Depersonalization/Derealization Disorder


What is Depersonalization/Derealization Disorder (DDD)?

Depersonalization/derealization disorder (DDD) is a mental health condition that causes sufferers to experience a persistent or recurring feeling of being outside of their body. This is known as depersonalization. They might also feel like happenings around them aren`t real. The latter is known as derealization. Some sufferers actually experience both depersonalization and derealization.

Symptoms of Depersonalization/Derealization Disorder

Depersonalization/derealization disorder is considered a single diagnosis, however, it has two distinct aspects. While depersonalization has its symptoms, depersonalization has its too. Let`s take a quick look at them.

Symptoms of Depersonalization

People who suffer depersonalization would usually feel detached from themselves as if they’re watching themselves on a movie screen. These are some of the common symptoms:

  • inability to recognize or describe emotions
  • feeling physically numb to sensations
  • feeling robotic or unable to control speech or movement
  • feeling unconnected to your body, mind, feelings, or sensations
  • inability to attach emotions to memories
  • a feeling of distortion in the body and the limbs
  • feeling like the head is wrapped in cotton

Symptoms of Derealization

People who suffer derealization feel detached from their environment, as well as the objects and people in it. The world seems distorted and unreal to them as if they’re observing it through a veil. People who suffer from this condition may also feel as if a glass wall is separating them from people and things that they care about. This disassociation can also create distortions in vision and other senses. Distance and the size or shape of objects may be distorted, and you may have a heightened awareness of your surroundings.

How long episodes of depersonalization/derealization disorder last is individual-based. It may last for hours, days, weeks, or even months. For some, the episodes may be chronic, evolving into ongoing feelings of depersonalization or derealization that may periodically get better or worse.

How to Diagnose Depersonalization/Derealization Disorder

people talkingStudies show that almost half of adults have experienced a dissociative episode, however, only about 2% of people meet the criteria for DDD. To diagnose depersonalization/derealization disorder, a doctor may first need to ensure that there aren’t other reasons for symptoms. They may have to check if the patient is on certain drugs, has a seizure disorder, or suffers other mental health problems like anxiety, post-traumatic stress disorder (PTSD), depression, or borderline personality disorder.

Once these potential causes are ruled out, a healthcare professional may need to check if the patient`s condition meets the criteria outlined in the Diagnostic and Statistic Manual of Mental Health Disorders (DSM-5):

  • persistent or recurrent episodes of depersonalization, derealization, or both
  • a feeling that whatever is actually felt is not real
  • significant distress or impairment of occupational or social functioning as a result of symptoms

There may be a need for imaging and other tests to rule out physical problems. Psychological tests, special structured interviews, and questionnaires can help to diagnose depersonalization/derealization disorder.

Causes of Depersonalization/Derealization Disorder

The most common causes of depersonalization/derealization disorder are depression, severe stress, and anxiety. Inadequate sleep or an overstimulating environment can worsen symptoms.

Usually, people with depersonalization/derealization disorder have experienced trauma in their lives; the most common are:

  • neglect, emotional or physical abuse in childhood
  • sudden death of a loved one
  • witnessing domestic violence

In about half of the cases of depersonalization/derealization disorder,  the stress that causes the condition is relatively minor, or not even obvious at all. Also, some people are more likely than others to suffer from psychiatric disorders. Women, for instance, are more likely than men to experience depersonalization/derealization or some other types of disassociative occurrence.

Here are some risk factors for depersonalization/derealization disorder:

  • A history of using recreational drugs that can trigger episodes of depersonalization or derealization
  • An innate tendency to avoid or deny difficult situations
  • Problems adapting to difficult situations
  • Depression or anxiety, particularly severe or prolonged depression, or anxiety with panic attacks
  • Witnessing or experiencing a traumatic event or abuse as a child or as an adult
  • Severe stress in any area of life, from important relationships to finances to work

How to Treat Depersonalization/Derealization Disorder

Some people completely recover from depersonalization/derealization disorder with targeted, personalized treatment. The chances of recovery are higher when healthcare professionals can combat the underlying stressors that triggered the condition. Some other people recover organically, without specific treatment. Let`s explore some treatment options:


Psychotherapy is one of the most effective ways to treat DDD. Cognitive-behavioral therapy (CBT), for instance, teaches sufferers strategies to block obsessive thinking about feeling things that aren’t real, alongside distraction techniques:

Grounding Techniques

These are techniques that call on the senses to help a person feel more in touch with reality. It may entail playing loud music to engage hearing, or holding an ice cube to help them feel connected to the sensation.

Psychodynamic Techniques

These techniques focus on working through conflicts and negative feelings that sufferers try to detach from. There`s also a need for moment-to-moment tracking.
How Cognitive Behavior Therapy Works

Eye Movement Desensitization and Reprocessing (EDMR) Therapy

Although EDMR therapy was originally designed to treat PTSD, it is also effective in treating mental health conditions such as depersonalization/derealization disorder.


SchizophreniaThere are no specific medications for treating depersonalization/derealization disorder, however, healthcare experts usually prescribe antidepressants and anti-anxiety drugs to relieve symptoms.


There are some other strategies that can help keep bring patients back to reality when they’re experiencing symptoms of depersonalization/derealization disorder:

  • Pinch the skin on the back of their hand.
  • Use temperature to shift their focus: you may place an extremely cold or warm object in their hand.
  • Ask them to look around the room and name or count the items that they see.
  • Ask that they slow down their breathing or take long, deep breaths so they can pay attention to how they inhale and exhale.
  • Encourage them to meditate, so they can develop greater awareness of their internal state.
  • Ask that they keep their eyes moving to stop them from zoning out.

If you have a loved one who has depersonalization/derealization disorder, rest assured that they need your love and support now more than ever. Encourage them to seek treatment and to stay strong.

Some Mental Health Facts

  • Dissociative amnesia is a condition that entails an inability to remember important information about one`s life.
  • People who suffer from dissociative fugue experience reversible amnesia that involves personality, memories, and personal identity.
  • Dissociative identity disorder is a condition marked by the presence of two or more distinct personalities within one individual.
  • One in five Americans has experienced some form of mental illness, with one in 25 experiencing severe mental illness such as schizophrenia or bipolar disorder.
  • The rate of mental health disorders doubles for people who have lived through a major disaster or been to war.
  • People with mental health issues are generally nonviolent. Studies show that only 3-5% of violent acts can be attributed to people with a severe mental illness.
  • Genetics, injury, physical illness, and traumatic life experiences are all causes of mental health illness.
  • A number of people with mental illness don`t seek treatment due to the associated stigma. Studies show that only 44% of adults with diagnosable mental illnesses receive treatment.
  • Treatment for mental health problems can entail prescribed or OTC medication, yoga, meditation, therapy,  and holistic treatments.