What do my derealization symptoms indicate?

Question

Hi doctor,

I feel really spaced out and detached from my surroundings. It is like I am in a dream. It is like there is a glass between me and the world and everything just seems really surreal and far away. I also have a lot of brain fog. Some memory problems and confusion.

I feel like this all day long, but it gets better and worse throughout the day. I have been experiencing this for about a month now. I have had a blood test, neurological exam (done by a family doctor and not a neurologist), and a brain scan that all came back normal. Does this sound like something could be wrong with my brain?

Please help.

Answer 1

Hi,

Welcome to icliniq.com. I read your query and understand your concerns. From the available description, it appears that you are having derealization episodes, which is a sensation of changed reality or that one's surroundings have altered. It is usually seen in schizophrenia, panic attacks, and dissociative disorders.

Other symptoms include feeling as though one's environment is lacking in spontaneity, emotional coloring, and depth. It is a dissociative symptom of many conditions, such as psychiatric and neurological disorders, and not a standalone disorder. The derealization episodes represent dissociation phenomenon occurring due to some stress in our life.

I am not sure what you are dealing with your life, but it is important to manage those stressful things and not to delay. In case you are not able to pinpoint, it will be appropriate tosee a psychologist. I hope this helps you. If you have more questions feel free to write back to me.

Thanks and regards.

Answer 2

Hello,

Welcome back to icliniq.com. Thanks for the follow-up. I am glad to know that information was useful for you and you have decreased stress in recent past. Regarding your current questions, I like to state thatepilepsy is one disorder, which can cause dissociation like episodes and make a differential diagnosis for such presentation.

However, chronic presentation throughout the day association with stress makes it unlikely that it is epilepsy. In my opinion, it is psychological disorder rather than a neurological disorder.

My opinion is based on the following available facts: 1. The presence of these episodes, and then spontaneous remission disappearance for six or more months. 2. The presence of stress and anxiety before onset. 3. Waxing and waning course, most neurological disorder progress further and there is little fluctuation. And definitely, a presentation which is classic for derealization. 4. Most importantly normal neuroimaging, which is rarely found in neurological disorders. Normal neurological examination, at least at the primary level.

I hope this answers you further. Feel free to write back to me if you have more questions.

Thanks and regards.