Depersonalization is an illness that also severely impacts the experience of the outside world. Impairments in the area of sensory experiences are particularly evident.
Some of those affected report that they are not able to recognize a previously familiar environment. They feel a clear dissonance to known locations or people. In very severe cases, the environment is not perceived as real and may be experienced as imaginary, with other people being perceived as marionettes. There is no longer a feeling of connection with other people.
Those affected also report that experiencing the environment as three-dimensional is no longer possible. In some cases, the outside world is experienced as merely two-dimensional. This can lead to those affected losing orientation when moving through spaces and to only being able to roughly estimate distances to people or objects. Consequences of this can be the inability to walk, as well as stumbling. The ability to actively take part in traffic can be significantly limited.
A further dimension in which those affected experience changes is the dimension of time. Many of those affected explain that in their experience, time passes slower or faster. This leads to great difficulties in assessing the time that has actually passed and to constantly having to confirm what happened.
The changed experience of the outside world is also referred to as derealization. Depersonalization and derealization only rarely occur separately.
Facing an altered experience of the outside world is best mitigated by using the already described tools, as here there is a combination of impairments in sensory perception and emotional limitations taking place. The outside world is experienced differently through the senses, which leads to a feeling of distance on the emotional level.
Many of those affected experience it as being helpful when they completely focus on the outside world and try to blend out the internal experience and the connected self-observation, to the extent that this is possible.