Am I Experiencing a Mental Health Issue? Reality vs. Dreams

Does this indicate a mental health issue?

Sometimes I feel like the current version of myself is not real, and that true reality exists only in my dreams when I am asleep.
However, I am unclear about what those dreams actually are.
It feels as if everything I am experiencing now is a dream, while the dreams themselves seem more real.
Someone told me that if I pinch myself and feel pain, that means I am in reality.
Yet, I have also pinched myself in dreams and felt pain, or I have pinched myself and woken up, only to realize that I woke up in a dream.
When I finally do wake up to what I believe is reality, I often experience severe headaches and dizziness.
Sometimes, even when I don’t want to go to a certain place, my body still moves there, and I don’t understand why I end up there, only to feel dazed for a moment before leaving.
Doctor, could you please tell me if I have a mental health issue or if I am experiencing some sort of confusion? It feels like I have mixed up dreams and reality, and I don’t know which one is truly real.

ANN, 20~29 year old female. Ask Date: 2013/11/22

Dr. Ding Shuyan reply Psychiatry

Hello, some mental illnesses, such as depression or certain psychotic disorders, can make individuals feel detached from the world around them, as if they are not fully engaged or that reality is not genuine, almost like they are mere observers.
Some people describe this sensation as looking at the world through a thin veil or mist.
Your description is quite accurate; this can certainly be a manifestation of symptoms.
I sense that those around you might notice that you seem to have difficulty concentrating, often zoning out, and your reactions may be slower than usual.
Additionally, emotions experienced in dreams tend to be more intense, but most people forget the content shortly after waking up, and the emotions from dreams rarely persist into the daytime for long.
Certain mental illnesses can indeed lead to an increase in dream frequency, with content that feels very vivid, sometimes causing fear or discomfort.
Although you are concerned about confusing reality with dreams, your worry indicates that you still have a clear distinction between the two.
Those who truly have issues often lack even this level of confusion.
Regarding your concern about whether this constitutes a mental health issue, we typically have a standard for continuously assessing ourselves and our surroundings for any changes or abnormalities.
In terms of physical health, symptoms like fever or pain are easily noticeable and generally considered objective indicators of illness.
However, mental or psychological issues are more abstract and subjective, making it difficult for both ourselves and those around us to fully and clearly evaluate.
Therefore, we tend to notice those mental or psychological symptoms that differ from our past selves or from the general population, usually those that we are more concerned about or that significantly impact us.
Typically, this involves only one or two symptoms rather than a comprehensive array.
Moreover, these symptoms do not necessarily correspond to specific diseases.
Thus, diagnosing a condition based solely on the symptoms we find most uncomfortable is not straightforward.
Often, it requires clarifying other symptoms to gain a complete picture.
This is also why seeking advice online can lead to misdiagnosis, which is why I often encourage individuals to consult a doctor for any concerns, as that is the safest approach.
I can sense your distress, but I want to encourage you that your issues can be resolved and improved.
Many mental or psychological problems are treatable, and some may even improve on their own over time.
Modern life is busy, with many responsibilities and roles to fulfill, leaving little time for illness.
I see that you are still quite young, and a wonderful life is just beginning for you.
Please seek medical attention promptly to address these issues early, so you can break free from these constraints and continue moving forward into the future.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2013/11/22

More Info

It sounds like you are experiencing a complex interplay between your dreams and your perception of reality, which can indeed be quite distressing. The feelings you describe—such as questioning the authenticity of your current state, experiencing confusion between dreams and reality, and even physical sensations like pain in dreams—can be indicative of a few different psychological phenomena.

Firstly, the sensation of feeling detached from reality is often referred to as "derealization." This can occur in various mental health conditions, including anxiety disorders, depression, and certain dissociative disorders. People experiencing derealization may feel as though they are observing themselves from outside their body or that the world around them is not real. This can lead to significant distress, as it seems to be happening in your case.

Additionally, the confusion between dreams and reality can be linked to a phenomenon known as "lucid dreaming," where individuals become aware that they are dreaming while still in the dream state. While lucid dreaming itself is not inherently problematic, if it leads to confusion about what is real and what is not upon waking, it can contribute to feelings of anxiety and disorientation.

The physical sensations you describe, such as feeling pain when pinching yourself in a dream, can also occur in lucid dreams or in states of heightened awareness during sleep. This can blur the lines further between what is real and what is a dream, leading to the confusion you are experiencing.

Moreover, the experience of feeling compelled to go to places or do things against your will can be a sign of dissociation or a lack of control over your actions, which can also be linked to anxiety or stress. This can manifest as a feeling of being on autopilot, where your body is moving without your conscious direction.

It's important to note that while these experiences can be distressing, they do not automatically indicate a severe mental health issue. However, they do warrant further exploration, especially if they are impacting your daily life and well-being. Mental health is a complex field, and symptoms can vary widely among individuals.
If you find that these experiences are causing significant distress or impairment in your life, it would be beneficial to consult with a mental health professional. They can provide a thorough assessment and help you understand the underlying causes of your experiences. Treatment options may include therapy, mindfulness practices, or, in some cases, medication to help manage anxiety or other symptoms.

In the meantime, consider keeping a journal of your experiences. Documenting your dreams and your feelings upon waking can help you identify patterns and triggers, which can be useful information to share with a mental health professional. Additionally, practicing grounding techniques—such as focusing on your senses, deep breathing, or engaging in physical activities—can help you feel more connected to the present moment and reduce feelings of disorientation.

Remember, seeking help is a sign of strength, and addressing these concerns early on can lead to better outcomes. You deserve to feel grounded and secure in your reality.

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