What is Depersonalization?

Published on December 16, 2019 by First Responder Wellness

An anxiety or panic attack can be a frightening and surreal experience, and the exact symptoms tend to vary between individuals, and even between episodes.  One of the most common but most difficult to explain symptoms of a panic attack is depersonalization, also sometimes referred to as derealization. While the experience is slightly different for everyone, depersonalization refers to a combination of physical sensation, emotions, and thoughts that cause the individual to feel as if they are not present in the moment or they have become entirely separate from their own body.  This feeling can be deeply disturbing, especially if the individual doesn’t recognize it as a symptom of a panic attack. Better understanding this symptom and what it may indicate for your mental health can help you take the right steps to manage your anxiety and seek treatment if necessary.

Different Versions of Depersonalization

Because depersonalization happens on an emotional, physical, and cognitive level in someone experiencing extreme anxiety, the experience can create different symptoms for each individual.  Some people experience a physical sensation that warns them depersonalization is starting to occur, such as a hot flash or tunnel vision. Many people feel as if they begin to lose control of their speech and body movements, or as if someone else is operating them while they begin to slowly detach.  Others feel as if they have left their body and are watching the situation from far away, or begin to ask themselves if they are real at all. Other symptoms of depersonalization and derealization may include the sense that parts of your body are distorted, a feeling of physical or emotional numbness, a distorted perception of time, or a feeling of detachment from your own memories. 

The common threads in experiences of depersonalization are a lack of control and a feeling of distance or isolation.  On the surface, this experience can feel like something terrible is happening to you, but in reality, it is yet another natural response to the fight or flight instinct that causes anxiety and panic.  Depersonalization is one way your mind is choosing to protect you from a perceived threat, even if that threat isn’t obvious to you or others on a logical level. 

Causes and Treatment

While the source of anxiety and panic is different for everyone, depersonalization and derealization are more common in people who have experienced trauma.  This means that individuals with a diagnosis of post-traumatic stress disorder or secondary-traumatic stress disorder are more likely to suffer from episodes of depersonalization as either their primary symptom of panic and anxiety, or one symptom of many.  Additionally, working in a very stressful environment can bring on episodes of depersonalization, as can a severely tumultuous home life. Much of learning to manage anxiety and panic symptoms is finding ways to create pockets of peace and calm in your life, even if you are often immersed in chaotic environments.

Many people who struggle with depersonalization and derealization also deal with other mental health issues such as anxiety, depression, and substance use disorders.  While depersonalization by itself is not dangerous, reoccurring episodes can cause difficulty with maintaining relationships, enjoying social interaction, job performance, and memory.  Depersonalization is usually a sign to pay closer attention to your mental health, or to see an expert to uncover what is causing your mind and body to react fearfully to seemingly safe surroundings.  Mental health professionals may use several strategies to help patients cope with dissociative episodes. Depersonalization and derealization can be managed, and at the very least it is important to mentally understand what is happening so that episodes don’t continue to spiral out of control into full-blown panic attacks.  

Depersonalization and First Responders

While anyone can experience depersonalization, first responders are especially at risk of this symptom of anxiety and panic.  One study published in 2017 in the European Journal of Psychotraumatology found that derealization and depersonalization are common in first responders, military members and veterans as a symptom of PTSD.  Another study, published in the same journal in 2018, looked at the relationship between dissociative symptoms such as depersonalization and derealization and an individual’s ability to function in their career.  The study concluded that “Successful recovery on a functional and symptomatic level may necessitate treatment of dissociative symptoms, particularly derealization.” Many people who experience this symptoms and others in association with severe anxiety and panic attacks turn to drugs or alcohol to cope.  Unfortunately, substance abuse only leads to worsened mental health over time, and may also lead to an addiction.  


The First Responders Treatment Program at Simple Recovery uses trauma-informed strategies to cater to the unique needs of law enforcement, firefighters, paramedics, and other first responders with substance use disorders and co-occurring mental illnesses.  We recognize that first responders encounter job-specific barriers and obstacles that come with the culture of their careers, and that existing stigmas may make seeking help for addiction and mental health issues especially difficult. Addiction does not have to mean the end of your career or a lifetime of struggling with your health and relationships.  By taking a holistic approach to treatment and addressing the underlying causes of addiction, Simple Recovery makes it possible for first responders to regain control of every aspect of their wellbeing. First responders dedicate their lives to protecting their community, and at Simple Recovery’s First Responder Treatment Program, we believe in dedicating our time and expertise to helping these compassionate individuals find a path to lasting sobriety and mental wellness.  If you or someone you love is struggling with addiction, call us now at 888-743-0490.