Why Does Everything Feel Unreal? Understanding Derealization

Hannah Bingler LPC, LAC.

Clinical Director

I received my Masters in Counseling from the University of Denver in 2020. I have worked in a variety of settings, including inpatient, outpatient, and private practice. I use a holistic approach rooted in psychodynamic therapy. I am familiar with CBT, DBT, Motivational Interviewing, Reality Therapy, Gestalt Therapy, and Person-centered approaches. I am trained in Accelerated Resolution Therapy and use it regularly to address issues that clients present with. I work with my clients to help them understand and address the roots of their presenting problems.

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Colorado Mental Health services was a beacon of hope during one of the darkest times in my life. From the moment I arrived, the staff treated me with compassion, respect, and unwavering support. They truly understood what I was going through and provided not just a place to heal, but the tools and guidance I needed to rebuild my life.

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I am grateful for Colorado Mental Health services. My experience into the world of recovery was with much apprehension. The staff at the inpatient facility, though PHP and IOP were extremely understanding and helpful while I came to a real understanding of what addiction is and how it has affected my life.

If you are reading this for yourself or a loved one I can relate. I looked for every reason why I didn’t need recovery. I thought I could manage addiction on my own. With every reason I could imagine why I didn’t belong there were 10 reasons why I did.

The community of friends I have met through therapy and groups that Colorado Mental Health services supports outside of therapy are incredible.
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Nothing is like Colorado Mental Health services. It was the best choice I’ve ever made regarding my addiction & recovery. Caring, professional staff (many whom are in long term recovery themselves and understand), comprehensive program, group & 1 on 1 therapy, and activities like yoga, hiking, and gym in a comfortable atmosphere in the beautiful, nature-filled Morrson/Conifer area. There 4 stage program changed my life. Detox, residential treatment, PHP, & IOP. And then there’s the excellent alumni program with tons of support through meetings, events & activities. If you’re committed to fighting an addiction, this is the place to go.

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Colorado Mental Health services is an incredible rehab facility. I received amazing care all the way from in patient to outpatient treatment. All of the staff and nurses were so kind and understanding and willing to help with anything that I needed. The therapists were also very helpful and provided great insight into our sessions and were incredibly knowledgeable. Colorado Mental Health services really helped me to regain control over my life and be able to find a new path and direction to head into. I could not recommend this facility enough and the amazing staff you get to meet and work with. I had a really great experience with them!

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Colorado Mental Health services is so much more than an addiction treatment program. This program and the incredible staff have allowed me to find a sense of purpose and a tight knit community. The skills and coping mechanisms taught during group therapy are so vital to my recovery and I continue to use them every day outside of treatment. The staff provided constant support and guidance every step of the way and continue to even after completing the program. Their unwavering support, deep knowledge, and compassion made the daunting journey of sobriety feel genuinely achievable and worthwhile. The uncertainty on the road to recovery can be overwhelming and may seem unfeasible at first. For anyone who is struggling with these fears and looking for some semblance of hope and meaningful connections this is your place.

If you’ve ever felt like your surroundings aren’t real or that you’re existing in a dream, you’ve probably had an episode of derealization. Derealization isn’t a mental health disorder itself — it’s actually a very common state that people experience for a short amount of time — but if it occurs regularly, that can be a sign of a deeper mental health issue.

Up to 75% of people say they’ve experienced derealization at some point in their lives [1], which can be a normal response to trauma, high stress, or fatigue. Frequent episodes that grow in intensity may signal a mental health condition such as depression and anxiety.

Here’s what derealization is, why it happens, what it can lead to, and treatment that’s available.

What Is Derealization?

Derealization is a mental state where you see the world around you as distorted, distant, or unreal. People and objects may feel like they’re not actually there, and you may have the sense you’re moving through a fog or there’s something separating you from your surroundings.

Most people experience derealization at least once: it arrives and passes. For others, episodes can last for hours or even months. It’s different from depersonalization, which is when you feel disconnected from your physical body, often seeing yourself floating outside of, or above, yourself. However, it’s possible to have derealization and depersonalization happen at the same time, and if both occur repeatedly, that may indicate depersonalization-derealization disorder (DPDR).

Infographic titled "Understanding Derealization: When the World Feels Unreal" explaining that derealization affects your perception of the world while depersonalization affects your connection to your body, common sensory symptoms like distorted perceptions and the glass wall effect, and that up to 75% of people experience a short-term episode while 1-2% have depersonalization-derealization disorder.

What Are the Symptoms of Derealization?

Symptoms of derealization are varied and can fluctuate in intensity. Some people say that symptoms make them feel like they are “going crazy,” but this recognition that something is different/unusual is actually a good sign. When someone can’t distinguish between reality and imagination, that can be the sign of a psychotic disorder.

Derealization symptoms include:

Feeling like the world is muted or fake
People and things seem fake, blurry, or the wrong size
Sounds are too loud, too quiet, or distorted
Time feels like it passes too fast, too slow, or stands still
People around you feel unreal, you may perceive them as robots, even if rationally you know they are not
A wall separates you from your external world

These symptoms overlap with symptoms of depersonalization-derealization disorder, a condition that can impact your relationships, work, and daily activities. Only 1-2% of the world’s population have the disorder [2].

Derealization most commonly is a symptom of other conditions, including:

PTSD and Complex PTSD (C-PTSD)
Depression
Panic disorder
Dementia
Schizophrenia
Substance use disorder
Dissociative disorders such as amnesia

What Causes Derealization?

Trauma is the most common cause of derealization, especially trauma that happened at a young age. Traumatic events in childhood can teach a person to detach from the world as a coping mechanism. It includes:

Sexual or physical abuse
Sudden death of a loved one
Witnessing domestic violence
Having a relative with a severe mental health disorder
Living in a natural disaster or conflict zone
Being in a car accident

Episodes of derealization can be triggered by direct links to trauma, or by everyday stressors, such as stress at work or an argument in a relationship.

One study found that approximately half of people exposed to trauma reported symptoms of derealization two weeks afterward. These people also had greater symptoms of PTSD and depression three months after the trauma [3].

Overactivation in parts of the brain that control emotion regulation may lead to feelings of detachment after a traumatic event. Other areas involved in emotional experience may cause the distorted perceptions that come with derealization [3].

Is There Treatment for Derealization?

Derealization can be uncomfortable and scary, but it is not life-threatening and can typically be managed at home with breathing and grounding exercises. If your episodes of derealization last for days, feel unbearable, or are increasing in frequency and intensity, you should seek clinical help.

Treatment programs such as our Intensiv e Outpatient Program (IOP) provide structured care for derealization, trauma, and other mental health challenges. They integrate evidence-based therapies such as Cognitive Behavioral Therapy (CBT), psychodynamic therapy, and Eye Movement Desensitization Reprocessing (EMDR) to help you understand your thoughts, process trauma, build self-awareness, and learn new skills to manage your mental health.

There’s currently no dedicated medication to treat derealization, but antidepressants, anti-anxiety medications, and mood stabilizers may help to alleviate symptoms [4].

Treatment has been repeatedly shown to improve symptoms and general mental health in dissociative disorders [5].

Infographic titled "Understanding Derealization: From Trauma to Healing" showing the root causes of detachment — trauma as the primary catalyst, everyday stress triggers, and that half of people exposed to trauma report derealization symptoms within two weeks — alongside pathways to recovery including grounding techniques, evidence-based clinical therapy like CBT and EMDR, and comprehensive holistic care.

Find Where You Belong at Colorado Mental Health Services

Our trauma-informed outpatient program treats mental health conditions, helping you connect with yourself and the world in the healthiest possible way. We have a team of licensed clinicians who personalize all care around your needs and experiences.

Our sessions include individual and group therapy, as well as holistic activities to nurture your mental, physical, and spiritual health. We also offer medication management to help you feel balanced, inside and outside of sessions.

We’re based in Lakewood, a short drive away from Denver, and are surrounded by the beautiful Front Range mountains. We also have virtual services for people who are unable to come to our center in person, ensuring you have access to the high-quality mental health care you deserve.

Healing is possible. It can start with a phone call. Speak with our admissions team today.

Sources

[1] National Alliance on Mental Illness. (2026). Dissociative Disorders. nami.org.

[2] Cleveland Clinic. (September 2023). Depersonalization-Derealization Disorder. my.clevelandclinic.org.

[3] National Institute of Mental Health. (June 2022). Feelings of Detachment After Trauma May Signal Worse Mental Health Outcomes. nimh.nih.gov.

[4] WebMD. (August 2024). Derealization explained. webmd.com.

[5] Griffiths, T. et al. (March 2025). Effectiveness of phase-oriented treatment for trauma-related dissociative disorders: a systematic review. European Journal of Psychotraumatology.

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