The sensation of feeling “high” or detached without substance use is a common experience, often described as feeling “out of it,” lightheaded, or like the world is unreal. These feelings are generally classified as derealization (the feeling that surroundings are unreal or dreamlike) or depersonalization (feeling detached from one’s own body or mental processes). These sensations are physical and psychological responses to various stimuli. Understanding the mechanisms behind these shifts in perception can help demystify the experience.
How Psychological States Alter Perception
Intense emotional states, particularly those associated with stress and anxiety, are a frequent cause of feeling detached or unreal. When a panic attack occurs, it triggers a rapid onset of physical symptoms as the body activates the “fight or flight” response. This surge of adrenaline and sympathetic nervous system activation leads to hyperventilation, which can quickly cause lightheadedness and a sense of detachment.
Dissociation, which includes depersonalization and derealization, is thought to be a built-in coping mechanism against overwhelming stress or trauma. In this state, the mind attempts to put distance between itself and intense, unpleasant feelings of anxiety. This mental buffering can result in observing your own actions from a distance or perceiving the world as foggy or surreal. This response is essentially the brain trying to protect itself from perceived psychological overload.
Chronic, sustained stress, even without a full-blown panic attack, keeps the sympathetic nervous system in a state of constant, low-level activation. This sustained tension can exhaust the body and impair cognitive function, contributing to a persistent feeling of being “out of it” or mentally distant. The feeling of being on “autopilot” or emotionally numb is a common manifestation of this prolonged psychological strain.
Everyday Physical and Lifestyle Causes
Aside from psychological factors, many common issues related to metabolism and lifestyle can trigger feelings of lightheadedness, confusion, or mental detachment. One significant cause is low blood sugar, or hypoglycemia, since glucose is the primary fuel source for the brain. When blood glucose levels drop too low, brain cells cannot function correctly, leading to symptoms like dizziness, inability to concentrate, and general confusion.
Dehydration is another simple but powerful physical cause that mimics an altered state. Reduced fluid intake leads to lower overall blood volume, which can temporarily decrease blood flow and oxygenation to the brain. When standing up quickly, this can result in orthostatic hypotension, causing a head rush, dizziness, or a momentary feeling of being detached.
Sleep Deprivation
A lack of quality sleep impairs the brain’s ability to regulate mood and process information efficiently. Chronic sleep deprivation leads to a “brain fog” that slows reaction times and muddles thinking, which can be perceived as an unusual state of consciousness.
Medication Side Effects
Many common, non-psychiatric medications, such as certain antihistamines or blood pressure drugs, can list temporary dizziness or lightheadedness as a side effect when beginning or adjusting the dosage.
Underlying Neurological and Vestibular Issues
More complex causes involve the systems responsible for balance and sensory processing. The vestibular system, located in the inner ear, is responsible for providing the brain with information about spatial orientation and movement. When this system is disrupted, it can cause vertigo—a false sensation of spinning or movement that can feel profoundly disorienting, sometimes described as feeling “drunk” or unsteady.
Benign Paroxysmal Positional Vertigo (BPPV) occurs when tiny calcium crystals become dislodged and float into the fluid-filled semicircular canals of the inner ear. This displacement sends incorrect signals to the brain, triggering brief but intense episodes of vertigo and unsteadiness. Other inner ear inflammations, like labyrinthitis, can also cause severe vertigo and imbalance.
Silent Migraine
Another neurological cause is the “silent migraine,” officially termed migraine aura without headache. This condition involves the sensory and visual disturbances typical of a migraine aura, such as visual snow, zigzag lines, or numbness, but without the subsequent head pain. These aura symptoms are caused by cortical spreading depression, a slow wave of altered electrical activity that sweeps across the brain’s surface, temporarily disrupting normal signaling and causing perceptual changes.
Postural Orthostatic Tachycardia Syndrome (POTS)
Conditions like Postural Orthostatic Tachycardia Syndrome (POTS) involve a dysfunction of the autonomic nervous system. This leads to poor blood flow regulation when upright. This results in lightheadedness, difficulty concentrating, and significant brain fog due to reduced oxygen-rich blood reaching the brain.
Recognizing Symptoms That Require Medical Attention
While many temporary feelings of being “high” are benign and linked to stress or lifestyle factors, certain accompanying symptoms require professional medical advice. If the feeling is accompanied by new, severe, or sudden symptoms, a healthcare provider should be consulted immediately. These red flags include:
- Sudden onset of numbness or tingling on one side of the body.
- Severe headache.
- Chest pain.
- Difficulty speaking clearly.
Any episode that results in a loss of consciousness or significant confusion warrants emergency medical attention to rule out acute issues. If the feelings of detachment or dizziness become persistent, increase in frequency, or begin to impair daily functioning, a consultation is necessary. A medical professional can help determine if the symptoms are metabolic, neurological, or psychological in origin and recommend appropriate treatment.