person disconnects from their thoughts, feelings, memories, or sense of identity. This coping mechanism manifests as depersonalization, where you feel detached from yourself, or derealization, where you feel detached from the world around you.
Depersonalization involves feeling like an outside observer of your own body or thoughts, where movements or speech feel automatic. Derealization makes the external world seem foggy, dreamlike, or surreal, sometimes making surroundings appear distorted, flat, or colorless. Both are common symptoms during periods of extreme stress, chronic anxiety, or panic attacks.
When the body enters a state of high alarm, the “fight or flight” response activates, flooding the system with stress hormones. Dissociation is theorized to be the brain’s attempt to buffer the overwhelming effect of anxiety or stress, creating mental distance from the frightening experience. This temporary disconnect can be triggered by severe stress, trauma, or chronic sleep deprivation, leading to the unsettling feeling of being “spaced out” or unreal.
Physiological Explanations: Systemic Body Changes
Beyond psychological factors, systemic physical changes affecting the body’s chemistry can induce feelings of lightheadedness and altered perception. The brain depends on a steady supply of oxygen and glucose, and disruptions quickly lead to a “fuzzy” or dizzy feeling. This often occurs with hypoglycemia, or low blood sugar, which starves the brain of its primary energy source.
Dehydration significantly decreases blood volume, leading to a drop in blood pressure and reduced blood flow to the brain. Mild dehydration, caused by insufficient fluid intake or excessive sweating, produces symptoms like weakness, fatigue, and lightheadedness. These systemic issues interfere with normal brain function, creating a sensation that mimics the mental effects of intoxication.
Another common physiological trigger is orthostatic hypotension, often described as the head rush felt when standing up too quickly. This occurs because gravity pulls blood into the legs and abdomen when transitioning positions. Normally, the body compensates by narrowing blood vessels and increasing heart rate to maintain blood flow to the brain. If this mechanism is delayed or insufficient, the brief reduction in cerebral blood flow results in a momentary feeling of dizziness, blurred vision, or confusion.
Vestibular and Neurological Factors
The balance system, centered in the inner ear and brain, can also be the source of sensations that feel like being “high.” The vestibular system senses balance and spatial orientation, and disorders affecting it can create a profound sense of unreality. Inner ear conditions like labyrinthitis or Benign Paroxysmal Positional Vertigo (BPPV) disrupt signals sent to the brain, causing true vertigo—the feeling that you or your surroundings are spinning.
This sensory mismatch, where visual input conflicts with inner ear balance signals, forces the brain to reconcile conflicting information. This struggle can lead to the psychological symptoms of derealization, making the world feel distorted or the ground feel like it is shifting. The constant discomfort and disorientation from vestibular issues can also trigger anxiety, further exacerbating feelings of detachment.
A significant neurological factor is the vestibular migraine, a form that frequently occurs without a painful headache. Vestibular migraines cause episodes of intense dizziness, balance issues, and vertigo that can last minutes or days. They are strongly associated with feelings of unreality and disconnection, often described as looking at the world from behind a window or veil. Furthermore, many common medications, including those for anxiety, depression, or blood pressure, can cause side effects like dizziness or lightheadedness, which are chemical disruptions affecting the nervous system.
Next Steps and Medical Consultation
While these experiences are often linked to manageable causes like stress or mild dehydration, any persistent or severe feelings of detachment warrant discussion with a healthcare professional. It is important to rule out more serious medical conditions that present with similar symptoms, such as heart problems, neurological disorders, or medication side effects. Keep a detailed record of the symptoms, noting their frequency, duration, and any potential triggers.
If the feelings of unreality are recurring, cause significant distress, or interfere with daily functioning, a professional evaluation is necessary. Seek immediate emergency medical care if the dizziness or detachment is accompanied by severe symptoms:
- Chest pain
- A sudden, severe headache
- Fainting
- Trouble walking
- Slurred speech
A primary care physician can guide the initial assessment and may refer you to a specialist, such as a neurologist, otolaryngologist (ENT), or mental health professional, to determine the underlying cause and develop a treatment plan.