• I’ve noticed that in the last few years - mainly during times of peak anxiety - my mind would slowly detach from reality. (Supplied)Source: Supplied
These feelings, so difficult to put on paper, have recently become more acute. I live in Melbourne, the current epicentre of Australia's coronavirus outbreak, and the government's decision to enter Stage 4 lockdown has pushed me over the edge.
By
Caroline Zielinski

26 Aug 2020 - 8:49 AM  UPDATED 18 Aug 2021 - 3:51 PM

Last week, during a lovely bike ride along the St Kilda foreshore, the world shifted on its axis. Cars on the road slowed down, the sky expanded and all noise became muted. I was waiting at a busy intersection to cross the road, and when the light turned green, it took me a while to recognise the signal to move.

It wasn’t the first time this had happened. I’ve noticed that in the last few years - mainly during times of peak anxiety - my mind would slowly detach from reality. Sometimes, time slows down and the air becomes dense. My movements are slow, everything is brighter and it takes all my effort to just stand up.

Other times, I feel alien to myself, as though I am inhabiting a body that is interchangeable, nothing but a sack of bones and skin and hair. It’s an intense yet strangely calm feeling, where I’m simultaneously devoid of emotion yet exist in a heightened state of awareness.

These feelings, so difficult to put on paper, have recently become more acute. I live in Melbourne, the current epicentre of Australia's coronavirus outbreak, and the government’s decision to enter Stage 4 lockdown has pushed me over the edge.

These feelings, so difficult to put on paper, have recently become more acute.

As I came home after that bike ride, I realised that in addition to the feelings of unreality I also felt nothing, and it was this absence of emotion that panicked me. Not knowing how to manage it, I called Beyond Blue, half-fearing they would immediately commit me to hospital. What transpired instead was life-changing.

“Have you heard of depersonalisation?” the lovely Beyond Blue counsellor asked. “It’s a common feeling among those who suffer from anxiety - it's the brain’s way of saying it’s had enough, a defensive mechanism to protect us in times of high stress”.

In all my years of therapy, I’ve never come across this term. I knew that people who suffer from panic attacks often report feeling surreal (I’ve had a few myself) but I didn’t realise this type of effect could happen outside of a panic attack.

“Many people experience feelings of depersonalisation and derealisation,” says professor of psychiatry at the Alfred Health and Monash University, Jayashri Kulkarni, when I call her up to get more information. “The simplest example of derealisation is the experience of driving through a traffic light and not remembering if it's red or green.”

“Many people experience feelings of depersonalisation and derealisation,” says professor of psychiatry at the Alfred Health and Monash University, Jayashri Kulkarni, when I call her up to get more information.

These experiences occur on a continuum, from transient episodes in healthy people under certain conditions (such as moments of stress or anxiety) to a serious psychiatric disorder such as depersonalisation disorder, or DPD, a chronic state of feeling outside your body and environment which can also include a loss of emotional reactivity.

And while depersonalisation (a subjective sense of yourself not being real) and derealisation (a sense of the world not being real) are thought to be common in people who suffer from anxiety, panic disorder and post-traumatic stress disorder (PTSD), they are sadly under-reported -- and recognised as a legitimate condition.

“Many health professionals may not be attuned to this condition or may not take it seriously,” says Beyond Blue’s lead clinical advisor, Dr Grant Blashki. “Generally, it’s not something that general medical professions have learnt a lot about or focused on.”

While it’s hard to know how prevalent dissociative experiences really are, experts suggest that depersonalisation is the third most prevalent mental health symptom after anxious and depressed mood. Some studies estimate that transient experiences of depersonalisation and/or derealisation occur in 34 to 70 per cent of people not suffering from anxiety, depression, panic disorders or PTSD, often materialising under conditions of great stress, fatigue or drug use.

Because the condition is often underreported (another clinical psychologist I talked to, Peter Walker, says it takes people a long time - as long as 12 years in some cases -  before they bring these experiences up with mental health professionals) not many people are aware of it - and how to deal with it.

Because the condition is often underreported (another clinical psychologist I talked to, Peter Walker, says it takes people a long time - as long as 12 years in some cases -  before they bring these experiences up with mental health professionals) not many people are aware of it - and how to deal with it.

Dr Blashki - who estimates that about a third of his patients with panic disorder experience some form of dissociative feelings - believes that depersonalisation and derealisation happen when the brain invokes self-protective measures during stressful times.

“What your brain is doing here in response to trauma or fear is saying, ‘that’s not real; I’m going to separate that from being real’, and it tends to overshoot, making everything seem unreal, not just the thing you fear,” he says.

Dr Kulkarni (who is also based in Melbourne) says she’s been seeing “a lot of depersonalisation during COVID, as people describe it as an anxiety response to being in lockdown”.

“While this sense of being somewhere else mentally, feeling outside of your body can seem frightening, it’s important to know that this feeling is not the end of the world, and that it’s not a psychotic phenomenon,” she reassures.

I find that being kind to myself on the days I feel surreal and accepting that it is happening - rather than fighting it - is helpful, as is taking a walk in nature with a loved one (if possible). Dr Kulkarni says it’s all about grounding yourself and seeking the familiar, the comfortable.

I find that being kind to myself on the days I feel surreal and accepting that it is happening - rather than fighting it - is helpful, as is taking a walk in nature with a loved one (if possible).

“The people I work with have a favourite spot to go to, perhaps a familiar place in their house or room, or they touch familiar objects such as photos, their business cards,” she says. “Others cross their arms, gently pinch themselves to bring themselves back to their bodies.”

For those who may be experiencing prolonged and intense periods of dissociation, Dr Blashki says the first step is to consult with a mental health professional or their GP.

“If you don’t know where to start, go to a GP, get a full checkup and keep reminding yourself it’s common, not dangerous and very manageable,” he says.

And while the feelings of unreality are creeping up more often during this latest lockdown, knowing that they’re a normal response to extreme feelings of stress makes them easier to manage.

Caroline Zielinski is a freelance journalist based in Melbourne. She writes on health, science, culture, social affairs and all issues related to women. Follow Caroline on twitter: @CE_Zielinski

The Truth About Anxiety with Celia Pacquola premieres at 8:30pm Sunday 3 October on SBS and SBS On Demand, as part of the Australia Uncovered strand of documentaries. All documentaries will be repeated at 10pm Wednesdays on SBS VICELAND from 15 September.

RECOMMENDED
Floatation therapy helped my anxiety
“It is the closest to being pain free I have been since I was diagnosed,” she excitedly said. For her, this was an incredible reprieve from the constant pain she hadn’t been able to escape.
How getting a dog helped ease my anxiety
Surprisingly, in my series of anxiety attacks, it was dogs that calmed me down.