First let's look at "depersonalization". This symptom phenomena commonly found in anxiety disorder sufferers, but especially those with panic attacks, is a symptom-induced experience, where a patient feels they are "unreal", like they no longer exist as a person. They may even feel they have become invisible and that others around them are real but they are not. Some patients describe it as feeling like being a robot and no longer like a human being. Patients have described episodes for example, of looking at their own hand, in front of their face and wondering if it is really there. Patients will also describe experiences of looking into a mirror and actually feeling as if they do not recognize them selves and they feel as if they are having some type of identity crisis. Obviously, these are very scary and very unpleasant experiences for anxiety patients and ones they certainly do not want to continue or reoccur.
These episodes of depersonalization are reported by some anxiety disorder sufferers, to happen immediately preceding the onset of a panic attack or with other severe anxiety symptoms, while others experience depersonalization during an attack of severe anxiety or panic symptoms. Once the depersonalization symptom is experienced by some anxiety suffers, they report that it will occur more frequently and will be triggered more easily, even with less severe anxiety symptoms.
"De-realization", is similar but in this case, that which seems to become unreal, is the person's surroundings. With de-realization, an anxiety sufferer will have episodes of experiencing feelings that their surroundings have become unreal. They will feel as if even reality itself is no longer something they can fully grasp, during those moments. They may even question the existence of things and wonder if life itself is a dream of some type. Some descriptions I have heard of this experience are; "like being inside a bubble", or "like trying to see everything, through a curtain" and "like everything is covered with a thick fog".
Many anxiety sufferers, will experience both depersonalization and de-realization, at the same time or these may alternate, so that they experience each at different times. During episodes of either, they will also commonly have mind fog, meaning they feel hazy and unable to concentrate. These features only add to the unpleasantness of these experiences.
What causes these strange feelings of depersonalization and de-realization that are so concerning to anxiety sufferers? Well we know the "fight or flight response" itself is a protection mechanism, created in us, to help us flee or flight danger and to help us perform more powerfully, with important tasks at hand. These unreality type symptoms, where things seem to become unreal, is very likely part of that same protection mechanism. It may be that our minds will cause ourselves and our surroundings, to temporarily fade from our minds, in order for us to concentrate more intensely, on locating the actual danger that threatens us. It is similar to the reason an anxiety patient's mind will race, because it is trying to scan for dangers that have threatened them and set off the fight or flight response. We also know that all senses are heightened during strong anxiety responses and this too likely adds to these feelings of unrealities.
See my article in "Related Conditions" entitled; "Coping with Anxiety Unreality Symptoms".
