Feeling as if you are watching yourself from outside your body, or as if the world around you is not real, has a name. Feeling outside yourself is called depersonalisation. Feeling that the world is unreal is called derealisation. The NHS says people and things may seem "lifeless" or "foggy". You can have one or both.
Brief episodes are common. In surveys, between a quarter and three-quarters of people say they have felt this at some point. It often comes with stress, anxiety, panic, low mood or trauma, or after taking cannabis or other drugs.
When the feeling lasts or keeps coming back and causes distress, it may be depersonalisation-derealisation disorder. This affects around 1 in 100 people. Help is available, and the feeling itself does not mean you are losing your mind.
Get help now
Call 112 or 999 in Ireland, 999 in the UK or 911 in the US, or go to an emergency department, if:
Get urgent help the same day if:
In Ireland, contact your GP or out-of-hours GP, freephone Samaritans on 116 123, or text 50808. In the UK, call NHS 111 and choose the mental health option, or call Samaritans on 116 123. In the US, call or text 988.
See a GP if:
The NHS describes depersonalisation as feeling outside yourself, observing your actions, feelings or thoughts from a distance. Derealisation is feeling the world is unreal. The NHS says it may last only a few moments, or come and go over many years.
Irish and UK health services describe related feelings in other conditions:
Many people with these feelings fear they are "going mad". Researchers describe depersonalisation as a sense of unreality with intact "reality testing". In other words, you usually know the feeling is not literally true.
Psychosis is different. The NHS says people with psychosis are often unaware that their hallucinations or delusions are not real. If you or someone you know is hearing voices or holding unusual beliefs, get help the same day.
A 2004 systematic review of the research found:
A 2023 systematic review put the rate of depersonalisation-derealisation disorder at around 1% of the general population. It was more common in adolescents and young adults, and in people with other mental health conditions. In studies of people with depression, the rate was around 50%.
In a US series of 117 people with the disorder, it usually began around age 16. It affected men and women about equally.
The NHS says dissociation is a way the mind copes with too much stress. Switching off from reality is a normal defence that helps people cope during a traumatic time. It becomes a problem when the threat has passed but the feeling continues.
Many people with dissociative disorders have had a traumatic experience, often in childhood. If the detached feeling began after a frightening or distressing event, read what guidelines recommend for PTSD.
The NHS and the HSE both list feeling disconnected from your body as a panic attack symptom. The NHS says panic attacks are frightening but not dangerous, and will not cause you physical harm. Most last between 5 and 20 minutes.
In the 2004 review, rates of depersonalisation in panic disorder ranged widely across studies, from about 8% to 83%. If you are not sure whether your anxiety has become a condition, see panic attacks versus panic disorder and anxiety the feeling versus anxiety the disorder.
Depersonalisation is common in depression. The 2023 review found rates around 50% in studies of people with depression. Our guide to what works for depression covers the treatment options.
In the 117-person US series, the most common immediate triggers were severe stress, depression, panic, cannabis and hallucinogens. If the feeling began after using a drug, tell your GP. This helps them understand what is going on.
Focal seizures. The NHS says some epileptic seizures cause unusual feelings or sensations. These include strange smells, changes in vision, or suddenly feeling scared. People may lose awareness of what is around them. Seizures usually last seconds to minutes and stop by themselves.
Other dissociative disorders. The NHS describes dissociative amnesia, with gaps in memory about yourself or events, and dissociative identity disorder. These are different from depersonalisation alone.
Physical illness. The NHS says a GP may examine you and do some tests to check whether another illness could be causing your symptoms.
The NHS says some dissociative disorders are short-lived. They may follow a traumatic event and settle by themselves over weeks or months. Others last much longer.
In the 117-person series, the disorder was usually long-lasting and often continuous. People said these things tended to make it worse:
They said these tended to ease it:
The NHS says people with dissociative disorders may also have depression, anxiety and panic attacks, PTSD, insomnia, or thoughts of self-harm or suicide.
A GP will want to know what the feeling is like, when it started, how often it happens and how long it lasts. For panic symptoms, the NHS says the GP will ask about these and may examine you to rule out other conditions.
It helps to think about:
The GP may refer you to a mental health specialist for a full assessment. The NHS says this may include questions about your thoughts, feelings and behaviour. Try to be open about your symptoms. You will not shock anyone.
The NHS says talking therapies are often recommended. They aim to help you cope with the underlying cause and to practise ways of managing periods of feeling disconnected. Eye movement desensitisation and reprocessing (EMDR) is sometimes used. The NHS says many people with a dissociative disorder make a full recovery with treatment and support.
The evidence for specific treatments is still limited. Here is where it stands:
The NHS says there is no specific medicine to treat dissociation. Antidepressants may be prescribed for related depression, anxiety or panic.
The HSE suggests these steps for panic attacks. They may help if the detached feeling comes with panic.
The HSE also suggests regular meals, physical activity such as walking or yoga, and CBT to change negative thought patterns.
Feeling detached for a long time can be frightening and lonely. If you are having thoughts of suicide or self-harm, please tell someone.
No. People with depersonalisation usually know the feeling is not literally true. That is a key difference from psychosis. If you are hearing voices or have unusual beliefs, get help the same day.
Yes. The NHS and the HSE list feeling disconnected from your body as a symptom of panic attacks. The HSE lists "feeling detached from reality" as a symptom of generalised anxiety disorder.
Brief episodes usually pass. The NHS says some dissociative disorders settle over weeks or months, while others last longer. Many people make a full recovery with treatment and support.
It can be a trigger. In a series of 117 people with the disorder, cannabis was one of the most common triggers, along with stress, depression, panic and hallucinogens. Tell your GP if you think a drug started it.
This article is general information, not medical advice. It cannot diagnose the cause of your symptoms. Talk to your GP about your own symptoms, and before starting, stopping or changing any medicine.
Reviewed by: Proco Team
Last updated: November 2026