What Is Depersonalization-Derealization Disorder (DPDR)?

Depersonalization-derealization disorder (DPDR) is a mental condition that causes you to feel detached from your body, thoughts, and environment. It used to be called depersonalization disorder, but the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) changed the name. DPDR is not related to substance use and is considered a separate condition by the DSM-5.

DPDR is one type of dissociative disorder. Dissociative disorders are mental conditions that make you feel disconnected from your subjective experience. They can affect your thoughts, memories, or actions.

This article will explain more about depersonalization-derealization disorder along with its symptoms, diagnosis, and treatment. 

Characteristics, Traits, and Symptoms 

Although they are separate experiences, depersonalization and derealization typically occur together in DPDR. Depersonalization means feeling like you are outside of your body or mind, while derealization means feeling like what is around you is not real.

Depersonalization can have the following symptoms:

• 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 can have the following symptoms:

• 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 
  

Symptoms of DPDR can last for hours, days, weeks, or months. Most people experience episodes of symptoms, but it is possible to have them chronically.

Diagnosis 

The DSM-5 outlines the criteria to diagnose depersonalization-derealization disorder. A person must have:

• Constant or recurring episodes of derealization, depersonalization, or both
• During these episodes, they are able maintain contact with reality
• Significant distress or impairment in areas of functioning

Your healthcare provider may order tests to rule out other medical conditions that may cause similar symptoms, such as: 

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

Causes 

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

• Severe stress
• Trauma 
• Anxiety 
• Depression 
• Domestic violence
• Emotional abuse or neglect
• Illicit drugs
• Sleep deprivation
• Growing up with a family member with a significant mental illness
• Having a loved one die suddenly 
• Having other mental disorders 
  

Treatment 

Some people are able to recover from depersonalization-derealization disorder on their own without treatment. Others may benefit from medications or psychotherapy. It is possible to make a complete recovery from DPDR.

Medications

A specific medication that treats depersonalization-derealization disorder does not exist, but your healthcare provider can prescribe medicine to treat some of the symptoms or related conditions.

You may need medications to treat: 

• Depression 
• Anxiety
• Panic attacks  
  

Medications may include:

• Antidepressants
• Anti-anxiety drugs
  

Psychotherapy

Psychotherapy is a common treatment for depersonalization-derealization disorder. It focuses on eliminating the underlying stressors that caused the condition and helping the patient become more grounded in their experience.

Psychotherapy may include: 

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

Coping

There are different ways to cope with DPDR, and you may have to try several of them before finding what works for you. Coping with depersonalization-derealization disorder can include:

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

Summary

Depersonalization-derealization disorder is a condition that makes you feel disconnected from your body, thoughts, and environment. Medications and psychotherapy are common treatment options that can help you. It is also possible to recover from DPDR without any treatment. 

A Word From Verywell

If you have depersonalization-derealization disorder, it is important to remember that recovery is possible. You have multiple treatment options to choose from and may even recover on your own. You may also want to try different coping strategies for dealing with DPDR episodes.