On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can assess the episodes, treat the anxiety, panic or low mood behind them and refer you for therapy; tests to rule out other causes and specialist therapy are in person.
- What it is: depersonalisation is feeling outside yourself; derealisation is feeling that the world around you is unreal. You know the feelings are not reality.
- How common: about half of people feel this way briefly at some point; 1 to 2% of people have the disorder, with episodes that last or keep coming back.
- Outlook: many people improve, and complete recovery is possible, especially when the stress behind it is dealt with.
- Emergency: call 112 for sudden confusion, a severe headache, weakness, a fit, or if you might act on thoughts of ending your life.
Do not book a video appointment if the feeling of unreality came on suddenly with confusion, a severe headache, weakness or numbness, slurred speech, a fit, or after a head injury or taking drugs, or if you are thinking about ending your life and might act on it. Call 112 or go to an emergency department.
Can an online doctor treat depersonalisation and derealisation?
Partly. A doctor by video can listen to what the episodes are like, look for what sets them off, treat anxiety, panic attacks or low mood that often come with them, show you grounding techniques, and refer you for talking therapy. Episodes that are new, unusual or come with other symptoms may need an examination and tests in person, and the disorder itself is treated with specialist talking therapy.
How an online consultation helps with depersonalisation and derealisation
- A name for what is happening: What these feelings are, why they happen, and how common a brief episode is.
- The triggers found: Panic attacks, anxiety, low mood, stress, lack of sleep, trauma and drugs such as cannabis.
- Other causes ruled out: The doctor checks whether a physical cause needs tests in person.
- A plan to feel present: Grounding techniques, treatment for anxiety or low mood, and a referral for CBT.
What the doctor checks in an online consultation
The doctor asks about signs of a physical cause and about safety first, then about the episodes. The doctor asks about:
- Warning signs: sudden onset with confusion, headache, weakness, numbness, problems with speech or vision, a fit, or a recent head injury.
- The episodes: what you feel, how long they last, how often they come, and what you were doing when they started.
- Anxiety and mood: panic attacks, worry, low mood, and thoughts of self-harm or suicide.
- Stress and trauma: recent or past events that may have set this off.
- Drugs, alcohol and medicines: including cannabis, other recreational drugs and any recent changes in medicine.
- Sleep: how much you sleep, and recent nights without sleep.
Before the call, note when the episodes happen and what you were doing. It helps to have words for the feeling, such as ‘like watching a film’ or ‘as if behind glass’.
What do depersonalisation and derealisation feel like?
Depersonalisation is the feeling of being outside yourself, watching your thoughts, feelings or body from a distance. Derealisation is the feeling that the world is unreal: people and things may seem lifeless or foggy. You can have one or both, and throughout you know the feelings are not reality.
Swipe sideways to compare →
| Depersonalisation: about yourself | Derealisation: about the world around you |
|---|---|
| Watching your thoughts, feelings or body from outside, as if floating above yourself | People and places feel unreal, like living in a film or a dream |
| Feeling like a robot, not in control of your speech or movements | Feeling cut off from people you care about, as if behind a glass wall |
| Body parts that seem the wrong shape or size | Surroundings that look blurry, colourless, flat or unusually sharp |
| Emotional or physical numbness | A distorted sense of time: recent events feel long ago |
| Memories that feel as if they are not your own | A distorted sense of distance, size and shape |
How long does it last?
Episodes can last moments, hours, days, weeks or months. In some people the feelings become constant and vary in strength, while others have them on and off over years.
Is derealisation normal?
A brief episode is very common: about half of people have felt detached from themselves or their surroundings at some point, often during stress, fear or exhaustion. It becomes a disorder when the feelings last or keep coming back and get in the way of work, relationships or daily life.
What causes depersonalisation and derealisation?
Dissociation is one way the mind copes with too much stress. High levels of stress and fear can bring on episodes, and these make them more likely:
- anxiety, especially with panic attacks, and depression
- serious stress, such as problems with relationships, money or work
- trauma, such as violence or abuse, in childhood or adulthood, including emotional abuse or neglect in childhood
- drug use: cannabis and other drugs can cause episodes
- a tendency to avoid stress, or difficulty describing emotions
The disorder affects 1 to 2% of people, men and women equally. It usually starts in the mid to late teens or early adulthood and rarely starts after 40.
Dissociation, depersonalisation and derealisation: what is the difference?
Dissociation is the broad term for feeling disconnected from yourself or the world. Depersonalisation and derealisation are two kinds of dissociation. Other dissociative conditions, such as memory gaps, need a specialist assessment.
Depersonalisation, or something else?
Swipe sideways to compare →
| Condition | What points to it | Read more |
|---|---|---|
| Panic attacks | A sudden surge of fear with a racing heart and breathlessness | Panic attacks |
| Anxiety | Worry most days, muscle tension, poor sleep | Anxiety |
| PTSD | Flashbacks and nightmares after a traumatic event | PTSD |
| Psychosis | Hearing voices or beliefs others do not share, without knowing they are not real | Psychosis |
| A physical cause | Sudden onset with confusion, headache, weakness or a fit | Emergency assessment |
How do you stop depersonalisation and derealisation?
Many people improve without treatment, and complete recovery is possible, especially when the stress behind it is dealt with. Talking therapy, especially cognitive behavioural therapy, often helps. No medicine has been proven to treat the disorder itself, but treating anxiety, panic or depression alongside it can help.
Grounding during an episode
Grounding uses your five senses to help you feel connected again:
- name things you can see around you, and describe them in detail
- hold an object with a strong texture, and notice how it feels
- listen for sounds near and far
- notice a strong smell or taste, such as mint
- slow your breathing, and feel your feet on the floor
Remind yourself that the feeling is a reaction to stress and fear, and that it will ease.
Which treatment might the doctor recommend?
Treatment depends on how long the episodes last, what sets them off, and what else is going on. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| A brief episode during stress, panic or exhaustion | Explanation, grounding and sleep | Yes | Not usually needed |
| Episodes with panic attacks or anxiety | Treatment for panic or anxiety, including CBT | Yes | If symptoms are severe |
| Episodes after cannabis or other drugs | Stopping the drug, and a review | Yes | If episodes continue |
| Feelings that last for weeks or keep coming back | Assessment and referral for CBT | Partly | For specialist therapy |
| New episodes with other symptoms, or unusual features | Examination and tests | Partly | For tests to rule out another cause |
| Sudden onset with confusion, headache, weakness or a fit | Emergency care | No | Call 112 now |
Feeling unreal and not sure why? A doctor can tell you in one consultation what is behind it.
See available times →Treatment options for depersonalisation and derealisation
What you can do yourself
- Use grounding when an episode starts, and practise it when you are calm.
- Keep a diary of episodes to spot what triggers them.
- Protect your sleep, and take breaks from stress where you can.
- Avoid cannabis and other drugs, which can bring on episodes.
- Tell someone you trust how it feels, so you do not face it alone.
Prescription treatment
A prescription is never issued without a consultation. There is no specific medicine for depersonalisation or derealisation. When depression, anxiety or panic attacks come with it, the doctor may prescribe an antidepressant after a full assessment, with reviews. Benzodiazepines are controlled medicines and are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Cannabis and other drugs, which can bring on episodes. Waiting alone with it for months: talking therapy helps, and many people recover fully.
Special situations
After a traumatic event
Feeling detached is common after trauma. If it comes with flashbacks or nightmares, the PTSD page explains what helps.
While travelling in Europe
Lack of sleep, jet lag, stress and drugs on a trip can bring on an episode. Rest, eat regularly and avoid cannabis and other drugs. Sudden confusion or other new symptoms abroad mean 112.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When depersonalisation and derealisation are treated online, and when you need in-person care
Treated online: assessment of the episodes and their triggers, grounding, treatment of anxiety, panic and low mood, and referral for talking therapy.
In-person care: examination and tests when another cause is possible, specialist therapy for the disorder, and any emergency.
When to get in-person care
Call 112 or go to an emergency department now for:
- sudden confusion, a severe headache, weakness or numbness, slurred speech or a fit
- feeling unreal after a head injury
- thoughts of ending your life that you might act on
Get medical advice the same day for:
- a first episode that does not settle after taking drugs
- hearing or seeing things that others do not
- thoughts of death or self-harm without a plan to act on them
You can also find a free, confidential crisis helpline in your country at findahelpline.com.
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the episodes: describe what they feel like, how long they last and what sets them off, and mention any drugs, alcohol or medicines.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s depersonalisation or derealisation? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Panic Attack can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about depersonalisation and derealisation
What is derealisation?
Derealisation is the feeling that the world around you is unreal: people and places may seem lifeless, foggy or flat, like a film or a dream. You still know the feeling is not reality.
What is depersonalisation?
Depersonalisation is the feeling of being outside yourself, watching your thoughts, feelings or body from a distance, as if you were an observer, or feeling like a robot or that your body is not your own. It often goes together with derealisation, and both are forms of dissociation, the mind’s way of coping with too much stress.
What does derealisation feel like?
With derealisation, many people describe being behind a glass wall, living in a film, or seeing the world as blurry, colourless or flat. Time and distance can feel distorted.
What triggers derealisation?
High levels of stress and fear, panic attacks, anxiety, depression, trauma, lack of sleep, and cannabis or other drugs can all bring on episodes of derealisation; so can migraine, some medicines and, rarely, epilepsy, which is why a doctor checks whether tests are needed. Many people notice their first episode during a panic attack or after a very stressful event.
Is derealisation normal?
A brief episode of derealisation is very common: about half of people have felt detached at some point. It is a disorder when it lasts or keeps coming back and affects daily life, which happens to 1 to 2% of people.
How long does derealisation last?
Episodes of derealisation can last moments, hours, days, weeks or months, and in some people the feeling becomes constant, which is when doctors call it depersonalisation-derealisation disorder. Many people improve, especially when the anxiety, panic or stress behind it is treated, and complete recovery is possible, though it can take time.
Does derealisation mean I am losing my mind?
No. During an episode of derealisation you know the feelings are not real, which sets it apart from psychosis. It is distressing, it can be treated, and many people recover fully.
How do you stop derealisation?
Grounding with your five senses can ease an episode of derealisation. Over time, treating anxiety or panic, reducing stress, avoiding drugs and cognitive behavioural therapy help most.
What can I do at home during a derealisation episode?
Ground yourself through the senses: name five things you can see, four you can touch, three you can hear, two you can smell and one you can taste; press your feet into the floor; and breathe out slowly for longer than you breathe in. Remind yourself that derealisation is harmless and will pass, and do not fight it or keep checking whether it has gone, which feeds the anxiety. Between episodes, sleep regularly, cut out cannabis and alcohol, and treat anxiety or panic.
Can depersonalisation and derealisation be prevented?
Often, by dealing with what sets them off: treat anxiety, panic attacks and low mood early, keep regular sleep, avoid cannabis and other recreational drugs, which are a common trigger of a first episode of depersonalisation, and limit alcohol. Learning grounding and breathing skills before you need them makes episodes shorter and less frightening, and talking therapy after trauma lowers the chance that dissociation becomes a habit of the mind. Episodes that keep returning despite this are worth a consultation.
What is the difference between dissociation and derealisation?
Dissociation is the broad term for feeling disconnected from yourself or the world. Derealisation is one kind of dissociation, focused on the world around you feeling unreal.
Is there medicine for derealisation?
No medicine has been proven to treat derealisation. An antidepressant can help when anxiety, panic or depression come with it, and benzodiazepines are never prescribed online.
Can an online doctor help with derealisation?
Partly. A doctor can assess episodes of depersonalisation or derealisation, look for triggers, treat anxiety or low mood and refer you for CBT. Tests to rule out other causes and specialist therapy are in person.
- Dissociative disorders, NHS, National Health Service (UK), reviewed 14 August 2023.
- Depersonalization-derealization disorder: symptoms and causes, Mayo Clinic (US), updated 5 September 2025.
- Depersonalization/derealization disorder, MSD Manual, Consumer Version, reviewed June 2025.
- Depersonalisation-derealisation disorder, See Me, Scotland’s programme to end mental health stigma, accessed 15 October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
Related conditions
Speak to a doctor about feeling unreal over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CEST · exact price before payment
See available times →