Several of our Therapists that are seeing clients in person have now been vaccinated. In addition to offering in person appointments we are also seeing clients for online sessions via video call.
by Dr. Becky Spelman on 20/07/2020

In the absence of therapy, people develop coping mechanisms in response to their mental health symptoms. Typically, these coping mechanisms are functional in the short term. For example, in the case of people with anxiety, the coping mechanisms they develop can allow the person to survive and get through their day without a panic attack, but they are usually very damaging over time.

Two common symptoms associated with anxiety disorders are depersonalisation and derealisation.

What are depersonalisation and derealisation?

Depersonalisation is a condition whereby the person has the feeling that they are no longer “in” their own body but, rather, watching it from a distance. This can be a very frightening feeling, associated with a sense of having little to no control over their own actions. People who experience this are often scared that they are “going mad”; losing touch with reality to the extent that they can no longer function in the world.

Depersonalisation is often associated with anxiety disorders, and can also be a symptom of other conditions, including substance abuse and a range of psychiatric illnesses.

Derealisation refers to the sense of feeling detached from the people and things in one’s environment. A person who experiences derealisation may feel that they have no control over their surroundings, and that their friends and family members are more like strangers than familiar and loved people. They often have the sensation of simply not knowing what to do.

Approaches in Treating Anxiety

Because both of these conditions tend to develop as an instinctive way of dealing with an approaching panic attack and with overwhelming anxiety, the only long-term way to eliminate the risk of experiencing them is to deal with the anxiety. Fortunately, there are many proven approaches that help to mitigate the symptoms of anxiety, or even eliminate it completely. On an immediate level, medication can help—but for a long-term approach it is crucial to undergo a suitable form of therapy, such as cognitive behavioural therapy, avoidance therapy, and so on; working together, you and your therapist can figure out which approach, or which combination of approaches, is best for you.

It may take some time in therapy before symptoms of anxiety recede significantly, so alongside a dedicated long-term approach to reducing anxiety, some behavioural changes can help to mitigate the symptoms of depersonalisation and derealisation.  These include using basic mindfulness and/or deep breathing techniques to return to the moment and to refocus on the things that are happening in the immediate environment. A therapist can teach you some simple techniques that you can use in your everyday life while you are still working to get your anxiety under control.

People who have suffered anxiety for a significant period of time may be at risk of a relapse when they are experiencing stress. Even when you have completed therapy, it may be a good idea to attend a support group, or have an occasional therapy session to support the positive changes you have made that help you to manage your condition.


If you would like to talk to someone about depersonalisation and derealisation, or about anxiety disorders in general, please get in touch with us at the Private Therapy Clinic by telephone at: +4402038820684 or book online.


Sadock, BJ; Sadock, VA (2015). “12: Dissociative Disorders”. Kaplan and Sadock’s Synopsis of Psychiatry (11th ed.). Wolters Kluwer. Epidemiology, pp. 454-455

Sierra, M.; Berrios, G. E. (2001). “The phenomenological stability of depersonalization: Comparing the old with the new”. The Journal of Nervous and Mental Disease. 189 (9): 629–36.

Simeon D (2004). “Depersonalisation Disorder: A Contemporary Overview”. CNS Drugs. 18 (6): 343–54.


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