The sensation of feeling disconnected from your body or perceiving the world as strange and unreal is often described as feeling “high” while sober. This altered state of consciousness occurs without psychoactive substances and is typically temporary. It represents a form of mental detachment where the mind separates itself from the immediate experience of the body or the environment. This phenomenon often occurs suddenly and can be profoundly unsettling, prompting people to question their grasp on reality.
Understanding Depersonalization and Derealization
The feelings of unreality are clinically defined as depersonalization (DP) and derealization (DR), two distinct dissociative states that frequently occur together. DP involves detachment from oneself, making you feel like an outside observer of your own thoughts, feelings, body, or actions. This can manifest as feeling emotionally numb, like a robot, or perceiving your limbs as distorted.
DR involves detachment from your surroundings, making the external world seem distorted, dreamlike, or unreal. Objects may appear blurry, colorless, or flat, and time may seem to speed up or slow down. Crucially, during both DP and DR, the person retains the awareness that these feelings are subjective and not real, a feature known as intact reality testing.
These states are understood as defensive mechanisms where the brain attempts to protect itself from overwhelming stress or emotional pain. By inducing a state of detachment, the mind creates distance from an intolerable experience. When these feelings become persistent or recurrent, causing significant distress or functional impairment, they may be diagnosed as a dissociative disorder.
Triggers: Psychological and Physiological Factors
Episodes of detachment are often brought on by a combination of psychological and physiological stressors that push the nervous system to its limit. Acute psychological factors like severe stress, intense anxiety, or the onset of a panic attack are the most frequent triggers. The mind initiates the dissociative response to cope with the sudden, overwhelming surge of “fight or flight” hormones. This reaction can also occur immediately following a traumatic event, serving as a mental shield against the full impact of the experience.
Physiological triggers involve specific changes in the body that disrupt normal brain chemistry. Severe sleep deprivation, for instance, impairs cognitive processing and increases the likelihood of an episode. Hyperventilation, the excessive rapid breathing often accompanying panic, is another common trigger. This over-breathing reduces the level of carbon dioxide in the blood (hypocapnia), which alters the body’s pH balance and constricts blood vessels in the brain, inducing feelings of unreality.
Low blood sugar (hypoglycemia) is a powerful physiological trigger. When the brain is deprived of glucose, the body releases stress hormones like epinephrine and cortisol to raise blood sugar levels. This rush of hormones generates a “survival” response that mimics severe anxiety, subsequently triggering detachment. Sustained dehydration can also contribute by impacting electrolyte balance and blood flow to the brain, stressing the entire system into a detached state.
Immediate Grounding and Self-Care Techniques
When an episode begins, the immediate goal is to interrupt the feeling of detachment by anchoring yourself firmly in the present moment through sensory engagement, a process called grounding. The 5-4-3-2-1 technique is a highly effective method that forces the brain to shift focus from internal distress to external reality.
The 5-4-3-2-1 Technique
- Name five things you can see around you.
- Identify four things you can physically touch.
- List three things you can hear.
- Identify two things you can smell.
- Name one thing you can taste (e.g., a piece of gum or a strong mint).
This systematic exercise engages multiple senses, overriding the mental distance with tangible, immediate data. Sensory stimulation can be intensified by holding an ice cube or splashing cold water on your face, as the sudden temperature change provides a powerful physical sensation. Controlled breathing exercises are crucial for resetting the body’s physiological response by correcting the hyperventilation that often accompanies anxiety and detachment. Focus on breathing slowly, aiming for a longer exhalation than inhalation, such as inhaling for a count of four and exhaling for a count of six. Physical movement can also help connect the mind back to the body. Try stomping your feet, clenching and unclenching your fists, or lightly pressing your palms against a wall to feel your muscles engage.
When to Seek Professional Guidance
While temporary episodes of detachment are common and often resolve on their own, there are specific signs that indicate the need for professional evaluation. You should consult a healthcare provider or a mental health expert if the feelings of depersonalization or derealization are persistent, lasting for weeks or months, rather than minutes or hours. Persistence suggests that the underlying stressor or physiological imbalance has become chronic.
Impairment is another clear signal to seek help, specifically if the episodes interfere with your ability to function normally in work, school, or relationships. If the feelings are accompanied by other severe symptoms, such as unexplained memory loss, hallucinations, or intense phobias, a professional assessment is warranted to rule out other medical or mental health conditions. Seeking guidance is especially important if the episodes are clearly linked to a history of trauma, as this indicates a deeper issue that benefits from therapeutic intervention.