What Is Depersonalization-Derealization Disorder (DPDR)?

Depersonalization-derealization disorder (DPDR) is a mental health condition that causes you to feel detached from your body, thoughts, and environment. DPDR can affect your thoughts, memories, or actions.

This article will go over depersonalization-derealization disorder, including what causes it, what the symptoms are, how it's diagnosed, and how it can be treated.

Depersonalization-Derealization Disorder Symptoms

Depersonalization and derealization are separate experiences but they typically occur together in DPDR.

Depersonalization means feeling like you are outside of your body or mind. Derealization means feeling like what is around you is not real.

Depersonalization symptoms can include:

• Feeling disconnected from your body, feelings, and mind
• Feeling outside your body and observing your life
• Not being able to describe your emotions
• Feeling numb 
• Feeling like a robot 
• Feeling like you cannot control what you say or do 
• Having memory problems 
  

Derealization symptoms can include:

• Feeling disconnected from your environment 
• Thinking the world is not real
• Feeling "like a glass wall" separates you from the world
• Having distorted vision, such as seeing blurry, colorless, and unusually small or large objects 
  

The symptoms of DPDR can last for hours, days, weeks, or months. Most people experience episodes of DPDR, but it is also possible to have them for a long time (chronic).

How Depersonalization-Derealization Disorder Is Diagnosed

According to the DSM-5, to be diagnosed with DPDR, a person must have:

• Constant or recurring episodes of derealization, depersonalization, or both
• Are able to maintain contact with reality during these episodes
• Significant distress or impairment in areas of functioning
  

Before making a diagnosis of DPDR, a healthcare provider will want to rule out medical conditions that cause similar symptoms. Tests they might do include:

• Physical exam
• Blood tests
• Urine tests 
• Brain MRI or CT scans 
• Electroencephalogram (EEG)
  

What Causes Depersonalization-Derealization Disorder?

The exact cause of DPDR is not known. However, there are several risk factors for depersonalization-derealization disorder including:

• Having other mental health conditions (including anxiety and depression)
• Having family members with mental health conditions
• Severe stress
• Trauma 
• The sudden death of a loved one 
• Experiencing domestic violence
• Experiencing emotional abuse or neglect
• Using illicit drugs (however, DPDR is considered a separate condition from substance use disorder in the DSM-5)
  
• Sleep deprivation
  

How Is Depersonalization-Derealization Disorder Treated?

It is possible to make a complete recovery from DPDR. Some people recover from depersonalization-derealization disorder on their own without treatment. Other people benefit from taking medications or having psychotherapy.

Medications for DPDR

There is no specific medication to treat DPDR, but your provider can prescribe medications to help with your symptoms or related conditions, such as:

• Depression 
• Anxiety
• Panic attacks 
  

Examples of medications that may help someone with DPDR include:

• Antidepressants
• Anti-anxiety medications
  

Psychotherapy for DPDR

Psychotherapy is a common treatment for depersonalization-derealization disorder. The focus is to eliminate the underlying stressors that caused the condition and help people feel "grounded" in their experiences.

Psychotherapy may include: 

• Cognitive behavioral therapy (CBT)
• Behavioral therapy 
• Psychodynamic therapy 
• Eye movement desensitization and reprocessing (EMDR)
• Hypnotherapy
  

Coping with Depersonalization-Derealization Disorder

There are different ways to cope with DPDR. You may have to try several of them before finding what works for you.

Strategies for living with depersonalization-derealization disorder can include:

• Meditation 
• Relaxation techniques
• Mindfulness 
• Breathing exercises
• Self-talk exercises 
  

Summary

Depersonalization-derealization disorder (DPDR) is a mental health condition that makes you feel disconnected from your body, thoughts, and environment. Some people experience DPDR after going through trauma, from sleep deprivation, or because they are genetically predisposed to the condition.

Some people with DPDR recover on their own and don't need help but if you have symptoms that you're having trouble managing, medications and psychotherapy can be effective.