How to Deal With Derealization?

Natalie Buchwald, LMHCUncategorized

By Natalie Buchwald, LMHC | Last Updated: June 14th, 2023
Reviewed by Steven Buchwald

Do you ever feel like you’re walking through a dream? Or as if the world around you isn’t real?

This may sound like an interesting, ethereal experience. For those dealing with derealization, it isn’t.

People with derealization disorder often feel disoriented and disconnected from themselves or the world around them.

If you have experienced this reality shift, you might have felt really scared.

To say derealization is unsettling would be an understatement.

Experiencing derealization does not mean anything is wrong with you. However, if this happens often, you may want to learn more about derealization disorder.

Derealization can be incredibly disruptive.

Learning more about the condition and your options can help you feel less alone (and more in control.)

If you’re ready to move through this, we are here to help you.


Derealization, or a feeling of unreality, has several triggers.

In some cases, derealization disorder can stem from:

  • Trauma (physical or psychological)
  • Stress
  • An inability to cope with reality
  • Substance abuse

In-the-moment derealization episodes, similarly, happen for many reasons. Sometimes, they happen after severe stress. These episodes may also occur after the use of recreational drugs.

Those are just generalities. Anyone can experience derealization. At any time.

When it occurs, it’s frightening—and having theories about the when and why don’t help in the moment.

You need to have a plan in place for when it does happen.

A good plan to deal with derealization includes weekly therapy and daily self-care.

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Therapy can help lessen the burden of derealization. Therapy may reduce the intensity and frequency of episodes. It could also equip you with the tools necessary to care for yourself as derealization occurs.

Derealization patients discuss the following in therapy:

  • Why their derealization symptoms are happening
  • Ways to distract or lessen the intensity of the symptoms of derealization
  • Ways to connect more strongly to their feelings and the world around them
  • Coping strategies to help them deal with stressful situations (or derealization triggers)
  • Addressing trauma from their past
  • Addressing current mental health conditions (e.g., depression or anxiety)

Your therapist may be able to help you address the deeper triggers for derealization disorder.

They can also help you build emotional regulation routines that allow you to take care of yourself every day.


Weekly therapy is vital for thriving with recurrent derealization episodes.

But it isn’t enough on its own.

You also need to know how to care for yourself in between sessions. Your therapist will provide specific suggestions, but some actions that may help include:

  • Take time each day to meditate. Focus on your breath. Incorporate practices that promote feeling calm and present. Then, when an episode occurs, you’ll have the muscle memory to rely on. This is easier said than done. Start by going for a walk, listening to low-fi or acoustic music, journaling, and seeing what works best to still your thoughts and soothe your brain.
  • Ask for help. Call or text a friend if you realize your thoughts are going to an unhelpful place.
  • Take care of your body. Prioritize sleep and rest, and move your body regularly. (Again, easier said than done — see whether you can take a tiny step forward in these areas, and ask your therapist if you need help.)

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  • You are not alone. Derealization can feel isolating. Know that your community and our team of mental health professionals are here for you.
  • You aren’t in danger. Derealization can feel incredibly dangerous. If an episode strikes, it can be hard to remember that you aren’t in a life-threatening situation. Breathe, and know that you can handle this.
  • You are going to be okay. Some people who experience derealization fear that they are broken or developing a severe condition. This is not necessarily the case. Speaking with a therapist can help you become more aware of your condition.
  • You don’t need to struggle. The stress of fighting derealization could make the episode worse. Discuss your options with your therapist. There may be a benefit to accepting the feeling, experiencing episodes as they occur, and trying your best to heal and grow over time.

At Manhattan Mental Health Counseling, we offer accessible, affordable, and high-quality therapy onlineCall us today to learn about your next steps.