Help: I feel like nothing is real

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Question for Dr. Kissen, Director of the Light on Anxiety Treatment Center of Chicago:

 I feel like nothing is real and I have outbursts of random noise

Response:
Two of the most psychologically painful symptoms of panic disorder is depersonalization and derealization.  This symptoms entail feeling that one is not real and that the world around one is not real. The origin of these symptoms is thought to be subtle changes in breathing patterns which results in shallow breathing ( hyperventillating ) and taking in too much oxygen/dumping too much carbon dioxide.  This leads to less oxygenated blood reaching the brain, which is not dangerous, but can be uncomfortable and for some, leads to feeling "like nothing is real". A short term solution to these symptoms is to engage in slow breathing (count to 3 on the in breath and count to 4 on the out breath) for five minutes.  Slow breathing creates a "relaxation response" and sends a signal to the brain, that the danger has past and the fight or flight response is no longer necessary.  A long term solution to these symptoms is to practice accepting that these sensations may surface from time to time and at the same time one can engage in meaningful, vitalizing living, even if they occasionally come along for the ride.  The more we struggle with panic like sensations, the more frequently and intensely they will surface.  The more we engage in life and give up the battle with these symptoms, the less they will show up and "call the shots".