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.

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.

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 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 depersonalization/derealization symptoms usually last for a few minutes but can persist for hours or days and they may recur intermittently for years.

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. 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
  

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 body
• Taking slow, deep breaths while focusing on the movement of your chest and diaphragm
• Calling a friend or family member and have them talk with you to help you feel more connected with other people and reality
• Keeping your eyes moving around your surroundings to prevent zoning out
• Practicing meditation to increase your awareness of your experience
• Looking around at your surroundings and counting the objects you see, saying their colors aloud, or naming the objects
  

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.