Episode 29: The Three Ds: Derealisation, Depersonalisation and Dissociation

Unlike other types of anxiety responses, derealisation and depersonalisation are stress responses which can make you feel like you are having an out-of-body or not-fully-lucid experience. Since anxious responses affect both the mind and body, experiences vary from person-to-person or relate to the situation you’re in. They are a result of stress, hyperventilating, or over-breathing over a long period of time. When something triggers an anxious response, it makes blood flow attend to the large muscles of our body (think fight, flight, freeze response behaviour in animals). There is increased blood pressure in the brain and blood oxygen levels. Derealisation means things may feel and look weird, and you can recognise your environment but it doesn’t feel like you’re there. You might even feel off-balance or have temporary tinnitus. Depersonalisation is when you feel like you are in a dream. You may “hear” your own voice louder, and have existential thoughts. Both derealisation and depersonalisation are harmless though the feelings that arise from the body’s response can feel scary. Dissociation is a response to trauma. People with PTSD may dissociate when they feel like they are back in their traumatic situation. This reaction is our minds’ way of experiencing less trauma by blocking out the experience we find ourselves in, even if the situation is only triggering a memory. Dissociation may be when we have a flashback whether we want to or not.

As discussed in this episode, vasovagal syncope is a similar but different body response. Similar to a panic episode like derealisation, depersonalisation, or dissociation, vasovagal syncope can happen simply by being triggered by a conversation or image. In some circumstances it can also be triggered by dehydration or constipation, and it may cause people to faint. Unlike derealisation, depersonalisation, or dissociation, vasovagal syncope decreases blood pressure in the brain, opens blood vessels in the calves and lower body, and is unique in that it is triggered specifically by the sight or graphic description of blood or injury. If you feel like it is coming on, your only injury may come from fainting, so it is advised to sit down or stabilise yourself against a wall.

We hope you found this episode informative and encourage you to share it with a friend you know who has experienced a dramatic body response, especially if they are unsure what it was.

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