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Depersonalization and Derealization

What Are These Common Symptoms of Panic Disorder?


Updated April 29, 2014

Photo Copyright Microsoft

Depersonalization and derealization are common symptoms of panic disorder.

Photo © Microsoft

Panic attacks are the most prominent symptom of panic disorder. If you have been diagnosed with panic disorder, you are well aware of the impact that these attacks can have on your life. Panic attacks typically occur unexpectedly and are characterized by many frightening physical sensations, such as shortness of breath, shaking, trembling, and chest pain.

People with panic disorder also have many upsetting and disturbing thoughts during a panic attack. For example, it is not uncommon for a person who is experiencing a panic attack to become fearful that they are going insane, terrified that they will completely loss control, or afraid that they are dying. Some may even feel as though they are detached from themselves and their surroundings, feeling as if they are losing touch with reality.

Known as depersonalization and derealization, these types of frightening thoughts are common symptoms of anxiety disorders, including panic disorder. Depersonalization and derealization can be so frightening that these symptoms can potentially increase a person’s feelings of fear, panic, and anxiety. Even though these thoughts can be extremely scary to have, they are only thoughts and therefore cannot cause harm to the person having a panic attack.

Although similar, depersonalization and derealization are separate and distinct features that often affect one’s thinking during a panic attack. The following explains and defines depersonalization and derealization, along with suggestions for getting help for panic disorder.


When experiencing depersonalization during a panic attack, a person may feel as if they are disconnected from themselves or a spectator of their own life. It can feel almost as if you are outside your own body, watching yourself from a distance. This terrifying feeling is often accompanied by thoughts and fears of losing touch with reality or lacking control over oneself.

Depersonalization can also bring up frightening physical sensations, such feelings of numbness and tingling. Others describe the experience as though they are robotic, feeling like they are just going through the motions, or sensing that they are unable to regulate their body. People who experience depersonalization often report that they felt outside themselves, as if they were watching a movie or dreaming.


These feelings of detachment from the self, or depersonalization, often coincides with symptoms of derealization. Derealization differs from depersonalization in that it involves feelings of detachment from one's environment. When experiencing derealization, a person often feels disconnected from their personal surroundings and external objects, including other people.

Many people who experience this symptom of panic disorder describe derealization as feeling spaced out or foggy. People and objects in the environment may begin to seem unreal, distorted, or cartoon-like. Others report feeling trapped by their environment or viewing their surroundings as surreal and completely unfamiliar.

What You Can Do

If you experience these symptoms during a panic attack, one of the most important things you can do is to remind yourself that these feelings will pass. Depersonalization and derealization typically subside as the panic attack and associated anxiety diminish. Thinking too much about these feelings may only bring about more panic and anxiety. Both of these symptoms seem to dwindle faster when the person stops focusing on the upsetting thoughts and sensations.

Depersonalization and derealization may feel very scary and disturbing, but they are not considered dangerous or life threatening. When experiencing these symptoms, you are not at risk for having a psychotic break or developing schizophrenia. However, depersonalization and derealization can be a sign that you have a more serious mental health disorder, such as depersonalization disorder. Only a qualified mental health provider can determine your diagnosis and treat your condition. If you have been experiencing these symptoms, seek professional help.

Seeking Professional Help

There are many qualified professionals who treat panic disorder. These providers will understand your symptoms and discuss potential treatment options for your condition. They will also be able to assist with any possible co-occurring mental health disorders, such as agoraphobia or depression.

Typical treatment plans for panic disorder and common co-occurring conditions include, medications for panic disorder, psychotherapy, or a combination of both of these treatment options. Your mental heal provider will work with you to determine the best treatment for your symptoms. Depersonalization and derealization are common symptoms of panic disorder, but can be managed through treatment.


American Psychiatric Association. "Diagnostic and Statistical Manual of MentalDisorders, 4th ed., text revision" 2000 Washington, DC: Author.

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