This mental health condition causes you to feel like you're seeing yourself from outside your body or that things around you are not real, or both.
Depersonalization-derealization disorder occurs when you always or often feel that you're seeing yourself from outside your body or you sense that things around you are not real — or both. Feelings of depersonalization and derealization can be very disturbing. You may feel like you're living in a dream.
Many people have a passing experience of depersonalization or derealization at some point. But when these feelings keep occurring or never fully go away, and they make it hard for you to function, it's likely depersonalization-derealization disorder. This condition is more common in people who experience trauma, such as violence, abuse or other kinds of extreme stress.
Depersonalization-derealization disorder can be serious and may get in the way of your relationships and work. It also can disrupt other daily activities. The main treatment for depersonalization-derealization disorder is psychotherapy, also known as talk therapy. Sometimes medicines also are used.
Short experiences of depersonalization or derealization are fairly common. But lasting and returning bouts of these symptoms can cause problems at work or school, or in other important areas of your life. During these bouts, you know that your sense of not being connected to your body or your surroundings are only feelings and not reality.
The experience and feelings of the condition can be hard to describe. Worrying about "going crazy" can cause you to become focused on checking that you exist and finding out what's real.
Symptoms usually begin in the middle or late teenage years, or in early adulthood. Depersonalization-derealization disorder is rare in children and older adults.
Symptoms of depersonalization include:
Symptoms of derealization include:
Bouts of depersonalization-derealization disorder may last hours, days, weeks or months. In some people, these bouts turn into ongoing feelings of depersonalization or derealization that may get better or worse at times.
Passing feelings of depersonalization or derealization are common and are not always a cause for concern. But ongoing or serious feelings of detachment and distortion of your surroundings can be a sign of depersonalization-derealization disorder or another physical or mental health condition.
See a doctor if you have feelings of depersonalization or derealization that:
The cause of depersonalization-derealization disorder is not well understood. Some people may be more likely to experience depersonalization and derealization than others. This is possibly due to genetic and environmental factors. High levels of stress and fear may cause bouts.
Symptoms of depersonalization-derealization disorder may be related to childhood trauma or other experiences or events that cause severe emotional stress or trauma.
Factors that may raise the risk of depersonalization-derealization disorder include:
Bouts of depersonalization or derealization can be scary and make it hard to function. They can:
Your doctor may determine or rule out a diagnosis of depersonalization-derealization disorder based on:
Depersonalization-derealization disorder is mainly treated using talk therapy. But medicines may be added to your treatment plan sometimes.
Talk therapy is the main treatment for depersonalization-derealization disorder. The goal is to control the symptoms to make them better or make them go away. Two types of talk therapy are cognitive behavioral therapy and psychodynamic therapy.
Talk therapy can help you:
No medicine has been proven to effectively treat depersonalization-derealization disorder. But medicines may be used to treat specific symptoms or treat depression and anxiety that often are related to the condition.
While depersonalization-derealization disorder can feel scary, knowing that it can be treated may make you feel better. To help you cope with depersonalization-derealization disorder:
You're likely to start by first seeing your primary care doctor or another primary care professional. It may be suggested that you see a doctor who specializes in brain and nervous system conditions, also known as a neurologist. Or you may see a doctor who specializes in diagnosing and treating mental health conditions, also known as a psychiatrist.
You may want to take a family member or friend along, if possible. Someone who goes along with you may remember something that you missed or forgot.
Here's some information to help you get ready for your appointment and learn what to expect.
Before your appointment, make a list of:
Some basic questions to ask include:
Do not hesitate to ask questions during your appointment.
Your doctor is likely to ask you some questions, such as:
Be ready to answer questions so you'll have time to talk about what's most important to you.