Depersonalization
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Try one of these related symptoms.
Depersonalization
Out of body experience
Feeling detached from self
Feeling detached from reality
Distorted perception of reality
I feel detached from myself
Feeling disconnected from self
I feel like an observer of my own life
Derealization
Depersonalization derealization
Feel like living in a movie or a dream
About the Symptom
Feeling detached from oneself such as they are observing their own life from outside their body. It can be caused by many different medical or psychiatric conditions.
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you feel detached from your body or mind, like an outside observer?
Reviewed By:
Charles Carlson, DO, MS (Psychiatry)
Dr. Carlson graduated from Touro University in Nevada with a degree in osteopathic medicine. He then trained as a resident in Psychiatry at Case Western Reserve University/University Hospitals where he was also a chief resident and completed a fellowship in Public and Community Psychiatry. After training, he started practicing in | Addiction Psychiatry at the U.S. Department of Veterans Affairs where he also teaches Psychiatry residents.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Content updated on Jan 29, 2025
Following the Medical Content Editorial Policy
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- Feeling detached/separated from your body or mind, like an outside observer
- I feel detached/separated from your body or mind, like an outside observer
- Feeling like an outside observer of your life (depersonalization)
- Feeling like I am observing my own life
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FAQs
Q.
Is the World Feeling Fake? Derealization Science & Medically Approved Next Steps
A.
Feeling like the world is fake can be derealization, a common and treatable dissociative symptom where surroundings feel unreal or dreamlike, often triggered by stress, anxiety, trauma, poor sleep, or substances, and it is distinct from psychosis. Medically approved next steps include getting a medical evaluation to rule out causes like thyroid or B12 problems, migraines, seizures, or medication effects; addressing anxiety or trauma with therapies such as CBT; using grounding and sleep optimization; and avoiding triggering substances. There are several factors to consider, including when to seek urgent care for persistent or disabling symptoms or red flags like severe confusion, neurological symptoms, chest pain, or thoughts of self harm; see below to understand more.
References:
* Steinberg, J., & Hollander, E. (2021). Depersonalization-derealization disorder: Current understanding and treatment. *Current Psychiatry Reports*, *23*(8), 1–9.
* Spiegel, D., Saperstein, A., & Spang, R. (2023). Current and emerging therapeutic strategies for depersonalization/derealization disorder. *Expert Review of Neurotherapeutics*, *23*(3), 223–232.
* Phillips, J. R., Spang, R. J., & Spiegel, D. (2021). The neurobiology of depersonalization-derealization disorder: A review. *Journal of Affective Disorders Reports*, *5*, 100185.
* Hunter, E. C. M. (2018). Depersonalization-derealization disorder: A review of clinical features, neurobiology, and treatment. *Current Opinion in Psychiatry*, *31*(1), 16–22.
* Spiegel, D., & Spang, R. (2020). Diagnostic and assessment approaches for depersonalization/derealization disorder: Current challenges and future directions. *Psychiatric Clinics*, *43*(1), 77–88.
Q.
Is it PTSD? Why Your Brain Stays Stuck and Medically Approved Next Steps
A.
PTSD is a real, treatable condition where the brain stays stuck in survival mode after trauma, with an overactive amygdala and reduced prefrontal regulation; intrusive memories, avoidance, mood changes, and hyperarousal that last more than a month and disrupt daily life may signal it. Medically approved next steps include trauma focused therapies like CPT, Prolonged Exposure, and EMDR, sometimes with medications, plus grounding, symptom tracking, and urgent care for unsafe symptoms; there are several factors to consider, and important details that could change your next step are explained below.
References:
* Thiebault S, et al. Posttraumatic Stress Disorder: From Neurobiology to Treatment. Int J Environ Res Public Health. 2023 Jan 26;20(3):2300. doi: 10.3390/ijerph20032300. PMID: 36768393; PMCID: PMC9914614.
* Di R, et al. Pharmacological and Non-Pharmacological Interventions for Post-Traumatic Stress Disorder (PTSD): An Overview of Systematic Reviews. J Clin Med. 2023 Sep 16;12(18):6021. doi: 10.3390/jcm12186021. PMID: 37731720; PMCID: PMC10532467.
* Srisurapanont M, et al. Neurocircuitry of Posttraumatic Stress Disorder: A Systematic Review of fMRI Studies. Psychiatr Investig. 2022 Jul;19(7):459-467. doi: 10.30773/pi.2022.0069. Epub 2022 Jul 18. PMID: 35928178; PMCID: PMC9332560.
* de la Rosa-Ruiz N, et al. The neurobiology of post-traumatic stress disorder: a critical review of the current evidence. Expert Rev Neurother. 2021 Sep;21(9):1041-1050. doi: 10.1080/14737175.2021.1947231. Epub 2021 Jul 1. PMID: 34215286.
* Gill J, et al. Posttraumatic Stress Disorder: Diagnosis, Pathophysiology, and Clinical Management. Neurotherapeutics. 2020 Jul;17(3):981-991. doi: 10.1007/s13311-020-00832-6. PMID: 32087364; PMCID: PMC7354974.
Q.
How can I tell if I'm an introvert?
A.
You may lean introvert if you recharge alone, prefer meaningful one-on-one conversations, need quiet to focus, and feel drained after extended socializing. There are several factors to consider—your place on the introvert–ambivert spectrum and simple self-checks like journaling, a Big Five test, and trusted feedback; see below for details and practical steps. Also see below for when to seek care (e.g., persistent fatigue, significant withdrawal, or feelings of detachment that could suggest depersonalization) and how to decide next steps in your health journey.
References:
DeYoung CG, Hirsh JB, Shane MS, Papademetris X, Rajeevan N, & Gray JR. (2010). Testing predictions from personality neuroscience: Brain struct… Cereb Cortex, 20087555.
D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhos… J Hepatol, 16879895.
Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient el… J Hepatol, 18242297.
Q.
Can anxiety cause depersonalization?
A.
Yes, anxiety can make you feel detached from yourself or the world, a feeling known as depersonalization.
References:
10.1176/ajp.125.8.1048
https://doi.org/10.1176/ajp.125.8.1048
Kolev OI, Georgieva-Zhostova SO, Berthoz A. Anxiety changes depersonalization and derealization symptoms in vestibular patients. Behav Neurol. 2014;2014:847054. doi: 10.1155/2014/847054. Epub 2014 Jan 28. PMID: 24803735; PMCID: PMC4006595.
Q.
How long does depersonalization last?
A.
Depersonalization can last for a few minutes or hours, and for some people, it may go on for days, weeks, or even longer if it becomes a disorder.
References:
Sierra M, Berrios GE. The phenomenological stability of depersonalization: comparing the old with the new. J Nerv Ment Dis. 2001 Sep;189(9):629-36. doi: 10.1097/00005053-200109000-00010. PMID: 11580008.
Simeon D. Depersonalisation disorder: a contemporary overview. CNS Drugs. 2004;18(6):343-54. doi: 10.2165/00023210-200418060-00002. PMID: 15089102.
Medford, N., Sierra, M., Baker, D., & David, A. S. (2005). Understanding and treating depersonalisation disorder. _Advances in psychiatric Treatment_, _11_(2), 92-100.
Q.
Is it common to get depersonalization from weed?
A.
Some people do feel detached or "numb" after using marijuana because it can change the way your brain works, and these feelings are a type of depersonalization.
References:
Mathew RJ, Wilson WH, Tant SR. Acute changes in cerebral blood flow associated with marijuana smoking. Acta Psychiatr Scand. 1989 Feb;79(2):118-28. doi: 10.1111/j.1600-0447.1989.tb08579.x. PMID: 2923005.
Mathew RJ, Wilson WH, Humphreys D, Lowe JV, Weithe KE. Depersonalization after marijuana smoking. Biol Psychiatry. 1993 Mar 15;33(6):431-41. doi: 10.1016/0006-3223(93)90171-9. PMID: 8490070.
Hürlimann F, Kupferschmid S, Simon AE. Cannabis-induced depersonalization disorder in adolescence. Neuropsychobiology. 2012;65(3):141-6. doi: 10.1159/000334605. Epub 2012 Feb 25. PMID: 22378193.
Q.
What are the 4 stages of depersonalization?
A.
Some experts describe depersonalization as progressing in four stages—from brief, odd feelings to more lasting disconnect from yourself—but not everyone goes through all these stages in the same way.
References:
Bezzubova EB. Klinicheskie osobennosti étapov formirovaniia depersonalizatsii v podrsotkovo-iunosheskom vozraste [Clinical features of stages in the development of depersonalization in adolescence and young adulthood]. Zh Nevropatol Psikhiatr Im S S Korsakova. 1985;85(11):1680-4. Russian. PMID: 4082838.
Baker D, Hunter E, Lawrence E, Medford N, Patel M, Senior C, Sierra M, Lambert MV, Phillips ML, David AS. Depersonalisation disorder: clinical features of 204 cases. Br J Psychiatry. 2003 May;182:428-33. PMID: 12724246.
Mula M, Pini S, Calugi S, Preve M, Masini M, Giovannini I, Conversano C, Rucci P, Cassano GB. Validity and reliability of the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER). Neuropsychiatr Dis Treat. 2008 Oct;4(5):977-86. doi: 10.2147/ndt.s3622. PMID: 19183789; PMCID: PMC2626926.
Q.
What does depersonalization feel like?
A.
Depersonalization feels like you are watching yourself from the outside, as if you are not really part of your own body.
References:
Mula M, Pini S, Preve M, Masini M, Giovannini I, Cassano GB. Clinical correlates of depersonalization symptoms in patients with bipolar disorder. J Affect Disord. 2009 May;115(1-2):252-6. doi: 10.1016/j.jad.2008.08.001. Epub 2008 Sep 11. PMID: 18786726.
Michal M, Beutel ME. Depersonalisation/Derealisation- Krankheitsbild, Diagnostik und Therapie [Depersonalisation/derealization - clinical picture, diagnostics and therapy]. Z Psychosom Med Psychother. 2009;55(2):113-40. German. doi: 10.13109/zptm.2009.55.2.113. PMID: 19402018.
Sutar R, Chaturvedi SK. Symptom profile and diagnostic utility of depersonalization-derealization disorder: A retrospective critical review from India. Indian J Psychiatry. 2020 Jan-Feb;62(1):91-94. doi: 10.4103/psychiatry.IndianJPsychiatry_347_19. Epub 2020 Jan 3. PMID: 32001937; PMCID: PMC6964445.
Q.
What is the definition of depersonalization?
A.
Depersonalization is when a person feels like they are watching themselves from the outside, as if they are not really in their own body.
References:
Sierra M, Berrios GE. Depersonalization: neurobiological perspectives. Biol Psychiatry. 1998 Nov 1;44(9):898-908. doi: 10.1016/s0006-3223(98)00015-8. PMID: 9807645.
Hunter EC, Sierra M, David AS. The epidemiology of depersonalisation and derealisation. A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2004 Jan;39(1):9-18. doi: 10.1007/s00127-004-0701-4. PMID: 15022041.
Murphy RJ. Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review. Innov Clin Neurosci. 2023 Jan-Mar;20(1-3):53-59. PMID: 37122581; PMCID: PMC10132272.
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