The experience of feeling unreal, disconnected, or “high” without consuming intoxicating substances can be deeply unsettling. This sensation of altered perception is a common symptom traced to psychological defenses, temporary shifts in body chemistry, or underlying neurological conditions. The feeling is often described as watching your life unfold from a distance, or having the world around you appear foggy, flat, or dreamlike. Understanding the potential causes of this detachment can help demystify the experience and point toward appropriate management.
Understanding Depersonalization and Derealization
The psychological explanation for feeling “unreal” involves two related phenomena: depersonalization and derealization. These are forms of dissociation, a mental process causing a lack of connection in a person’s thoughts, memory, or sense of identity.
Depersonalization is detachment from oneself, making you feel like an outside observer of your own thoughts, body, and emotions. You might feel emotionally numb, like a robot, or sense that your limbs or voice do not truly belong to you.
Derealization is detachment from your surroundings, making the external world seem unreal, distorted, or dreamlike. Objects might appear blurry, colors dull, or time might seem to speed up or slow down unnaturally.
These dissociative states are often triggered by intense stress or trauma, serving as an automatic psychological defense mechanism. The brain attempts to mentally distance itself from overwhelming emotional experiences by creating a barrier of unreality.
This survival response can be activated by non-life-threatening stressors, such as severe anxiety or panic attacks. Persistent or recurring episodes causing significant distress may be diagnosed as depersonalization-derealization disorder. The individual retains a clear understanding that their feelings of unreality are subjective, meaning the condition is not a sign of psychosis. Individuals with chronic anxiety or a history of childhood trauma are more prone to this coping style.
Physiological Triggers and Chemical Imbalances
Acute changes in the body’s internal chemistry can temporarily induce sensations of detachment and unreality.
One common physical trigger is hyperventilation, which is rapid breathing often associated with panic or high anxiety. This excessive breathing lowers the blood’s carbon dioxide (CO2) level, causing a temporary change in blood pH. This shift constricts blood vessels in the brain, reducing blood flow and resulting in lightheadedness, tingling sensations, and derealization.
Another cause is hypoglycemia, or low blood sugar, which starves the brain of its primary fuel source. When glucose levels drop, the brain cannot function optimally, leading to confusion, dizziness, shakiness, and an altered sense of self. Severe dehydration can also mimic these sensations, causing confusion and dizziness due to electrolyte imbalance and reduced blood volume.
Extreme sleep deprivation is a powerful trigger that alters brain function. A lack of adequate sleep increases theta wave activity in the prefrontal cortex, which is associated with decreased self-awareness and dissociation. These physiological causes are usually transient and resolve quickly once the underlying imbalance is corrected.
Neurological and Systemic Health Explanations
The feeling of unreality can sometimes be a symptom of an underlying medical condition affecting the nervous system.
Atypical migraines, such as vestibular migraines, can present with symptoms including profound dizziness, vertigo, and detachment, even without a severe headache. These episodes stem from abnormal electrical activity in the brain that temporarily disrupts sensory processing.
Certain types of focal seizures, particularly those affecting the temporal lobe, manifest as brief, intense episodes of altered perception. These seizures involve abnormal electrical discharges and may include an “aura” with a sudden rush of fear, a distorted sense of reality, or an out-of-body sensation.
Disorders of the vestibular system, which manages balance and spatial orientation, can also cause chronic dizziness, vertigo, and a pervasive sense of disconnection.
Prescription medications are another systemic cause, as some drugs list depersonalization or derealization as a documented side effect. Medications that affect neurotransmitter systems, such as Selective Serotonin Reuptake Inhibitors (SSRIs) or anti-anxiety medications, may trigger these dissociative feelings, which typically resolve once the medication is discontinued.
When to Talk to a Doctor and What to Expect
Occasional, brief feelings of detachment can be a normal reaction to stress, but a medical evaluation is warranted if they are persistent, recur frequently, or interfere with daily activities. Consult a healthcare provider if the feelings are intense enough to affect your ability to work or maintain relationships. Seek immediate medical attention if the feeling is sudden, new, or accompanied by concerning neurological symptoms like fainting, chest pain, or unexplained confusion.
When preparing for a medical appointment, gathering specific information will help the doctor narrow down the potential causes. You should keep a detailed log of your symptoms, noting their frequency, duration, and what you were doing right before they started. This helps distinguish between psychological, physiological, and neurological triggers. A comprehensive list of all prescription medications, over-the-counter drugs, and supplements is also necessary, as drug side effects need to be ruled out.
The diagnostic process typically begins with a physical examination and laboratory tests to rule out common physiological causes, such as blood sugar imbalances, thyroid issues, or vitamin deficiencies.
If physical causes are excluded, your doctor may refer you to a specialist, such as a neurologist or a mental health professional, for a more detailed evaluation. This evaluation involves discussing your medical history and emotional state to determine if the symptoms are related to an atypical migraine, a seizure disorder, or an underlying anxiety or dissociative disorder.