The sensation of feeling detached, foggy, or mentally altered while completely sober is a confusing and often alarming experience. This feeling, which can mimic intoxication or a dream-like state, is far more common than most people realize. This detachment is not a sign of “going crazy” but is frequently the result of an understandable biological and psychological response. These episodes have roots in both mental health and physical conditions that affect how the brain processes reality. Exploring these underlying causes can help validate your experience and provide a clear path toward managing these sensations.
Understanding Depersonalization and Derealization
The clinical terms for the feeling of being “high when you’re not” are depersonalization and derealization. Depersonalization involves a profound sense of detachment from your own self, feelings, or body. You might feel like an outside observer watching your own life, or that your movements and speech are not entirely under your control. This can lead to the sense that your limbs or body are distorted in size or shape.
Derealization describes a similar detachment, but it is focused on the external world. People experiencing derealization often report that their surroundings feel unreal, foggy, or dreamlike, as if they are separated from the world by a glass wall. Objects may appear distorted, flat, or colorless. Both of these states are forms of dissociation, which is the brain’s automatic, protective mechanism to cope with overwhelming emotional distress or threat.
Psychological and Stress-Related Triggers
The most frequent causes for these feelings of unreality are psychological, stemming from the body’s reaction to stress. Acute anxiety and panic attacks can instantly trigger dissociation as the mind attempts to shield itself from an intense threat response. During a panic attack, the surge of adrenaline and hyperventilation alters blood flow and oxygen levels in the brain, leading to lightheadedness, perceptual changes, and a feeling of being spaced out.
Chronic stress and burnout also play a significant role by keeping the nervous system in a constant state of high alert. This mental exhaustion can lead to a sustained emotional numbness, which is a core feature of depersonalization. The brain downregulates emotional processing to conserve resources, resulting in a persistent feeling of detachment from one’s feelings or memories.
Another common contributor is severe sleep deprivation, which destabilizes brain function and cognitive clarity. A lack of restorative sleep can impair judgment and slow reaction times, mimicking the fogginess of intoxication. Trauma, particularly emotional abuse or neglect experienced in childhood, is also strongly associated with developing a pattern of dissociation as a long-term coping strategy.
Physical and Neurological Factors
The feeling of a detached or altered state can also be a symptom of various physical and neurological conditions.
Migraine auras are a common example, where temporary nervous system disturbances occur before or during a headache. These can include visual symptoms like seeing zigzag lines, shimmering spots, or temporary blind spots, which can make the environment feel surreal. Migraine can also induce a rare phenomenon called Alice in Wonderland Syndrome, where a person perceives objects, other people, or parts of their own body as distorted in size or shape. This perceptual distortion creates an intense sense of unreality and is believed to be caused by altered electrical activity in the brain’s visual processing centers.
Conditions affecting the inner ear, known as vestibular disorders, can also produce feelings of detachment. The inner ear contains the otolith organs, which provide the brain with a sense of gravity and spatial orientation. When conditions like labyrinthitis or BPPV disrupt these signals, the brain receives a sensory mismatch between what it sees, what it feels, and what the inner ear is reporting. This sensory conflict can lead to intense disorientation and derealization symptoms, such as feeling as if you are walking on shifting ground.
Fluctuations in blood sugar are another physiological cause of altered perception, specifically hypoglycemia. Since glucose is the primary fuel for the brain, deprivation leads to neuroglycopenic symptoms like confusion, dizziness, and difficulty concentrating. This state of mental fogginess and lightheadedness can easily be misinterpreted as feeling inebriated. Certain medications, including some antibiotics, pain relievers, and psychiatric drugs, can also list depersonalization or derealization as a potential side effect. These drug-induced symptoms typically resolve once the medication is stopped, but they highlight the chemical sensitivity of the brain’s perception of reality.
Tracking Symptoms and Seeking Professional Help
When these sensations are recurrent or cause distress, the first step is to methodically track the episodes. Keep a detailed log noting the exact time the feeling started and stopped, what you were doing right before it began, and any accompanying symptoms like nausea or heart palpitations. It is also helpful to record your sleep quality, recent major life changes, and all medications you are taking.
This detailed symptom journal provides valuable data for a healthcare professional. A doctor will perform a physical exam and may order lab tests to rule out physical causes like blood sugar issues or neurological conditions. If physical causes are excluded, a mental health professional can provide a full evaluation for conditions like a dissociative disorder, anxiety disorder, or depression.
A professional evaluation is necessary to identify the root cause and establish a treatment plan. Seek immediate emergency care if the feeling is accompanied by sudden, severe symptoms such as a new, intense headache, loss of consciousness, or difficulty speaking, as these can indicate a serious neurological event. For non-emergency symptoms, consulting a general practitioner, neurologist, or mental health specialist is the appropriate path to recovery.