Depersonalization, Derealization and Panic Disorder

These Frightening Thoughts Are Common For Those with Panic Disorder

stressed woman with hands on head
Marc Romanelli/Blend Images/Getty Images

Panic attacks are the hallmark symptom of panic disorder. If you have been diagnosed with panic disorder, you are well aware of the impact that these attacks can have on your life. These frightening events often occur unexpectedly and are characterized by disturbing physical sensations, such as shortness of breath, shaking, trembling and chest pain.

You may have many upsetting and distressing thoughts during a panic attack. You might worry that you are going insane or that you are losing control. Fear of death and a preoccupation with that fear is common. In some cases, you may feel detached from yourself and your surroundings.

Known as depersonalization and derealization, these types of frightening thoughts are common symptoms of anxiety disorders, including panic disorder. Depersonalization and derealization can be so scary that these symptoms can potentially increase your feelings of fear, panic and anxiety. Although similar, depersonalization and derealization are separate and distinct issues that often affect your thinking during a panic attack. 


When experiencing depersonalization during a panic attack, you may feel as if you are detached from yourself or like you are a bystander in your own life. It can feel as if you are outside your own body, watching yourself from a distance. This terrifying feeling is often accompanied by thoughts and fears of losing touch with reality or lacking control over yourself.

Depersonalization can also bring up frightening physical sensations, such feelings of numbness and tingling. Others describe the experience as though they are robotic, feeling like they are just going through the motions, or sensing that they are unable to regulate their body. 


Feelings of detachment from the self, or depersonalization, often coincides with symptoms of derealization. Derealization differs from depersonalization in that it involves feelings of distance from your environment. When experiencing derealization, you may feel disconnected from your personal surroundings and external objects, including other people. Your loved ones may feel like strangers to you. 

Many people who experience this symptom of panic disorder describe derealization as feeling spaced out or foggy. People and objects in the environment may begin to seem unreal, distorted or cartoon-like. Others report feeling trapped by their environment or viewing their surroundings as surreal and completely unfamiliar.

What You Can Do

If you experience these symptoms during a panic attack, one of the most important things you can do is to remind yourself that these feelings will pass. Depersonalization and derealization typically subside as the panic attack and associated anxiety diminish. Thinking too much about these feelings may only bring about more panic and anxiety. Both of these symptoms seem to dwindle faster when you stop focusing on the upsetting thoughts and sensations.

Depersonalization and derealization may feel very scary and disturbing, but they are not considered dangerous or life threatening.  However, depersonalization and derealization can be a sign that you have a more serious mental health disorder, such as depersonalization disorder. Only a qualified mental health provider can give you an appropriate diagnosis and treat your condition. If you have been experiencing these symptoms, seek professional help.

Seeking Professional Help

There are many qualified professionals who treat panic disorder. These providers specialize in managing your symptoms and will discuss potential treatment options for your condition. They will also be able to assist with any co-occurring mental health disorders, such as agoraphobia or depression.

Typical treatment plans for panic disorder include medications for panic disorder, psychotherapy or a combination of both of these treatment options. Your mental heal provider will work with you to determine the best treatment for your symptoms based on your individual situation. 

Was this page helpful?
View Article Sources
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Illnesses, 5th edition, 2013.