Mental-Cognitive Symptoms

How Anxiety Can Cause Distorted Reality

  • Anxiety can be so overwhelming to the brain it alters a person’s sense of reality.
  • People experience distorted reality in several ways.
  • Distorted reality is most common during panic attacks, though may occur with other types of anxiety. It is also often referred to as “derealization.”
  • The ability to identify that something about reality seems “off” is a sign that it is anxiety, as those that are losing touch with reality often have no sense that it is happening.
  • Several techniques that bring a person back to the moment can help decrease some of the discomfort of distorted reality.
Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated March 1, 2021

How Anxiety Can Cause Distorted Reality

Anxiety is its own distorted reality. It changes the way your mind processes information, so that you experience the symptoms of fear when there is no fear around, negative thinking, overthinking, and the tendency for your mind to notice cues that match your psychological expectations.

Anxiety can also cause distorted reality as a symptom, and that symptom may be so severe that some worry they are losing touch with the world. In the end, it's often simply anxiety.

All Anxiety is Distorted Reality

Anxiety disorders all produce their own distorted reality, both as a symptom and as a function of what anxiety really is.

Most people with anxiety don't realize how often anxiety is distorting their mindset. That's because the human brain and cognition are more complicated than it seems. Anxiety changes the chemical messenger levels in your brain, and when it does it causes your mind to perceive things differently, even though it feels entirely natural for you.

Derealization with Anxiety

But when most people talk about distorted reality, they're talking about a phenomenon known as "derealization." Derealization is a defense mechanism of the brain during times of extreme anxiety, most often during panic attacks although they may occur to anyone that is under intense stress.

This type of reality distortion is different for each individual, and its cause is not entirely clear. It's likely that the mind simply shuts down certain components during extreme stress, because otherwise the intensity of that stress would be too damaging to the brain. It simply tunes out the world instead, and that leaves the individual suffering from that anxiety to feel as though something is off about the world.

People experience distorted reality in a variety of ways:

  • Some people simply feel like something's off, but can't picture what's wrong.
  • Some people find themselves incredibly lost and confused.
  • Some people stop processing the information around them.
  • Some people feel as though they're watching themselves from outside their body (this is known as "depersonalization").

Other anxiety symptoms may increase this feeling as though you're at a loss for reality. Anxiety can cause such intense distractions that you have trouble forming a coherent thought. Anxiety can cause images and flashes of unusual thoughts or concerns. Anxiety can also cause physical symptoms like lightheadedness and dilated pupils that make the world around them harder to focus on.

Derealization is also the type of condition that creates its own anxiety, which unfortunately may increase the likelihood of intense anxiety in the future. Those with distorted reality often think that something may be wrong with their mind, focusing on diseases like schizophrenia and brain tumors and monitoring themselves in a way that fuels further anxiety.

It's an unfortunate reality for many of those who struggle with extreme stress, and one that doesn't have an easy solution.

You're Not Losing Touch With Reality

There are health conditions that can cause a loss of touch with reality, and there is no harm in seeing a doctor if you are concerned. But the easiest way to tell that you are not losing touch with reality is that you think that you are losing touch with reality.

Those that truly do have a dysfunction in their brain that causes distorted reality have no idea their reality is distorted, because their brain is processing that information as if it's normal. When someone develops schizophrenia and hears voices (for example), those voices are really talking to them. They don't think they're "losing their mind" because their mind is processing those voices as if they are real and normal.

The mere fact that you can wonder to yourself whether you're losing touch with reality is indicative of the fact that you are not. In addition, nearly every disease that causes a loss of reality isn't as temporary as those with anxiety experience. Some people experience weeks without a lucid moment, others months. 

Don't forget to talk to your doctor if you're concerned.

How to Get Back to Reality

It's important to remember that distorted reality from anxiety is not dangerous. It's not considered permanent, it's not expected to be gradual, and it's not expected to occur as long as you don't experience extreme anxiety. Rarely does anyone experience this loss of reality at any point other than an anxiety attack.

If you start to experience this distorted reality, there are a few tips you can try to "get back." Most experts recommend performing some activity that requires you to be "in the moment," and then focusing on the sensations you get from the activity. This is something that may require a bit of practice, but can be very helpful overall. Some examples include:

  • Running your hands under cold water and focusing on the cold.
  • Pinching yourself and reminding yourself that you're real.
  • Count specific types of objects in the room, or identify them by color.

They may sound simple, and possibly a bit silly, but they bring your mind and thoughts back into the present moment, which is believed to be an important part of controlling it.

The only way to ensure that your loss of reality doesn't come back, however, is to make sure that you're learning to stop extreme anxiety.  


De-realization is a term that refers to experiencing a loss of touch with reality. It is most common during periods of intense anxiety, such as during a panic attack, but it can also occur with other anxiety conditions as well. Use different techniques to bring yourself “back to reality,” but also make sure you’re prioritizing an anxiety reduction treatment. 

Questions? Comments?

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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