Depersonalisation in Nurses—What Is It & How to Deal With It

There are many connections to be made between depersonalization-derealization disorder and the nursing profession. Because trauma is believed to be a main cause, one might wonder if it’s possible to avoid some semblance of depersonalisation with a profession that deals with constant trauma. It is certainly possible, however, for nurses to remain aware of depersonalisation and take efforts to deal with it.

Depersonalisation is the persistent feeling that either the outside world is not real, or you are not really inside your body. A passing feeling of this sort is normal, but certain professionals—such as nurses—might find that it persists beyond that. Talk therapy, or psychotherapy, is the best form of treatment if depersonalisation persists.

If depersonalization becomes persistent, it could significantly interfere with one’s daily activities and personal relationships. Serious sufferers of depersonalization-derealization disorder may require medical attention and medication. Generally, it can be treated in the same vein as post-traumatic stress disorder, as it has similar causes and symptoms.

Depersonalisation is a Side-Effect of Nurse Burnout

Nurse turnover is related to nurse burnout. Nurses are more overloaded with patients today than ever before. Patients today have more diagnoses than ever before. Part of this is a result of advancements in medical knowledge, which leads to a layered understanding of diseases that used to fall under a single diagnosis. Regardless, it increases the workload for nurses because they have to pay attention to each diagnosis for each patient—not just each patient.

As Workloads Increase, so Do Stress Levels

An increased workload means an increase in stress. If you increase the workload for a high-stress job, the stress-level can become untenable. An untenable stress level yields burnout. A burnout is precisely a complete physical and mental response to persistent stress.

Burnout Side-Effects

There are a lot of side-effects of burnout. A very unfortunate one is that it makes one’s work suffer. For those in the medical field, that is unacceptable. Nurses do not suffer from burnout alone if they continue to work. Their patients suffer from a lack of care.

As one’s work suffers from burnout, so does everything else one does from day to day. Here are some other aspects of life that you can expect burnout to affect negatively:

  • Self-care routines
  • Nutrition
  • Sleep schedules

If you fail to meet your daily needs in any of those categories, your overall health will suffer. When nurses are too burnt out to take care of themselves, it is nearly impossible for them to go on caring for their patients. This can, in turn, lead to cynicism about one’s own profession, spawning from resentment for the thing causing the burnout.

When Burnout Leads to Depersonalization

From this level of discontent with one’s job, depersonalization can occur. When a nurse turns their back on their profession, they turn their back on their patients. In order to accomplish something like this, they must dehumanise their patients in order to prevent themselves from caring. It is not their intention to be cruel—it is the condition of burnout that keeps them from being able to handle what is in front of them anymore.

Depersonalisation is a Dreamlike, Disassociated State

Depersonalisation, or disassociation, is the feeling of being disconnected from one’s surroundings. Nurses suffering from demanding and stressful workloads may need to disconnect from their work in order to get through it. Disassociation means detachment. If the only way to feel unburdened by something is to detach oneself from it, the mind can make that happen before one is even conscious of their own stress level.

Disassociation from Oneself

Depersonalisation specifically means feeling detached from oneself and their surroundings. It is somewhat of an identity crisis. However, it does not seem to matter to the person suffering from it.

We typically imagine someone dramatically having an identity crisis and expressing despair over it. That is not depersonalisation because someone suffering from depersonalisation feels utterly detached from their identity.

Disassociation versus Derealization

Derealization seems like another matter altogether, but it is wrapped up in the diagnosis for the depersonalisation – derealisation disorder. Derealisation is the feeling that the outside world is not real.

Depersonalization-derealization disorder applies to either feeling. If the feeling of depersonalization or derealization becomes persistent and interferes with one’s life, it might be a serious disorder.

Depersonalisation and Other Disorders

Depersonalisation is also a common symptom of other psychological disorders, such as the following:

  • Post-Traumatic Stress Disorder
  • Schizophrenia
  • Depression
  • Obsessive-Compulsive Disorder
  • Phobias
  • Migraines
  • Epilepsy

The Causes of Depersonalisation Are Common in the Nursing Field

Some main causes linked to depersonalization are:

  • Stress
  • Anxiety
  • Depression
  • Lack of sleep

These causes are unavoidable for those who have decided to become nurses. Nurse schedules are typically atypical, by which I mean that their schedules are ever-changing. What is typical is that every shift is likely to be both exhilarating and exhausting. Another standard is a 12-hour shift, which many can hardly even imagine.

A Day In the Life of a Nurse

Let’s take a look at the typical workday of a daytime nurse. Theoretically, we could imagine:

  • 5:00 AM – the start of the shift that continuously becomes more hectic
  • 12:00 PM – 7 hours later—lunchtime arrives.
  • 1:00 PM hits, and it is time for afternoon rounds and another 5 hours of work
  • 6:00 PM – the night shift finally takes over

Imagining the night shift is yet another exhausting exercise of the mind. Let’s not forget the physical and emotionally taxing work that is part of that 13-hour shift.

Therefore, the nursing profession promises a dose of the following depersonalization causes with every shift:

  • Lack of sleep
  • Anxiety
  • Depression
  • Stress

Cutting Out Caffeine Can Help You Deal with Depersonalisation

One way to deal with depersonalization is to lower your caffeine take. If you are a coffee lover, you might be thinking, What? Seriously? The answer is yes—seriously. And I am sorry to say so.

Caffeine Induces Anxiousness

Here’s the thing, caffeine ups your anxiety levels. Anxiety is a root cause of depersonalisation. Caffeine can also be a serious mean of exacerbation to the other physiological issues you experience, along with depersonalisation. It affects your sleep, your appetite, and your blood pressure.

Not all of these effects are generally bad for you. A decrease in appetite could even be a good thing for some people. However, if you are struggling with depersonalization, then caffeine is not going to help you deal with it. It will only make things worse.

Why? Because increasing your anxiety makes it worse, for one thing. Sleep deprivation makes it worse also. Taking measures to deal with depersonalization means finding a way to calm down.

Dealing with Depersonalisation Requires the Opposite of Stimulation

To deal with depersonalization, you need to find a way to relax and de-stress. Your brain needs to become calmer. Caffeine does not work that way. Caffeine will work against you this time.

If you are a nurse, you may be thinking, But I can’t get through the workday without coffee. And, you may be right. But, if you’re experiencing depersonalization, you need a break from work anyway. During your days off, cut caffeine out.

You need to get some real rest and relaxation. Caffeine does all of the following for you:

  • Increases heart rate
  • Increases blood pressure
  • Increases anxiety
  • Causes insomnia
  • Gives you headaches
  • Makes you dizzy
  • Gives you nausea
  • Makes you irritable
  • Increases alertness

Depending on what your daily life is like, you might gladly take that increased alertness along with everything else. That’s fair. However, you do not need to increase your alertness and contribute to the physiological issues that are already rooting your depersonalization experience.

You Do Not Have to Give Up Caffeine Forever or Go Cold Turkey

Some may say cut caffeine out immediately. I say cut it out when you can. Take a few days off to do a caffeine detox/comedown. Cut it out when you can do so without it, adding to your stress level.

You do not want to do anything that will make you feel defeated or worse about your work. You need to get away from it. You need to take a breath and get some sleep without having to feel alert at all. Then, when you have recovered, you can get back to work and have your coffee too.

A Better Sleep Pattern Can Help You Deal with Depersonalisation

Since sleep deprivation is associated with depersonalization, you will want to manage your sleep schedule to deal with depersonalisation. Sleep deprivation is actually associated with various dissociative disorders.

Though it twists the tongue and sounds redundant, it is important to distinguish that it is more accurate to say sleep is associated with depersonalization than to claim it is an absolute cause. Disorders of this sort often come with conflicting opinions about whether or not sleep deprivation is a symptom or a side-effect.

However, it does not really matter whether sleep deprivation is a cause or simply a symptom if you are searching for answers about how to deal with depersonalization.

Whether it is causational or not, sleep is an aspect of depersonalization that requires treatment.

Sleep deprivation is most likely a contributor to depersonalization as well as a side-effect of it. Therefore, it is really important to manage it.

Managing Your Sleep Schedule

You might want to start by resetting your sleep routine. You should get a minimum of 7 hours of sleep a night. And, the night part is important here. Nurses on the night shift are probably the most prone to depersonalisation and sleep deprivation. The reason for this is because their circadian rhythm is disrupted by their shift schedule.

The circadian rhythm is the natural pull between waking hours and sleeping hours. Some have said the invention of electricity has severely affected our circadian rhythm because the sun no longer has complete control over our waking and sleeping hours. However, this comes with the idea that we are naturally meant to enjoy our waking hours during the day and our sleeping hours at night.

Managing Sleep Helps Counteract The Night Shift Effect

The principle behind all of this rests a lot on the fact that people who work night shifts or get jet-lagged feel physiological disruption from it. From there, it is not much of a stretch to see that sleep deprivation can appear in the form of someone who may get 7-9 hours of sleep during the day.

This means that managing your sleep schedule is about more than counting hours. It is also about when you sleep.

In fact, managing your sleep schedule is about all of the following:

  • Consistency
  • Realistic goals
  • Moderate adjustments over time
  • Number of hours (7-9)
  • Sleep hygiene
  • Melatonin
  • Caffeine moderation
  • Breathing techniques
  • Sleeping as close to nighttime as possible

Sleep Hygiene

Sleep hygiene now involves relatively new concepts, such as avoiding screen time before bed. It also includes some older ideas like avoiding artificial light close to bedtime altogether. Moderating caffeine and alcohol before bed is always recommended, as is hydrating. The really important thing is that you prioritize improving upon your sleep pattern if you are suffering from depersonalization.

Dealing with Your Anxiety Can Help You Deal with Depersonalisation

Depersonalisation is a symptom of anxiety. Therefore, dealing with depersonalisation might simply mean dealing with your anxiety so as to ameliorate the symptoms.

If you are experiencing other symptoms of anxiety—especially major ones like panic attacks—anxiety may be the root of your depersonalization.

And if you are a nurse, anxiety can be hard to avoid.

Some Nurses Experience Anxiety For the First Due to the Career

You do not have to be an anxious person to suffer from anxiety.

Nurses that never had to deal with anxiety prior to beginning their career can develop anxiety issues from their work environment. For many nurses, anxiety takes its first hold during nursing school. Nursing school clinicals can be a major source of stress and anxiety. As is often the case when professionals who have their own work to do are asked to train students, nursing students may feel like a burden to those responsible for their instruction.

The Pressures of Being a Nurse Cause Anxiety

The pressure to be an ace at all basic nurse skill sets is another major source of stress and anxiety for burgeoning nurses. Besides natural aptitudes, nurses from different departments hone different skill sets depending on the equipment they most frequently use.

Any change of department can make someone feel suddenly inadequate, a basic skill set they are now required to perform as well as every other nurse in the department. Feeling inadequate is a major source of anxiety when inadequacy is simply not an option.

Anxiety Can be Caused by Bad Supervisors

A bad preceptor can be another major source of anxiety during a nurse’s career. At some point in a nurse’s career, they are at the whims of a preceptor. If you have a nurturing or motivating preceptor, that could be an absolute blessing. If you have one that would like to see you fail, it could become a source of such intense anxiety that you suffer from the symptom of depersonalisation.

Some Ways to Deal With Anxiety

Regardless of what is causing anxiety—and therefore, depersonalisation—it needs to be dealt with. There are ways to cope with anxiety, which, in turn, are ways to cope with its symptom of depersonalisation:

  • Take the time to breathe at work.
  • Take a minute to let yourself feel your emotions when you get the chance.
  • Talk to someone.

Breathing rituals and techniques should be the first thing you adopt. All nurses should have a practice of knowing when they need to close their eyes and take a deep breath. Another really important thing to do when experiencing anxiety is to allow yourself to feel whatever you’re feeling.

Nurses have to disassociate from their feelings, which can cause both anxiety and disassociation—a killer combination for stirring up some depersonalization.

Anxiety is like your body telling you that the feelings you have let simmer are now about to boil over. It is better that you make time to deal with them before they come to boil while you are with a patient.

That means feeling what you have been trying not to feel. You find a safe space to let them boil until they evaporate into thin air. Sometimes that’s really all you need to do—let yourself feel the feeling you have been holding back. Of course, sometimes you need someone in the room to help you get there, like a therapist.

Talk Therapy Can Help You Deal with Depersonalisation

If depersonalisation becomes a chronic problem, a therapist can test for a disorder. Beyond that, a therapist can help treat depersonalisation through talk therapy and, if necessary, certain medications.

Talk therapy is a way to treat a lot of the possible sources of depersonalization as well, such as anxiety and sleep disorders.

Whatever the root of depersonalization, a therapist’s goal is to help patients safely experience the emotions that are causing them psychological distress.

Why We All Suffer from Psychological Distress at Times

In Civilization and its Discontents, Freud essentially tells us that we do not really have a chance of avoiding psychological distress, especially neuroticism, because we need to be civilised and a part of a civilisation.

Those who take on major roles within a civilization, like a role within the medical profession, are hyper prone to emotional distress and discontent because of all they deal with day to day.

Though therapy today has come a long way since Freud, the goal is still to help people understand their discontents in a way that they can both face them and manage them.

Why Talk Therapy Can Help with Depersonalisation

Someone suffering from depersonalization needs to come face to face with either themselves or their environment. What they are experiencing is a loss of a sense of self. They have become disassociated from their own body or sense of being. ]

A therapist will ask them to look deep enough within themselves that they will, hopefully, find themselves on the inside of their bodies once more.

Avoid Self-Medicating When Dealing with Depersonalisation

There are all kinds of ways to self-medicate. When dealing with depersonalization, you should avoid self-medicating with alcohol or marijuana. A major reason you should avoid alcohol is that it can be harmful to your sleep. Sleep deprivation is the last thing you want to add to when you are dealing with depersonalization.

Marijuana May Increase Your Anxiety, Despite Its Reputation for Calming Effects

The reason you should avoid marijuana is that it might increase your anxiety, believe it or not. Sure, many people successfully use marijuana to decrease their anxiety. Those people probably are not dealing with depersonalization because their anxiety has been successfully tempered.

There are cases in which marijuana increases anxiety. In fact, it seems to be the case that marijuana either relieves anxiety or increases it. That means that if it is not reducing your anxiety, it is probably doing the opposite. If it is doing the opposite, then it is definitely not a good thing to do when dealing with depersonalisation.

Avoid Stimulants in General Because They Interfere with Sleep and Increase Anxiety

It is very important to cut out substances that contribute to potential sources of depersonalization, such as sleep deprivation and anxiety. Any stimulant should be avoided, really. Anxiety is, in many ways, a state of being over-stimulated. Stimulants will only exacerbate both anxiety and sleep deprivation, which are associated with depersonalization.

Keep Good Company When Dealing with Depersonalisation

Being alone is not necessarily a bad idea when you are dealing with depersonalization. You may need time away from work and the environment that is causing the stress behind your experience of depersonalization. However, quality company is a very good idea when dealing with depersonalization.

Staying Social Can Help You Stay Connected to Yourself

Socialization is important for someone experiencing any kind of disassociation. Becoming too isolated can make disassociation worse. So too, can a stressful social situation. Good company, on the other hand, can make someone feel like themselves again.

Sometimes we all need others to see us and to make it known to us that they see us. Nurses might, at times, be treated like they are not individuals. Patients, at times, treat them as a mere means to their ends. Doctors are known to, at times, treat nurses as a conglomerate rather than as individuals. Being treated like you are not an individual can make you feel as if it is so.

Be Picky About Your Company

Good company makes one feel seen as an individual again. It is of great importance to keep the company of someone who sees you the way you want to see yourself. It is that kind of individual who can help you return to yourself. And, of course, you should be sure to do the same for them.

Maintain (Or Seek Out) Hobbies to Deal with Depersonalisation

Hobbies become a part of our identity that goes beyond our professions. When your work is what is removing you from yourself, your hobbies can bring you back. The conditions that make one prone to depersonalization can hinder one’s motivation to continue one’s hobbies.

For instance, a day filled with stress and anxiety at work might make a night of Netflix sound better than the activity of the hobby—especially if the activity is physically or mentally demanding.

Nurses May Feel Too Busy for Hobbies, But Everyone Needs Something Outside of Work

While it is completely understandable to let hobbies slip away while dealing with depersonalization, trying to get back to them is a potential way to combat depersonalization.

Hobbies are a part of your identity that your professional life should not take away from you. Your hobby can bring you back inside yourself by making you feel like yourself again. If you have let any kind of hobby get away from you because of your job, and your job is creating a sense of depersonalization, you must reclaim your hobby.

Social Hobbies Could Be the Secret to Successfully Escaping Depersonalisation

Social hobbies might do the trick even faster. If you have to be on any kind of team for your hobby, you can find yourself within your role on the team. As a nurse, you can feel alone within your team. It might be part of a team effort without the stakes being quite as high.

Hobbies Take the Pressure Off

In a way, that is the best thing about hobbies—the stakes are lower. As soon as you call something a hobby, that is basically what you are establishing. You are calling it something that you enjoy, but you do not depend on it financially or claim to be a professional.

That makes it inherently less stressful, which means you can allow yourself to relax while still embracing a part of who you are by doing something you enjoy doing.

Open Up About Your Depersonalisation to Others

A sure way to keep your depersonalisation going is to keep it to yourself. The more isolated you feel, the more estranged from yourself you can become.

This does not mean nurses should tell their patients about their depersonalization, nor does it mean they should tell anyone at work who might use it against them. It means that if you are struggling with depersonalization, you should talk to someone about it.

It could be extremely beneficial to tell:

  • Your partner
  • A close friend
  • A family member

The people who know you the best could be apt to remind you who you are and help you feel like you are yourself again.

If You Do Not Want to Tell People You are Close To, Tell a Therapist

If the only safe way to do that is therapy, then you should go that route. It is possible that your experience of depersonalisation is too serious for your friends and family to help you with. In that case, you need to make more advanced efforts. This might mean seeking a therapist. It might mean taking a mental health break from work.

Find a Way to Take Time Off from Work to Deal with Depersonalisation

At some point, nurses may need to seriously consider taking a significant amount of time off to deal with their depersonalization issues. This time should be used to relax, first and foremost. It might also be used to catch up on sleep and return to a healthier sleep schedule. It would also be helpful to use it to spend quality time with others.

Getting Away from the Environment Causing Distress Could be the Solution

It may simply be enough to get away from the work environment that is cultivating the roots for depersonalisation. Because there are so many reasons for nurse burnout and depersonalisation, removing those aspects for some time might be all that is needed. Vacations may be the best medicine in some cases.

You May Not Be Able to Properly Care for Your Patients

It is also a good decision for nurses to take time off work when they are experiencing depersonalization because depersonalization can make their work suffer, which means patients suffer. If feelings of depersonalization persist, you should take time off work and seek to remedy the issue.


Depersonalisation is the feeling of being outside of oneself. Nurses often experience depersonalisation when they are burned out by the demanding aspects of their profession and work schedule. Since depersonalisation is associated with stress, anxiety, and lack of sleep, you should get rest and take a break from work to deal with it. Anything you do to combat anxiety and reclaim your identity may be your antidote.

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