The feelings of having 

no sense of time and space and feeling like you are an outsider looking in on the world are recognized symptoms of a traumatic brain injury (TBI), specifically associated with depersonalization and derealization. These are real neurological and psychological symptoms resulting from the brain’s difficulty processing information correctly after an injury. 

Understanding the Symptoms

• Loss of sense of time and space: This is a known result of a TBI, likely due to damage to brain regions like the frontal and temporal lobes that are involved in cognitive functions such as attention, working memory, and spatial orientation. You might have difficulty judging distances, reading maps, or estimating how much time has passed.
• “Outside of the world looking in” (Derealization): This is a symptom of derealization, where the world around you feels unreal, distant, foggy, or dreamlike, as if you’re watching a movie.
• “Feeling detached from yourself” (Depersonalization): This involves a sense of separation from your own body, thoughts, or feelings, as if you are a robot or an outside observer of your own life. 

Management and Treatment

These experiences can be very distressing, and it is important to seek professional help. The symptoms are often treatable, especially with a multidisciplinary approach. 

• Seek professional evaluation: Consult with a doctor or a mental health professional experienced with brain injuries. They can rule out other conditions (like seizures or anxiety disorders, which can have similar symptoms) and develop a targeted treatment plan.
• Neuro-optometric rehabilitation: Problems with vision and visual processing are a common cause of disorientation and balance issues after a TBI. A neuro-optometrist or neuro-ophthalmologist can provide specialized therapy, including prism glasses or eye exercises, to “rewire” the brain’s visual processing.
• Occupational and physical therapy: Therapists can help you establish routines, use aids like timers to manage time-sensitive tasks, and work on exercises to improve balance and coordination, which can help alleviate feelings of disorientation in space.
• Psychotherapy/CBT: Talk therapy, such as cognitive behavioral therapy (CBT), can provide coping strategies for dealing with the anxiety and frustration associated with these symptoms.
• Medication: In some cases, medication (such as certain antidepressants or anticonvulsants) may be used to manage associated symptoms like anxiety, depression, or seizures, which can worsen the feelings of detachment.
• Lifestyle adjustments:
  • Prioritize adequate sleep and a healthy diet.
  • Take frequent breaks from demanding activities.
  • Avoid bothersome light sources (e.g., fluorescent lights).
  • Reduce clutter to avoid visual overload.
  • Engage in regular, appropriate exercise, which can help with brain function and mood. 

Resources

• The Brain Injury Association of America or Headway Ireland can provide information and support resources specific to TBI recovery.
• If you or a loved one is in crisis or having thoughts of self-harm, call emergency services or a suicide and crisis hotline immediately (e.g., in the U.S., call or text the 988 Suicide & Crisis Lifeline). 

Recovery from TBI takes time, and the brain has an impressive ability to adapt. Working with specialists and utilizing coping strategies can significantly improve your symptoms and quality of life.