Panic & Anxiety: Derealization & Depersonalization - You Aren't Going Crazy!

Two of the most horrifying little goodies that so often accompany panic attacks and severe anxiety are derealization and depersonalization. Both can be absolutely crippling and take you right to the turnstiles of your perception of insanity. This article will discuss what these spooky phenomena are and what may cause them.

Coming from personal experience, derealization is a deep and disturbing sensation of unreality and detachment from one’s immediate world, rather an altered state of consciousness. It’s been described as feeling as though one is looking at the world through thick glass. I mean, you can see clearly, are fully oriented, and can function; however it’s like you’re operating in a very exclusive dimension. It is an absolutely terrifying experience and generally leads to the belief that insanity is at hand - especially if one hasn’t the knowledge as to what’s really going on. As derealization presents, one becomes extremely concerned about what to do and how to find help. See, it’s all about the fear of being, and appearing, crazy - or at the very least, extremely strange.

Now, just as derealization is an environmental perceptual issue, depersonalization is an equally disturbing self-perception phenomenon. During my junior year in college I walked into the house I shared with some buddies and caught a glimpse of a photograph hanging on the wall of the six of us. Though it was only a glimpse, something just didn’t seem right - that quickly. So I stopped, walked back to the photo and saw this person right in the middle of the picture. I knew who he was, yet I didn’t. But it was me! I can’t tell you how frightening that sensation was. Depersonalizaton holds the potential to snatch away your last morsels of identity and security, having any sort of concept of self relegated to the dumpster.

So, what actually causes these sensations? Recent research has suggested that extraordinary and frightening sensations, such as near-death and out-of-body experiences - which I believe are in the same ballpark as derealization and depersonalization - may occur because of stress-induced malfunctioning brain chemistry. For example, a structure in the temporal lobe (lower side) of the brain known as the angular gyrus, specifically the right angular gyrus, is believed to process sensory input in an effort to aid in the perception of our physical selves. Featured in one particular study was a seizure disorder patient participating in a course of electrical stimulation treatment. During a procedure the electrodes were applied to the right side of the patient’s head (right angular gyrus?), and guess what? When the juice was turned on the patient reported an out-of-body experience. Now, this research doesn’t specifically address the cause of derealization and depersonalization; however it begins to point some fingers. At least I think so.

The strange sensation of floating outside of the body during times of perceptual disorientation may be generated by any number of things, including panic, intense anxiety, major life stress, emotional and physical trauma, and brain disease or injury. As it applies to mental and emotional distress, perhaps as life circumstances begin to overwhelm us we become victims of transitioning consciousness as our minds react by generating custom-tailored out-of-body experiences known as derealization and depersonalization. V.S. Ramachandran, M.D., Ph.D., director of the Center for the Brain and Cognition at the University of California, San Diego, underscores the power of perceptual alteration by proposing there’s a shift in the very boundaries of self-perception when incoming sensual input doesn’t comply with what one perceives and requires as the norm. By the way, do whatever you can to read any of Ramachandran’s writings because it’s absolutely amazing stuff. This guy is the real deal.

As a past sufferer of this hocus-pocus, I view derealization and depersonalization, intense perceptual alterations, as the mind’s self-protective reaction to the ultimate perceived state of overload. It just seems to me that when the mind believes it’s mega-overwhelmed it flips the switch on a perceptual filter, believing even the slightest additional bit of stimuli may lead to various degrees of psychic meltdown. Yes - it’s the mind in a powerful state of defense. Within this theoretical framework, the mind is trying to give itself a fighting chance to sort and process that with which it’s already wrestling, so it chooses to inhibit the sensory messages streaming in from one’s immediate internal and external experience.

Now, unfortunately, the mind’s fear circuitry is chugging along very independently and just as efficiently as its perceptual filter. So off go the alarms because the sensations experienced as a result of the mind’s work to defend itself, which may include derealization and depersonalization, are causing the alarm circuitry to freak. As a result, one flips into all-out panic mode, desperately trying to reestablish a sense of perceptual orientation and comfort. And that only makes things worse because it totally interrupts the mind’s immediate mission of managing thousands of cars at rush-hour. And so one is left with this ever-building traffic jam caused by two vehicles: an overloaded mind on the verge of meltdown and a very agitated and loudly rebellious fear circuitry. Needless to say, no one’s going anywhere.

I might also suggest that derealization and depersonalization may also present as a result of the mind being so consumed by its present overload, it simply can’t deliver perceptual accuracy in response to what the senses are bringing to the table. Don’t ever forget – this is all about how we receive self and the world. And there’s only so much of the mind to go around. Yes - it does have its limits.

Dr. V.S. Ramachandran, from his book, A Brief Tour of Human Consciousness: From Imposter Poodles to Purple Numbers (Pi Press, 2004), sets the table for his thoughts on derealization and depersonalization by mentioning two fascinating neurological disorders. The first, Capgras Delusion, is characterized by the patient being convinced a close family member or friend is an imposter. The patient has no problem grasping familiarity of appearance and behavior; however the relational significance just isn’t there, and the patient is fully aware of the disconnect. Ramachandran then mentions Cotard’s Syndrome, a neurological disorder characterized by the patient believing she has lost everything, even parts of her body, and believes she may, indeed, be dead and is walking about as a corpse.

Ramachandran suggests derealization and depersonalization may well be caused by the same altered brain circuitry that brings on Capgras and Cotard’s, even to the point of referring to derealization and depersonalization as rather a “mini-Cotard’s.” In the face of a life-threatening emergency a piece of anatomy in the frontal lobe of the brain, the anterior cingulate (also involved in the processing of physical pain), becomes active. Its ensuing action pulls in the reins on the brain’s fear circuitry. As a result, disabling phenomena such as fear and anxiety fall by the wayside. But it doesn’t stop there, as the anterior cingulate then ramps-up alertness just in case we need to defend ourselves. Well, the bottom-line is we’re left in this emotionally void and hypervigilant state, and Dr. Ramachandran proposes we have but two alternatives to account for what’s happened: “The world just isn’t real,” presenting in the form of derealization, and “I’m not real,” presenting in the form of depersonalization. Go back several paragraphs to my description of my personal experience with depersonalization. One of my statements was, “I knew who he was, yet I didn’t.” Kaboom - what a fit.

I find all of this really very fascinating, especially when you consider that something that feels so horribly frightening, and that holds the potential to cause such major dysfunction, may actually be the mind’s naturally intended way of protecting itself. Indeed, the mind may be saying, “I’ve got a bit more than I can handle here - could someone please help me out?” To me, assigning a personality, if you will, to the mind gives its generated distressing phenomena a bit of softness and gentleness; making them seem so much less abysmal. I mean, it’s like the mind is this living, feeling being to which we can show compassion as it’s hurt, confused, worn-out, and desperately in need of rest and care. I really believe in this relationship with mind, and it’s my opinion the only thing that keeps us from realizing its fullest two-way potential is overcoming our misinterpretations and overreactions to the mind’s naturally occurring protective mechanisms. Yes - as soon as we sense the beginnings of sensations such as derealization or depersonalization, and the alarms sound, we think our way to exaggerated and inappropriate reactions. And it’s this dynamic that causes all the hubbub, not the perceptual alterations themselves.

Well, hey - that's it for this writing. Hopefully you know a bit more than you knew coming in. And if derealization and/or depersonalization are tearing your life apart, here's hoping for some insight and relief. Don't ever forget - you are not going crazy! Keep an eye out for my article, Panic Attacks and Anxiety: Adios! to Derealization and Depersonalization. It's a great bit of follow-up.