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Mental Health · Guide

Dissociation & Derealization

Dissociation involves feeling disconnected from your thoughts, feelings, body, or environment. Learn...

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Medically reviewed
Dr. Sarah ChenPsy.D
Last reviewed May 2026 · Editorial standards

Understanding dissociation

Dissociation exists on a spectrum from normal (becoming absorbed in a book, highway hypnosis) to clinical (dissociative identity disorder, depersonalization/derealization disorder). In the middle range, dissociation is an extremely common response to trauma and overwhelming stress — a way the mind creates distance from unbearable experience.

Derealization and depersonalization

Derealization involves feeling that the world is unreal, dreamlike, foggy, or distant. Depersonalization involves feeling detached from your own thoughts, feelings, sensations, or body — like you're observing yourself from outside. These experiences are distressing but not dangerous. They are among the most common psychiatric symptoms and often accompany anxiety, depression, and PTSD.

Dissociative symptoms are a normal response to abnormal levels of stress or trauma. They are not a sign of psychosis or "going crazy." The symptoms feel alarming but are your mind's protective response to overwhelming experience.

Sources
[1]ISSTD — International Society for Traumatic Stress
[2]NIMH — Dissociative Disorders
Frequently asked questions
No — derealization and depersonalization are frightening but not medically dangerous. They are among the most common psychiatric symptoms. The anxiety they provoke often worsens them, as the brain intensifies monitoring for signs of unreality. CBT and mindfulness approaches that reduce the secondary anxiety about dissociation are effective treatments.
Dissociation is the nervous system's emergency response to overwhelming experience. During trauma, dissociation creates psychological distance from unbearable experience. In people with complex trauma histories, dissociation can become a habitual response to stress or distressing emotions, triggered long after the original trauma.
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