Depersonalization/Derealization Disorder: Understanding the Symptoms and Treatment Options

Depersonalization/Derealization Disorder is a mental health condition that can be very distressing for those who experience it. It is characterized by feeling detached from oneself and the world around us. People with this disorder may feel they are watching themselves outside their body or that their surroundings are unreal.

Depersonalization/Derealization Disorder symptoms can include a sense of unreality, feeling disconnected from emotions, and experiencing a loss of identity. These symptoms can be triggered by stressful events or trauma but occur spontaneously. The disorder can significantly impact daily life, making it difficult to work, socialize, or engage in hobbies.

Although Depersonalization/Derealization Disorder can be a challenging condition to live with, treatment options are available. Therapy, medication, and lifestyle changes can all effectively manage symptoms and improve quality of life. With the proper support and resources, those with this disorder can learn to manage their symptoms and lead fulfilling lives.

Depersonalization/Derealization Disorder

Understanding Depersonalization/Derealization Disorder

If you or someone you know has ever experienced a feeling of detachment from oneself or the environment, they may have Depersonalization/Derealization Disorder (DDD). This section will discuss the definition of DDD and its prevalence.


DDD is a mental health condition that affects a person’s perception and experience of themselves and their surroundings. It is characterized by recurring and persistent feelings of either depersonalization or derealization.

Depersonalization is a feeling of detachment from oneself, where one feels like an outside observer of one’s thoughts, feelings, and actions. It can be described as feeling like an actor in a play or as though one is in a dream-like state.

Derealization is a feeling of detachment from one’s surroundings, where one feels as though the world around them is unreal or unfamiliar. It can be described as feeling like one is in a movie or as though the environment is distorted or artificial.


The prevalence of DDD is not well-established, but it is estimated to affect up to 2% of the general population. It is more common in individuals who have experienced trauma, such as physical or sexual abuse or have a history of anxiety or depression.

DDD can significantly impact a person’s life, affecting their relationships, work, and daily activities. It is crucial to seek professional help if you or someone you know is experiencing recurring and persistent feelings of depersonalization or derealization.

Symptoms of Depersonalization/Derealization Disorder

Depersonalization/Derealization Disorder (DDD) is a mental health condition that can be challenging to diagnose and treat. The symptoms of DDD can be distressing and disruptive to daily life. Here are some of the common symptoms of DDD:

  • Depersonalization Symptoms: Feeling disconnected from oneself, as if watching oneself from outside the body. This can include feeling like one’s thoughts and actions are not their own, feeling like an observer of one’s own life, or feeling like one is in a dream-like state.
  • Derealization Symptoms: Feeling disconnected from one’s surroundings, as if they are not real or are distorted. This can include feeling like the world is foggy or surreal, feeling like objects are changing shape or size, or feeling like one is in a movie or video game.
  • Emotional Numbness: Feeling emotionally detached or numb, as if one’s emotions are not genuine or are muted. This can include feeling like one is not experiencing or emotions are not connected to one’s thoughts or actions.
  • Anxiety and Panic: Feeling anxious or panicky, often triggered by the symptoms of DDD or by situations that feel unfamiliar or disorienting.
  • Depression and Hopelessness: Feeling depressed or hopeless, often due to the chronic nature of DDD or the difficulty in finding effective treatment.

It’s important to note that everyone experiences DDD differently, and some people may not experience all of these symptoms. Additionally, the severity and frequency of symptoms can vary over time and may be influenced by stress, trauma, or other factors.

Suppose you or someone you know is experiencing symptoms of DDD. In that case, seeking help from a mental health professional who can provide an accurate diagnosis and effective treatment options is essential.

Causes and Risk Factors

Depersonalization/derealization disorder is a complex mental health condition whose exact causes are not yet fully understood. However, researchers have identified various factors that may contribute to the development of this disorder.

Genetic Factors

Studies have suggested that genetic factors may play a role in developing depersonalization/derealization disorder. Individuals with a family history of dissociative disorders may be more likely to develop this condition. However, more research is needed to understand the genetic factors contributing to this disorder fully.

Environmental Factors

Environmental factors can also contribute to the development of depersonalization/derealization disorder. Traumatic experiences such as physical or emotional abuse, neglect, or other forms of severe stress can trigger the onset of this disorder. Substance abuse, particularly dissociative drugs such as ketamine, can also increase the risk of developing depersonalization/derealization disorder.

Other potential environmental factors that may contribute to this disorder include:

  • Chronic stress
  • Anxiety
  • Depression
  • Sleep deprivation
  • Medical conditions that affect the brain, such as epilepsy or brain injuries

It’s important to note that not everyone who experiences these environmental factors will develop depersonalization/derealization disorder. However, these factors may increase the risk of developing this condition.

Diagnosis Process

If you think you may have Depersonalization/Derealization Disorder, the first step is to visit a mental health professional. They will conduct a psychological evaluation to diagnose the disorder.

Psychological Evaluation

During a psychological evaluation, the mental health professional will ask questions about your symptoms, medical history, and personal life. They may also use various assessment tools to evaluate your mental health. The evaluation will help the mental health professional determine if you have Depersonalization/Derealization Disorder or another mental health disorder.

Medical Tests

A physical health problem, medications, recreational drugs, or alcohol can sometimes cause depersonalization/Derealization Disorder. Therefore, mental health professionals may order medical tests to rule out physical health problems. These tests may include blood tests, brain scans, or other medical tests.

To ensure an accurate diagnosis, it is essential to be honest and open during the diagnosis process. Once diagnosed, the mental health professional will work with you to develop a treatment plan tailored to your specific needs.

Treatment Options

If you are diagnosed with Depersonalization/Derealization Disorder, different treatment options are available, including psychotherapy and medication. It is important to note that no one-size-fits-all treatment exists, and what works for one person may not work for another. Therefore, working with a mental health professional to find the best treatment plan for you is essential.


Psychotherapy is the primary treatment for Depersonalization/Derealization Disorder. Two types of talk therapy are commonly used to treat this disorder: cognitive-behavioral therapy (CBT) and psychodynamic therapy.

In CBT, the therapist works with you to identify and change negative thoughts and behaviors contributing to your symptoms. This therapy can help you learn coping skills and strategies to manage your symptoms.

In psychodynamic therapy, the therapist helps you explore your unconscious thoughts and feelings to gain insight into your condition. This therapy can help you understand the root cause of your symptoms and develop healthier coping methods.


While medication is not the first-line treatment for Depersonalization/Derealization Disorder, it can help manage symptoms. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), are commonly prescribed to treat this disorder. These medications can help regulate the levels of serotonin and other neurotransmitters in the brain, which can improve mood and reduce symptoms.

However, it is essential to note that medication should always be used in conjunction with therapy and under the supervision of a mental health professional. Additionally, it may take several weeks or even months for medication to take effect, so patience is essential.

Living with Depersonalization/Derealization Disorder

Dealing with depersonalization and derealization can be challenging, but there are ways to manage and cope with the symptoms. Here are some self-care tips and support groups that may help.

Self-Care Tips

  1. Stay grounded: Focus on your senses and try to stay present in the moment. You can touch the ground, hold an object, or interact with your environment to help you stay connected.
  2. Practice relaxation techniques: Deep breathing, meditation, and yoga can help reduce anxiety and stress, which may trigger depersonalization and derealization.
  3. Get enough sleep: Lack of sleep can worsen symptoms, so getting enough rest is essential. Establish a regular sleep routine and avoid caffeine and alcohol before bedtime.
  4. Regular Exercise can help reduce stress and anxiety and improve your overall well-being. Find an activity you enjoy, such as walking, swimming, or biking, and try to do it regularly.
  5. Eat a healthy diet: Eating a balanced diet can help you feel better physically and mentally. Avoid processed foods and sugar; eat plenty of fruits, vegetables, and whole grains.

Support Groups

Joining a support group can be a helpful way to connect with others who are going through similar experiences. Here are some resources to consider:

  1. Depersonalization/Derealization Support Group: This online support group allows people to share their experiences and find support and understanding.
  2. Anxiety and Depression Association of America: The ADAA offers resources and support for people with anxiety disorders, including depersonalization and derealization.
  3. International Society for the Study of Trauma and Dissociation: The ISSTD provides information and resources for people with dissociative disorders, including depersonalization and derealization.

Living with depersonalization and derealization can be challenging, but seeking help and support is essential when needed. With the right tools and resources, you can learn to manage your symptoms and improve your quality of life.

Frequently Asked Questions

What are the symptoms of depersonalization disorder?

Depersonalization disorder is characterized by a persistent feeling of being disconnected from oneself. Some common symptoms of depersonalization disorder include feeling like you are watching yourself from outside your body, feeling like you are in a dream, feeling emotionally numb, and feeling detached from your surroundings. Other symptoms may include memory problems, anxiety, and depression.

How long does derealization last?

The duration of derealization disorder can vary from person to person. Some people may experience it for a few minutes, while others may experience it for days, weeks, or even months. In some cases, the symptoms may be chronic and last for years.

What does derealization disorder feel like?

Derealization disorder is characterized by a feeling of detachment from one’s surroundings. People with derealization disorder may feel like they are in a dream or that their surroundings are unreal. They may also feel disconnected from their own body or that their body is not theirs.

What triggers depersonalization-derealization?

Depersonalization-derealization disorder can be triggered by various factors, including stress, trauma, drug use, and certain medical conditions. Some people may also experience depersonalization-derealization disorder as a symptom of another mental health condition, such as anxiety or depression.

What are the 4 stages of depersonalization?

There are four stages of depersonalization, which include mild, moderate, severe, and chronic. In the mild stage, people may experience occasional episodes of depersonalization. In the moderate stage, the symptoms may be more frequent and intense. In the severe stage, the symptoms may be constant and debilitating. In the chronic stage, the symptoms may last for years.

How to stop derealization?

There are several strategies that can help manage and reduce the symptoms of derealization disorder. Some of these strategies include practicing relaxation techniques, such as deep breathing and meditation, avoiding drugs and alcohol, getting enough sleep, and seeking professional help from a mental health provider. In some cases, medication may also be prescribed to help manage the symptoms.


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