Depersonalization-derealization disorder is when you feel that you're observing yourself from outside your body or that things around you aren't real.
Depersonalization-derealization disorder occurs when you persistently or repeatedly have the feeling that you're observing yourself from outside your body or you have a sense that things around you aren't real, or both. Feelings of depersonalization and derealization can be very disturbing and 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 completely go away and interfere with your ability to function, it's considered depersonalization-derealization disorder. This disorder is more common in people who've had traumatic experiences.
Depersonalization-derealization disorder can be severe and may interfere with relationships, work and other daily activities. The main treatment for depersonalization-derealization disorder is talk therapy (psychotherapy), although sometimes medications also are used.
Persistent and recurrent episodes of depersonalization or derealization or both cause distress and problems functioning at work or school or in other important areas of your life. During these episodes, you are aware that your sense of detachment is only a feeling and not reality.
The experience and feelings of the disorder can be difficult to describe. Worry about "going crazy" can cause you to become preoccupied with checking that you exist and determining what's actually real.
Symptoms usually begin in the mid- to late teens or early adulthood. Depersonalization-derealization disorder is rare in children and older adults.
Symptoms of depersonalization include:
Symptoms of derealization include:
Episodes of depersonalization-derealization disorder may last hours, days, weeks or even months at a time. In some people, these episodes turn into ongoing feelings of depersonalization or derealization that may periodically get better or worse.
Passing feelings of depersonalization or derealization are common and aren't necessarily a cause for concern. But ongoing or severe feelings of detachment and distortion of your surroundings can be a sign of depersonalization-derealization disorder or another physical or mental health disorder.
See a doctor if you have feelings of depersonalization or derealization that:
The exact cause of depersonalization-derealization disorder isn't well-understood. Some people may be more vulnerable to experiencing depersonalization and derealization than others, possibly due to genetic and environmental factors. Heightened states of stress and fear may trigger episodes.
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 increase the risk of depersonalization-derealization disorder include:
Episodes of depersonalization or derealization can be frightening and disabling. They can cause:
Your doctor may determine or rule out a diagnosis of depersonalization-derealization disorder based on:
Treatment of depersonalization-derealization disorder is primarily psychotherapy. However, sometimes medications may be added to your treatment plan.
Psychotherapy, also called counseling or talk therapy, is the main treatment. The goal is to gain control over the symptoms so that they lessen or go away. Two such psychotherapies include cognitive behavioral therapy and psychodynamic therapy.
Psychotherapy can help you:
There are no medications specifically approved to treat depersonalization-derealization disorder. However, medications may be used to treat specific symptoms or to treat depression and anxiety that are often associated with the disorder.
While depersonalization and derealization disorder can feel frightening, realizing that it's treatable may be reassuring. To help you cope with depersonalization-derealization disorder:
You're likely to start by first seeing your primary care doctor, but you may be referred to a doctor who specializes in brain and nervous system disorders (neurologist) or a doctor who specializes in diagnosing and treating mental health disorders (psychiatrist).
You may want to take a family member or friend along, if possible. Someone who accompanies you may remember something that you missed or forgot.
Here's some information to help you get ready for your appointment and what to expect from your doctor.
Before your appointment, make a list of:
Some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask: