Severe stress and emotional pain can also manifest as derealization and depersonalization. These states can sometimes feel like dissolving into the background, or like arcing or being wrenched out of yourself and observing a wax version of yourself. They can feel like a translucent, razor-sharp, slicing kaleidoscope of perception, or like being hyper-aware of being aware—trapped inside your optic nerves, unable to exit into the world or retreat into thought.

It can feel like realizing, all at once and with a kind of violence, that reality is real. Or like shaking a snow globe in which a static facsimile of your life plays out behind glass—without you.

Jane Charlton offers a striking description of DPDR:

“Imagine you’re holding a snow globe in your hands. The world is in the globe, but you feel like you’re on the outside of the glass. Somehow, you are unable to connect the ‘I’ looking in with the world in the globe. That connection and its absence makes all the difference to whether or not I feel I am alive. If I quieten my mind, I can almost taste the colour and richness of life as I knew it before. It comes with a sense of expectation, a feeling of being an agent in changing and plotting a course through the world. This is, I think, the very act of ‘living’, which I bear witness to in others, all day, every day. I still understand it academically, but I can barely remember what it feels like. These days I’m in a constant state of grief; I feel as if I’m grieving for my own death, even if I seem to be around to witness it.”

The wait becomes a wake. (See Anna Ciaunica’s Aeon article When the Self Slips, from which Charlton’s description is excerpted. Ciaunica has also co-authored several papers on DPDR, including The Transparent Senses and the “Second Skin”: Implications for the Case of Depersonalization. For a broader academic overview, see Dissociation and the Dissociative Disorders: Past, Present, Future.)

The writer and journalist Lucy Cosslett describes DPDR, as it co-occurs with PTSD, in equally vivid terms:

“Strangest of all, though, is this ghost-ship feeling of not being really there. A floating sensation of being outside yourself, like when you are a child and someone tells you about the universe, or you think really hard about how strange humans look, objectively: our noses, our slender, tapering fingers... My self is in splinters, basically. I’m a simulacrum, a cardboard cut-out trudging woodenly through the city.”

DPDR can cast you into a state not unlike the eerie stasis of Twin Peaks—everything both familiar and wrong, charged and emptied out at once.

There is often a loss of proprioception and interoception as we decamp—or are shocked—into our heads. DPDRD is sometimes characterized as a form of escape when no escape is possible: escape from a world you cannot bear to inhabit, from a self you do not wish to be, or from events and sensations that overwhelm. But the escape itself frequently becomes more unbearable than the thing escaped.

The novelist Kingsley Amis reportedly feared being left alone due to such dissociative episodes. During nighttime attacks, his partner would bring their young children to him, as a kind of anchor—a way to remind him that he was still connected to the rest of the world.

One way to understand depersonalization is through analogy: in war films, when a bomb explodes, the impact is sometimes conveyed by a high-pitched ringing. All other sound drops out. A deafened soldier looks around; others speak, but their voices don’t register. He is present, but cut off.

Or else, depersonalization is like trying to protect a flickering flame from a never-ending storm, cupping it desperately with one hand—vainly, because it always goes out.

A large bell is rung, but instead of sound, it creates silence.

The bell marks not presence but absence.

Unlike acute trauma, which is sharp and singular, DPDRD often follows accumulated, diffuse, or “slow” trauma. It arises in lives where mistreatment is not explosive but incessant, where no action or utterance reduces harm, where helplessness becomes the water in which one swims. You sever what makes intersubjectivity possible.

The DSM-5-TR acknowledges this in clinical terms:

“There is a clear association between the disorder and childhood interpersonal traumas in a substantial portion of individuals… In particular, emotional abuse and emotional neglect have been most strongly and consistently associated with the disorder.”

Depersonalization-derealization disorder is not simply a mental disorder. It is a rupture in mediation—between inner and outer, self and other, perception and presence. It throws the sufferer into a negative metaphysics, where the scaffolding of being is both visible and missing.

To suffer DPDRD is to live in a world where the ordinary becomes astonishing, but not in the redemptive way of awe—in the sterile, stunned, dislocated way of horror. 

This rupture has a political dimension. In a society where structural violence is ambient, where recognition is transactional, and where care is administered through bureaucratic scarcity, dissociation may become a mass phenomenon. The individual condition mirrors a social logic: if the world fails to respond, then withdrawal is not dysfunction but adaptation.

DPDRD becomes a political symptom of a world that no longer affords embeddedness. It reflects not merely the personal effects of trauma but the social withdrawal of the world itself—what Judith Butler might call the withdrawal of grievability, or what Berardi might name the anaesthetization of affect under late capitalism.

It is not that DPDRD sufferers are too fragile for the world; it is that the world has become too fragmentary and violent to hold selves together.

Molten Speech, Buckshot Thought

Thought does not stand outside speech. It hides on the tongue, doubles back from the mouth. You think with the memory of how you last failed to say. And so, over time, your thoughts grow cautious — timid, even. They begin to pre-censor. You imagine how the sentence will fail in advance, and so it never forms. You anticipate the wrongness. The blank stares. The dropped call. The absence of reply. And so you don't just become afraid of speaking — you become afraid of thinking. The words lose weight, then shape, then even texture. Soon, you think in fog. You think in grunts. You think in refusal.

It doesn’t stop there. You start to shape your perception of reality based on what you’ve left unsaid. You become the echo chamber of your own withheld language. You interpret others’ silences through the lens of your own. You see rejection in neutrality, aggression in quiet, distance in pause. Everything returns to you — not as confirmation, but as accusation. A life lived in feedback loops becomes indistinguishable from surveillance.

Anne Boyer, writing while undergoing chemotherapy, says:

"I am not writing this to be read. I am writing this because it is what I have left."

There is something unspeakably true about that. Writing not to communicate but to remain — as if language, even broken, even failing, might still mark a trace. A scratch on the wall of the cave. A nail dug into your own skin so that later, someone can say: yes, there was someone here.

But depression isn't always even that generous. Often, it is the sense that nothing you say will survive the saying. That the moment the sentence ends, it will mean nothing. That you will be misunderstood, or worse, understood and still left alone.

Paul Celan understood this collapse. A poet of the aftermath, of language-after-holocaust, he wrote:

“No one bears witness for the witness.”

That line holds in it a terrible inversion. That even if you do speak, there may be no one who can hear you rightly. That the wound you carry is untranslatable. That it arrives in language only to be deflected, dulled, mistaken.

And so what happens? You stop trying. Or rather, you keep trying, but inwardly. The performance continues, but not for others. You rehearse sentences in your head all day and say nothing. You write messages and delete them. You practice inflections, then never make the call. Thought feeds speech feeds silence feeds failure feeds thought. The loop is sealed.

Sarah Kane, in 4.48 Psychosis, writes:

“I cannot go on.
I go on.”

But she didn’t.

Language for her, too, became both lifeline and razor. Each phrase edged with the desire for connection and the certainty of its impossibility. Her last play ends mid-line. No punctuation. No closure. Just the rupture of form itself.

How could it end any other way?

We imagine that silence is the opposite of speech. But in these states, silence is speech’s parasite. Every word that might have been said becomes the content of the silence. It swells. It accuses. And it clings to the body like a weight no one else can see.

So what’s left?

A sentence begins:

“I just wanted to say—”

But the words catch.

You feel your jaw seize. The sentence has no shape. You’re suddenly unsure what you wanted to say, or if you ever wanted to say anything, or if you just wanted not to disappear.

You try again:

“I don’t really know how to…”

But nothing follows. Not because you lack the words — but because all the words are wrong. Too sharp. Too soft. Too late. Too much.

The silence returns. Not empty now, but full. Swollen with the failure.

You nod. You smile. You pretend.

Inside: the echo of a sentence never said.

A thought that never quite made it to the surface.

A silence that speaks louder than you ever could.

Speaking can feel like violence. Not in the metaphorical sense of raising your voice or saying something cruel, but in the way a rusted machine grinds its own gears to move an inch. The words come, but not as words. They come like boulders pushed uphill, as John Folk-Williams once wrote. And on other days, they leap and spin and spark like stray fire — manic, uncatchable. Either way, they betray you.

There is no safe middle ground. No steady rhythm of inner speech translating gently into outer sound. Instead: either a stuttering jammed syntax that refuses to cohere, or a fusillade of words that move faster than thought, spilling over themselves like liquid metal. Not a language problem, but a relation problem. A breakdown in mediation between thought and world, thought and body, body and mouth.

At fifteen I imagined letters as buckshot tearing through my brain, carving slow and sadistic paths toward my mouth. They brought globs of blood with them. Speech was an exit wound.

That kind of violence leaves marks — not only on the body, but on the structure of thought itself. You don't just lose fluency. You begin to lose trust in expression. You hear yourself say “I don’t know,” when you do know, but can’t find the shape. You begin to anticipate the misfiring, and in doing so, you feed it. What you don’t say becomes the content of your thought. What you can’t do becomes the premise of your being. And so silence thickens. And isolation sharpens.

Eventually, the symptoms stop being symptoms. They become mirrors. Misfiring becomes identity. The injury becomes indistinguishable from the person who is injured.

David Foster Wallace wrote that depression feels “like being underwater,” but worse — that it’s the moment you realize there is no surface. No up. No exit. Just a suffocating, spatial despair, stretched out across days, weeks, months. It’s the moment you when you realize you're the blackhole and nothing else.

That’s what it does. Depression removes the mediation between self and affliction. There’s no “you” who has the depression. There’s only the blackhole. And the falling. Even when you're still.

When people speak of depression, they often speak of feeling sad, or tired, or hopeless. But these words feel misplaced, like trying to describe atmospheric pressure with terms for the weather. Depression is not the storm. It’s the impossibility of atmosphere altogether — the vanishing of breathable air, of navigable space, of the very idea that direction still exists.

Sometimes it's just a phone call. One that needs to be made — to a friend, a doctor, a landlord. But the moment the thought arises, the body lurches. Your stomach curdles as though you’ve swallowed something toxic. Your hands go cold, your chest tightens. The numbers on the phone become not symbols but threats. You feel like vomiting. There’s no “choice” not to call — there’s just the real, bodily impossibility of action. To ask a passerby for the time is not a social act but an existential gauntlet. Every tiny encounter becomes an unbearable negotiation with visibility, with shame, with the risk of being witnessed failing to be human.

The irony is that the less you act, the more you think. But the more you think, the more poisoned the act becomes. The unsaid begins to rot, fermenting in your mouth. You rehearse the words you might have said, the actions you should have taken. But they are no longer in time. They belong to an alternate version of you who never existed. The real you is the one who didn’t say, didn’t act, who now thinks about not saying, not acting. The loop feeds itself until thought collapses under the weight of its own echo.

This is what people miss when they ask you to “explain what you’re feeling.” There is no “what.” There is no solid emotional object you could point to. There’s only the slow undoing of the means by which a person might have a feeling. Depression doesn’t just make you feel bad; it dissolves the structure that would allow feelings to form at all. And if feelings do arise, they arrive malformed — bloated with dread, stripped of orientation, resistant to being named. Language becomes a failed prosthetic, each word misfitted, each sentence a betrayal of what you meant but couldn’t say.

Wallace again, in a later essay: “It’s like there’s this poisonous fog bank rolling in, and it just keeps coming. You can’t reason with it. You can’t escape it. It gets into your clothes, into your lungs, under your eyelids.” The fog is not a metaphor for emotion. It is the world now. What remains of you inside it is not quite alive but unable to fully disappear. You are not drowning. You are the water. You are the silence under the water. You are the pressure against your own chest. Language, in these states, doesn’t break down gently. It betrays. You open your mouth and either nothing comes out — or something comes out that you didn’t mean, and now cannot retract. You lose the privilege of sincerity. Not because you lie, but because speech itself loses traction. Like shoes on ice, your words skid out from under you, graceless. Or they crumble midair. You become afraid of words, then of thought itself, then of people, then of time. Eventually, the only thing you can do is withdraw — from expression, from relation, from intention.

And yet, even silence is not safe. Because now you think about the silence, too. And it accuses you. You didn’t speak. You couldn’t act. And so you must be — what? Weak? Broken? The silence fills with these meanings. Meanings you did not choose, but that now reside in you, like swallowed glass.

Eventually, all that’s left is the failed attempt. The moment you open your mouth to say something — anything — and what comes out is not the right thing, not even close. And the person across from you blinks, confused. Or worse, concerned.

You close your mouth. You nod. You pretend.

Inside, the sentence dies.