Feelings of unreality are very common among anxiety sufferers. These feelings can vary considerably between different people, and sometimes it is the world around you that feels unreal, in other cases it may be that you yourself feel unreal. In yet other cases, you may suffer both of these problems. Many sufferers of anxiety will associate these feelings with a fear of gong mad, and many patients will ask whether these experiences are the first signs of mental illness. At this point, I must say without hesitation that anxiety states, phobias and panics do not develop into serious mental illnesses such as schizophrenia or manic depression, therefore No Panic members should feel reassured!
Where then do these feelings come from? This of course is the $64,000 question. However, feelings of unreality are often influenced by hyperventilation and simply focusing on slowing one’s breathing down, or cupping one’s hands to re-breath carbon dioxide may be very helpful. One experiment which I often try with patients is to get them to artificially overbreathe (this is not a dangerous thing to do!). This then often brings on the feeling of unreality, demonstrating to the patient very clearly, that the problem can be caused in this way. In turn, one can then show the patient how to breathe slowly, and diaphragmatically, and thus reduce the feeling. However, unreality, like many anxiety symptoms, is a condition which often becomes part of a vicious cycle, and the more one worries about it, the more the feeling comes. Unreality feelings can often be triggered by external stimuli, such as loud noise, bright lights, or the motion of a train or the underground. One of the most common triggers for unreality feelings is going into a bright, crowded supermarket with bright fluorescent lighting and people milling around in a hurried way. Feelings of unreality are then often linked to feeling alienated from the world, and this can then lead to feelings of further detachment. Quite often, unreality feelings may be linked to depressed mood, and once more the vicious cycle operates.
The message therefore, for the sufferers of this distressing experience is to be reassured that the feeling itself is not dangerous, does not lead to mental illness, and in many cases will respond to simple breathing exercises. Cases where the unreality is linked to depression, obviously treatment for the depression is called for.
In closing, it must be said that many sufferers keep these feelings to themselves. It is often quite helpful to disclose how you feel to a health professional, such as your GP, who will reassure you, or talk to fellow sufferers. This obviously is where No Panic comes into its own, so please use your contacts within our organisation to share some of your feelings and experiences.
Professor Kevin Gournay is an Emeritus Professor at the Institute of Psychiatry. He has more than 35 years of experience and is the author of more than 130 articles and books. He is based in Cheshunt Hertfordshire.