Experiencing detachment or unreality while using cannabis can be profoundly unsettling. This phenomenon, often described as feeling “high” in an uncomfortable way, is a common side effect of cannabis use. This feeling of the world or oneself becoming strange is a form of dissociation. Understanding the underlying mechanisms can help demystify the experience.
What Derealization Feels Like
The feeling of unreality during cannabis intoxication is categorized into two experiences: derealization (DR) and depersonalization (DP). Derealization involves feeling detached from the external world. Surroundings may appear foggy, dreamlike, two-dimensional, or unreal, seeming altered or unfamiliar.
Depersonalization, conversely, is detachment from the self. One feels like an outside observer of their own thoughts, body, or emotions, manifesting as watching oneself from a distance or feeling disconnected from one’s movements. While these two states are separate, they frequently occur together and are often grouped as DPDR. When triggered by a substance, these feelings are temporary dissociative states and do not indicate a permanent mental illness.
The Neurochemistry of Dissociation
The primary psychoactive compound in cannabis, delta-9-tetrahydrocannabinol (THC), directly triggers these dissociative episodes. THC interacts with the brain’s endocannabinoid system, which regulates mood, memory, and anxiety. High doses of THC overstimulate the amygdala, the brain’s center for processing fear and emotional responses, triggering an intense panic or anxiety response.
This overwhelming stress activates dissociation, a primitive psychological defense mechanism. Dissociation is the brain’s “freeze” response, attempting to cope with the perceived threat by mentally “tuning out” the distressing reality.
Modern cannabis strains often contain high concentrations of THC and low levels of cannabidiol (CBD), making them more likely to induce this anxiety response. THC reduces functional connectivity between the amygdala and somatosensory areas, contributing to the feeling of detachment from the body and surroundings. The dissociative effect is a byproduct of the brain managing the intense anxiety and altered sensory input caused by high THC concentration.
Immediate Grounding Techniques
When an episode of derealization or depersonalization begins, the most effective immediate response is to use grounding techniques. These techniques anchor the mind to the present moment by engaging the senses, redirecting attention away from internal detachment toward external reality. The 5-4-3-2-1 technique systematically engages all five senses:
- Name five things you can see in your immediate environment, focusing on details like color and shape.
- Identify four things you can physically touch or feel, such as the texture of your clothing or the solid ground beneath your feet.
- Name three distinct sounds you can hear, like a distant car or the hum of a fan.
- Focus on two things you can smell, such as a nearby scent or the air around you.
- Identify one thing you can taste, such as a sip of water or the lingering taste in your mouth.
Other helpful tips include deep, slow breathing, which regulates the nervous system, and changing your environment by moving to a quiet, safe space. Reminding yourself that the feeling is temporary and drug-induced can also help reduce the panic that fuels the dissociation.
Preventing Future Episodes
Reducing the risk of future dissociative episodes requires focusing on dose control and mental state. The principle of “start low and go slow” is paramount, as high doses of THC trigger the anxiety response leading to dissociation. Edibles carry a higher risk because their delayed effects are often more intense and long-lasting, making precise dosing difficult.
The mental state and environment, known as “set and setting,” also play a significant role in risk reduction. Avoid using cannabis when feeling anxious, stressed, or in an unfamiliar location, as this increases the likelihood of a negative experience.
Choosing products with a balanced THC-to-CBD ratio can be beneficial. CBD is known for its anti-anxiety properties and helps suppress the panic response that initiates dissociation. For some individuals, complete abstinence from cannabis is the only way to prevent recurrence. If feelings of derealization or depersonalization persist for days or weeks after use, or if underlying anxiety is severe, consulting a mental health professional is advisable.