Mental Health Trauma & Stressor-Related Disorders What Is Depersonalization-Derealization Disorder (DPDR)? Can Involve Disconnectedness or Numbness By Lana Bandoim Lana Bandoim Facebook LinkedIn Twitter Lana Bandoim is a science writer and editor with more than a decade of experience covering complex health topics. Learn about our editorial process Updated on December 01, 2022 Medically reviewed by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Diagnosis Causes Treatment Coping Frequently Asked Questions 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. DPDR or Depersonalization Disorder? DPDR used to be called depersonalization disorder, but the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) changed the name. The average age of onset for depersonalization/derealization disorder is 16 with the majority of cases being diagnosed before age 20. According to one study, 72% of those diagnosed with depersonalization/derealization disorder have another mental health diagnosis. Anxiety and depressive spectrum disorders are the most common. 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. Anna Efetova / Getty Images What Does It Mean to Dissociate? Depersonalization-Derealization Disorder Symptoms Both depersonalization and derealization are symptoms that can be experienced as part of dissociative disorder. Depersonalization and derealization are separate experiences. You may experience one of these more profoundly than the other, but they typically occur together in DPDR. With depersonalization/derealization, there's the sense that you're watching your life—like watching a movie. Some people say it is like an out-of-body experience. 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 mindFeeling outside your body and observing your lifeNot being able to describe your emotionsFeeling 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 depersonalization/derealization symptoms usually last for a few minutes but can persist for hours or days and they may recur intermittently for years. Dissociative and Conversion Disorder: Similarities and Differences 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 bothAre able to maintain contact with reality during these episodesSignificant 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) How Can You Tell If You're Having Derealization? What Causes Depersonalization-Derealization Disorder? The exact cause of DPDR is not known. It commonly occurs in post-traumatic stress disorder (PTSD) and is thought to be a way to cope with trauma. Risk factors for depersonalization-derealization disorder include: 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 What Causes Dissociation? Coping with Depersonalization-Derealization Disorder Depersonalization/derealization disorder can be highly distressing, so be sure to discuss your symptoms with a healthcare provider so you can get a proper diagnosis and treatment plan. If you or a loved one is experiencing symptoms of depersonalization/derealization, there are some strategies you can use to help you feel more connected to yourself and reality. These include: Gently pinching your skin to feel more connected to your bodyTaking slow, deep breaths while focusing on the movement of your chest and diaphragmCalling a friend or family member and have them talk with you to help you feel more connected with other people and realityKeeping your eyes moving around your surroundings to prevent zoning outPracticing meditation to increase your awareness of your experienceLooking around at your surroundings and counting the objects you see, saying their colors aloud, or naming the objects Help Resources If you or someone you know is struggling with depersonalization/derealization, you can contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information about support and treatment facilities near you. For more resources about mental health, see our National Helpline DataBase. How to Use Mindfulness to Feel More Grounded 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. Frequently Asked Questions What are examples of depersonalization? Some examples of depersonalization include feeling like you are:Detached from your bodyOutside of your body and watching itRoboticIn a dream or not in the real world What triggers depersonalization? Depersonalization can be triggered by stressors—for example, abuse and violence, substances and medications, or sleep deprivation. How is derealization different from depersonalization? Depersonalization means that you are feeling detached from your own body and identity. Derealization is feeling detached from your surroundings. How long does depersonalization last? An episode of depersonalization can last for hours, days, weeks, months, or longer. Each person experiences it differently. Is dissociation common? According to one estimate, between 26% and 74% of people will experience symptoms of depersonalization/derealization at some point in their life, but only 1 to 2% of these individuals meet the criteria to be diagnosed with depersonalization/derealization disorder. Is depersonalization psychosis? Depersonalization and psychosis are not the same things. However, a person who is experiencing psychosis may also have symptoms of depersonalization.The difference is that someone with DPDR who is feeling depersonalization is aware of it, while someone who is experiencing psychosis is not. Is DPDR the same as OCD? Depersonalization-derealization disorder (DPDR) is not the same as obsessive-compulsive disorder (OCD). However, a person with OCD may experience feelings of depersonalization or derealization. It's also possible for someone to be diagnosed with both conditions. What Are the Signs of OCD? 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Alliance on Mental Illness. Dissociative disorders. Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. 2013. pp. 302–306. ISBN 9780890425541. Sutar R, Chaturvedi S. Symptom profile and diagnostic utility of depersonalization–derealization disorder: A retrospective critical review from India. Indian J Psychiatry. 2020;62(1):91. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_347_19 Merck Manual. Depersonalization/derealization disorder. Cleveland Clinic. Depersonalization/derealization disorder. Sierra M, David AS, Hunter ECM. The epidemiology of depersonalisation and derealisation. Social Psychiatry and Psychiatric Epidemiology. 2004;39(1):9-18. doi:10.1007/s00127-004-0701-4 Büetiger JR, Hubl D, Kupferschmid S, et al. Trapped in a Glass Bell Jar: Neural Correlates of Depersonalization and Derealization in Subjects at Clinical High-Risk of Psychosis and Depersonalization-Derealization Disorder. Front Psychiatry. 2020;11:535652. Published 2020 Sep 11. doi:10.3389/fpsyt.2020.535652 Boysan M. Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile Analysis. Noro Psikiyatr Ars. 2014;51(3):253-262. doi:10.4274/npa.y6884 By Lana Bandoim Lana Bandoim is a science writer and editor with more than a decade of experience covering complex health topics. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit