What Is Depersonalization-Derealization Disorder (DPDR)?

Can Involve Disconnectedness or Numbness

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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.

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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:

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:

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:

Examples of medications that may help someone with DPDR include:

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: 

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

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

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 body
    • Outside of your body and watching it
    • Robotic
    • In 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.

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.
  1. National Alliance on Mental Illness. Dissociative disorders.

  2. Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. 2013. pp. 302–306. ISBN 9780890425541.

  3. Sutar R, Chaturvedi S. Symptom profile and diagnostic utility of depersonalization–derealization disorder: A retrospective critical review from IndiaIndian J Psychiatry. 2020;62(1):91. doi:10.4103%2Fpsychiatry.IndianJPsychiatry_347_19

  4. Merck Manual. Depersonalization/derealization disorder.

  5. Cleveland Clinic. Depersonalization/derealization disorder.

  6. Sierra M, David AS, Hunter ECM. The epidemiology of depersonalisation and derealisationSocial Psychiatry and Psychiatric Epidemiology. 2004;39(1):9-18. doi:10.1007/s00127-004-0701-4

  7. 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

  8. Boysan M. Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile AnalysisNoro 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.