Feeling lightheaded, detached, confused, or unusually euphoric when completely sober is a common human experience. These feelings, which mimic intoxication, can be confusing and frightening. The sensations are rarely a sign of serious danger and most often point to temporary imbalances in the body’s chemistry or a psychological defense mechanism. Many causes are benign and easily corrected, while others represent the body’s natural reaction to stress or fatigue.
Understanding Depersonalization and Derealization
One of the most direct psychological answers to the feeling of being “high” is dissociation, which often manifests as depersonalization or derealization. Depersonalization involves feeling detached from one’s own body, thoughts, or emotions, creating a subjective sense of unreality. A person might feel like an outside observer of their own life, watching their actions, speech, or feelings as if they belong to someone else.
This detachment can lead to feeling emotionally numb, where the body itself feels strange or foreign. Depersonalization is a profound alteration of self-awareness, but the individual retains the understanding that their experience is subjective, setting it apart from conditions like psychosis.
Derealization, by contrast, is a feeling of detachment from the outside world, where the environment seems distorted, dreamlike, or unreal. The world may appear foggy, colorless, or two-dimensional, and objects might seem altered in size or clarity. Time perception can also be distorted, seeming to speed up or slow down.
Both depersonalization and derealization are dissociative symptoms, often triggered by severe stress, panic, or trauma. They function as a psychological defense mechanism, slowing down emotional processing to cope with an overwhelming situation. While transient episodes are common, persistent, distressing, and life-interfering symptoms may be diagnosed as depersonalization-derealization disorder.
Physical Causes That Alter Sensation
Beyond psychological factors, several immediate physiological conditions can alter sensation and mimic the feeling of intoxication by affecting how the brain receives energy or blood flow. One common culprit is hypoglycemia, or low blood sugar, which is the brain’s primary source of energy. When blood glucose levels drop too low, the brain cannot function optimally, leading to neurological symptoms.
Symptoms of hypoglycemia often include lightheadedness, dizziness, confusion, difficulty concentrating, and a feeling of weakness. Similarly, dehydration reduces blood volume, making the circulatory system less efficient, which can result in sluggishness and lightheadedness. Insufficient fluid intake is a frequent cause of mild dizziness, as the body struggles to maintain stable blood pressure and deliver oxygenated blood effectively.
Another physical cause is orthostatic hypotension, a sudden drop in blood pressure that occurs when quickly moving from a sitting or lying position to a standing one. If the cardiovascular system fails to constrict blood vessels quickly enough, the temporary reduction in blood flow to the brain causes symptoms. These symptoms include blurriness, dizziness, and mental confusion, which are typically brief but can feel profoundly disorienting. Severe sleep deprivation can also impair judgment, slow reaction times, and even lead to hallucinations, creating a state similar to being under the influence.
The Role of Anxiety and Hyperventilation
Acute stress and anxiety attacks are powerful triggers that produce intense physical sensations often misidentified as being “high.” These episodes activate the body’s fight-or-flight response, initiating an adrenaline dump. This surge of stress hormones causes an elevated heart rate, rapid breathing, and a heightened state of alertness that can feel like an overwhelming rush.
A central mechanism is hyperventilation, the rapid, shallow breathing common during panic attacks. Hyperventilation causes an imbalance in blood gases because the excessive expulsion of carbon dioxide (\(CO_2\)) lowers its concentration in the bloodstream. The reduction in \(CO_2\) changes the blood’s pH, leading to a state called respiratory alkalosis.
Low \(CO_2\) levels trigger vasoconstriction, the narrowing of the blood vessels supplying the brain. This constriction temporarily reduces blood flow, causing lightheadedness, dizziness, and a feeling of unreality or detachment. The altered chemistry also causes tingling or numbness, particularly in the hands and around the mouth. These physiological changes create a disorienting experience that closely mimics the effects of intoxication.
Knowing When to Consult a Professional
While many episodes of feeling “high” when sober are transient and linked to identifiable triggers, medical evaluation is sometimes warranted. If the sensations of detachment, dizziness, or confusion begin suddenly with no clear trigger, seeking professional advice is prudent. This is especially true if the feeling is accompanied by severe symptoms like chest pain, an inability to think straight, or a loss of consciousness.
If these feelings are persistent, happening almost daily, or worsening over time, they may indicate an underlying condition requiring treatment. When the symptoms begin to significantly interfere with daily life, work, or relationships, a health care provider can help determine the cause. A professional can perform tests to check blood sugar levels, blood pressure, and other physiological factors to rule out a physical cause and recommend appropriate care.