Discussing Feelings of Unreality with Your Doctor

You’ve been experiencing a persistent sense of detachment, a feeling that the world around you isn’t quite real, or perhaps that you aren’t quite real. This unsettling sensation, often described as derealization or depersonalization, can be a significant source of anxiety and distress. It’s crucial to understand that you are not alone in this experience and that seeking professional medical attention is a vital step in understanding and managing these feelings. Approaching your doctor with these concerns, while potentially daunting, is a necessary part of navigating this complex terrain.

The symptoms you’re describing fall under a spectrum of dissociative experiences. These aren’t simply fleeting moments of daydreaming; they represent a significant disruption in your sense of self, your consciousness, and your perception of reality. It’s like observing yourself from a distance, as if you’re a character in a movie of your own life, or as if the world itself has lost its vibrancy and solidity, becoming a blurry, artificial stage set.

Differentiating Derealization and Depersonalization

While often used interchangeably, derealization and depersonalization have distinct nuances:

Derealization: You feel a profound sense of unreality about your surroundings. The world might appear hazy, foggy, or as if viewed through a veil. Colors may seem muted or overly bright, sounds distant or distorted. Familiar places can feel alien and unfamiliar, as if you’ve stepped into a dream and can’t quite wake up. It’s as if the external world has become a stage prop, lacking genuine substance.

Depersonalization: You experience a disconnect from your own body and mind. You might feel like an observer of your own thoughts, feelings, and sensations, rather than an active participant. There can be a sense of emotional numbness, as if your emotions are not truly your own, or a feeling of being a robot, going through the motions without genuine internal experience. It’s akin to wearing a mask that you can’t remove, or feeling like your body is not your own.

Common Manifestations of Dissociative Feelings

Beyond the core definitions, these feelings can manifest in various ways that might be confusing or alarming to you:

Distorted sense of time: Time can feel like it’s speeding up, slowing down, or even standing still. Moments might feel fleetingly brief or endlessly stretched.
Altered perception of self and body: You might feel detached from your limbs, as if they don’t belong to you, or experience phantom sensations. Your reflection in the mirror might seem like a stranger’s.
Emotional blunting: A significant reduction in your capacity to feel emotions, both positive and negative. This can lead to feelings of apathy and detachment from interpersonal relationships.
Sense of being in a dream or fog: As mentioned, the world can feel muted, unreal, or as if you’re perpetually navigating through thick fog.
Distorted perception of distance or size: Objects might appear farther away or closer than they are, or their sizes might seem disproportionate.
Feeling disconnected from memories: Past events might feel like they happened to someone else, lacking personal resonance or emotional weight.

If you’re struggling with feelings of unreality and are unsure how to communicate this to your doctor, you might find it helpful to read an article that offers guidance on this topic. Understanding how to articulate your experiences can be crucial in receiving the support you need. For more insights on this subject, check out the article on Unplugged Psych by following this link: How to Talk to a Doctor About Feeling Unreal.

Preparing for Your Doctor’s Appointment

Approaching your doctor requires clear communication. Think of this appointment as setting sail on a journey to understand your internal landscape. The more precise your charting, the better your navigator (your doctor) can guide you. Bringing a structured approach can ensure you cover all necessary ground.

Documenting Your Experiences

Before you even make the appointment, dedicate time to jotting down your observations. This written record will be a valuable tool, acting as a detailed map for your doctor.

Keeping a Symptom Journal

Frequency and duration: How often do these feelings occur? How long do they typically last? Are there specific times of day or situations when they are more prominent?
Intensity: On a scale of 1 to 10, how intense are these feelings of unreality? Does the intensity fluctuate?
Triggers: Can you identify any specific events, situations, thoughts, or stressors that seem to precede or exacerbate your symptoms? This might include stress, lack of sleep, fatigue, or even certain sensory stimuli.
Associated symptoms: Are there other physical or emotional symptoms that accompany the feelings of unreality? This could include anxiety, panic attacks, racing heart, shortness of breath, dizziness, or a general sense of unease.
Impact on daily life: How do these experiences affect your ability to function in your daily life? Consider your work, relationships, hobbies, and self-care. Do you avoid certain activities because of these feelings?

Noting Any Significant Life Events

Dissociative experiences can sometimes be linked to significant life events, even if they occurred in the past. Consider if there have been any major changes or traumas in your life that might be relevant. This could include:

Periods of intense stress or pressure.
Significant losses or bereavements.
Traumatic experiences (physical, emotional, or sexual abuse, accidents, natural disasters).
Major life transitions (moving, changing jobs, relationship changes).
Substance use or withdrawal.

Identifying Your Concerns and Questions

Beyond describing your symptoms, it’s important to articulate what you hope to gain from the appointment. Your questions are the compass points that will help both you and your doctor navigate towards understanding and solutions.

Formulating Specific Questions for Your Doctor

Prepare a shortlist of questions to ask. This ensures you don’t leave the appointment with a lingering cloud of uncertainty. Examples include:

“What could be causing these feelings of unreality?”
“Are these symptoms a sign of a serious underlying condition?”
“What diagnostic tests might be necessary?”
“What are the potential treatment options available?”
“Are there lifestyle changes I can make to help manage these feelings?”
“Is this something I can overcome, or is it a chronic condition?”
“When should I seek further medical attention?”

Communicating Effectively with Your Doctor

doctor about feeling unreal

The doctor’s office is a space for critical exchange, like a dialogue between an explorer and a cartographer. Your ability to convey your experiences accurately and honestly is paramount. Don’t hesitate to be direct and thorough.

Describing Your Symptoms Clearly and Concisely

When you’re in the appointment, focus on relaying the information you’ve gathered in your journal. Use clear language and avoid medical jargon where possible, unless you are certain of its meaning.

Using Descriptive Language

Instead of saying “I feel weird,” try to elaborate. For instance, “I feel like I’m watching myself from a distance, as if my body isn’t quite mine,” or “The world around me seems muted and distant, like I’m looking through a pane of smudged glass.”
Be precise about the nature of the disconnection. Are you detached from your body, your thoughts, your emotions, or your surroundings?
Explain the subjective experience. How does it feel to be in this state of unreality? Is it frightening, confusing, numb, or something else?

Being Honest About Frequency and Impact

Don’t downplay your symptoms. It’s easy to minimize your own experiences, but your doctor needs an accurate picture.
Emphasize how these feelings are impacting your life. This provides crucial context for the severity of your condition.

Voicing Your Fears and Expectations

It’s natural to feel apprehension. Your doctor is there to address those fears and set realistic expectations.

Expressing Anxieties and Concerns

Be open about your fears. Are you worried about a serious illness, losing your mind, or the long-term effects of these symptoms?
If you have been researching online, you can mention what you’ve found, but also state any confusion or concern these findings have generated.

Setting Realistic Expectations

Understand that a diagnosis might not be immediate. Many conditions require thorough investigation.
Be prepared for a process of exploration. Your doctor will likely ask a series of questions to rule out various possibilities.
It’s important to communicate what you hope to achieve from treatment. Are you seeking symptom relief, a definitive diagnosis, or strategies for coping?

The Diagnostic Process: What to Expect

Your doctor will initiate a multi-faceted approach to understand the root cause of your feelings. This process is like a detective piecing together clues to solve a mystery.

Medical History and Physical Examination

The initial steps are foundational, aiming to gather essential information and rule out common physical causes.

Gathering Detailed Information

Your doctor will review your medical history, asking about:

Pre-existing medical conditions.
Current medications you are taking (prescription, over-the-counter, and supplements).
Family history of mental health conditions or neurological disorders.
Lifestyle factors such as diet, exercise, sleep patterns, and substance use.

Conducting a Physical Examination

A thorough physical examination helps to assess your overall health and identify any physical signs that might be contributing to your symptoms. This might include:

Checking your vital signs (blood pressure, heart rate, temperature).
Neurological assessments to test reflexes, coordination, and sensory function.
Examining your eyes, ears, nose, and throat.

Diagnostic Tests and Referrals

Depending on the initial findings, your doctor may order further tests or refer you to specialists.

Potential Diagnostic Tests

Blood tests: These can help identify underlying medical conditions such as thyroid problems, vitamin deficiencies (e.g., B12), or electrolyte imbalances that can mimic dissociative symptoms.
Imaging studies: In some cases, an MRI or CT scan of the brain might be ordered to rule out neurological issues such as tumors, lesions, or structural abnormalities.
Electroencephalogram (EEG): This test measures electrical activity in the brain and can help diagnose seizure disorders that might be presenting with unusual perceptual experiences.

Referrals to Specialists

Your doctor might refer you to one or more specialists for further evaluation:

Neurologist: If there’s suspicion of a neurological condition.
Psychiatrist: If a primary mental health condition is suspected, such as an anxiety disorder, panic disorder, or trauma-related disorder.
Psychologist: For therapy and assessment.

If you’re struggling with feelings of unreality, it can be challenging to communicate your experiences to a doctor. It’s important to approach the conversation openly and honestly, sharing specific symptoms and how they affect your daily life. For additional guidance on this topic, you might find it helpful to read a related article that offers tips on effectively discussing mental health concerns with healthcare professionals. You can check it out here: how to talk to a doctor about your feelings. Being prepared can make a significant difference in receiving the support you need.

Moving Forward: Treatment and Management Strategies

Topic	Details	Tips for Discussion	Possible Questions to Ask
Describe Your Symptoms	Explain feelings of unreality, detachment, or disconnection from surroundings or self.	Be specific about when symptoms occur, their duration, and intensity.	What might be causing these feelings? Are they related to anxiety or another condition?
Frequency and Duration	How often and how long the feelings last (e.g., daily, weekly, minutes, hours).	Keep a symptom diary to provide accurate information.	Is this a sign of a mental health disorder or something else?
Triggers	Identify any situations, stressors, or substances that seem to trigger the feelings.	Note any patterns or recent life changes that coincide with symptoms.	Can lifestyle changes help reduce these episodes?
Impact on Daily Life	How these feelings affect work, relationships, and daily activities.	Be honest about any difficulties or limitations caused by symptoms.	What treatments or therapies can improve my quality of life?
Medical History	Share any past mental health diagnoses, medications, or relevant medical conditions.	Bring a list of current medications and previous treatments.	Could my current medications be contributing to these feelings?
Next Steps	Discuss possible referrals, tests, or therapy options.	Ask about follow-up appointments and monitoring progress.	What should I do if symptoms worsen or change?

Once a diagnosis or a working hypothesis is established, your doctor will discuss a tailored plan. The journey of management is often a collaborative effort, requiring your active participation.

Understanding Treatment Options

Treatment approaches will vary significantly based on the underlying cause of your symptoms.

Medical Interventions

Medication: If your symptoms are linked to conditions like anxiety, depression, or panic disorder, your doctor might prescribe medications such as selective serotonin reuptake inhibitors (SSRIs) or other anxiolytics.
Treatment of Underlying Medical Conditions: If a physical health issue is identified, treating that condition is paramount and may resolve the dissociative symptoms.

Psychotherapy and Behavioral Approaches

Therapy plays a critical role in addressing the psychological components of dissociative experiences.

Cognitive Behavioral Therapy (CBT)

CBT can help you identify and challenge negative thought patterns and develop coping mechanisms for managing anxiety and distress associated with derealization and depersonalization. It’s like learning to reframe the narrative of your experiences.

Dialectical Behavior Therapy (DBT)

DBT focuses on teaching skills for emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. These skills can be highly beneficial in managing the overwhelming nature of dissociative episodes.

Trauma-Informed Therapy

If your symptoms are linked to past trauma, therapies specifically designed to address trauma, such as Eye Movement Desensitization and Reprocessing (EMDR) or trauma-focused CBT, may be recommended.

Lifestyle Adjustments and Self-Care

Beyond professional interventions, proactive self-care can significantly contribute to your well-being.

Prioritizing Sleep and Nutrition

Consistent Sleep Schedule: Aim for 7-9 hours of quality sleep per night. Irregular sleep patterns can exacerbate anxiety and dissociative symptoms.
Balanced Diet: Nourish your body with whole, unprocessed foods. Avoid excessive caffeine and sugar, which can trigger anxiety.

Stress Management Techniques

Mindfulness and Meditation: Regular practice can help you stay grounded in the present moment and reduce rumination.
Physical Activity: Engage in regular exercise. It’s a powerful stress reliever and mood booster.
Relaxation Exercises: Techniques like deep breathing, progressive muscle relaxation, or guided imagery can help calm your nervous system.

Building a Support System

Communicating with Loved Ones: Share your experiences with trusted friends and family. Their understanding and support can be invaluable.
Support Groups: Connecting with others who have similar experiences can combat feelings of isolation and provide practical advice.

Your journey to understanding and managing feelings of unreality is a testament to your strength. By approaching your doctor with preparation, honesty, and a willingness to explore, you are taking a powerful step towards reclaiming your sense of self and firmly planting your feet back in the solid ground of reality.

FAQs

What does it mean to feel unreal?

Feeling unreal, often described as depersonalization or derealization, is a sensation where a person feels detached from themselves or their surroundings. It can feel like being in a dream or watching oneself from outside the body.

Why is it important to talk to a doctor about feeling unreal?

Discussing these feelings with a doctor is important because they can help identify any underlying medical or psychological conditions, such as anxiety, depression, or neurological issues, and recommend appropriate treatment or therapy.

How should I prepare for a doctor’s appointment about feeling unreal?

Before the appointment, note when the feelings started, how often they occur, any triggers, and other symptoms you experience. This information will help the doctor understand your situation better and make an accurate diagnosis.

What kind of questions might a doctor ask about feeling unreal?

A doctor may ask about the duration and frequency of the sensations, any recent stress or trauma, your mental health history, medication use, and whether you have experienced other symptoms like dizziness or memory problems.

What treatments are available for feeling unreal?

Treatment depends on the cause but may include therapy such as cognitive-behavioral therapy (CBT), medication for underlying conditions like anxiety or depression, stress management techniques, and lifestyle changes to improve overall mental health.