Depersonalization or Derealization Disorder

Are You Feeling Detached From Yourself or Your Surroundings?

A man suffering from depression.
A man suffering from depression. Aleli Dezmen/Getty Images

Depersonalization/derealization disorder is a type of dissociate disorder in which the sufferer has a persistent or recurring feeling that they are outside their body (depersonalization) or that what's happening around them isn't real (derealization). The Diagnostic and Statistic Manual of Mental Health Disorders, 5th Edition (DSM-5), published in 2013, combined these two conditions into one disorder.

What Are Dissociative Disorders?

Dissociative disorders are a group of four diagnosable conditions, including depersonalization/derealization disorder. The other three dissociative conditions are dissociative amnesia, dissociative fugue and dissociative identity disorder.

People with these disorders have a fragmented sense of their identity, their memories and/or their consciousness. The hallmark of these conditions is an involuntary disconnection from reality.

Symptoms of Depersonalization/Derealization Disorder

People with depersonalization disorder feel detached from themselves - their body, mind, feelings or sensations. They may feel like they're observing their own lives from outside themselves.

People with derealization disorder feel detached from their environment - objects, other people, etc. They may feel like they're looking at the world through a veil, and the world may seem distorted and unreal.

Unlike with a psychotic disorder, people with depersonalization/derealization disorder know that their experiences of detachment aren't real. Therefore, they may fear that they're "going crazy." Understandably, dissociative disorders can lead to depression and anxiety.

What Causes Depersonalization/Derealization Disorder?

About 2 percent of people - both men and women - experience depersonalization/derealization disorder.

If you're suffering from depersonalization/derealization disorder, it's likely that you recently experienced extreme stress. Severe stress, anxiety, and depression are common triggers for the condition. A lack of sleep or an overstimulating environment can make symptoms worse.

Often, people with depersonalization/derealization disorder experienced past trauma in their lives. They might have suffered emotional or physical abuse or neglect in their childhood, witnessed domestic violence, or had a loved one die unexpectedly, for example.

Diagnosis and Treatment

A doctor will start by checking for other possible causes for the symptoms, such as drug abuse, other mental health problems or seizures.

Once these are ruled out, the he will consider symptoms, along with the results of psychological tests, interviews, and questionnaires.

If you're diagnosed with depersonalization/derealization disorder, treatment will include:

  • Psychotherapy. Psychodynamic psychotherapy and cognitive-behavioral therapy are most commonly used.
  • Possibly medications. There's no drug approved specifically for depersonalization/ derealization disorder. Doctors sometimes prescribe anti-anxiety drugs and antidepressants to treat this condition.

    Recovery

    Some people experience a complete recovery from depersonalization/derealization disorder. The chances of this are best when the underlying stressors that contributed to and triggered the condition can be successfully dealt with.

    While some people unfortunately don't get better with any treatment, others recover gradually on their own with no treatment.

    Sources:

    Depersonalization/derealization Disorder. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/basics/definition/con-20033401 .

    Dissociative Disorders. Merck Manual. http://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/overview-of-dissociative-disorders.

    Highlights of Changes from DSM-IV-TR to DSM-5. American Psychiatric Publishing.

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