Depersonalization-Derealization Disorder – Symptoms and Causes
Understanding the Disorder
Depersonalization-derealization disorder creates persistent feelings of observing yourself from outside your body or sensing that your surroundings aren’t real. These sensations can feel like living in a dreamlike state.
Many experience brief moments of depersonalization or derealization, but the disorder arises when these feelings are frequent or constant, affecting daily life. This condition appears more commonly in people who have experienced trauma, such as abuse, violence, or severe stress.
The disorder can significantly impact a person’s life, making relationships, work, and everyday activities challenging. Those affected may feel disconnected from their thoughts, feelings, and surroundings.
Key characteristics include:
- Feeling detached from oneself
- Sensing the world is unreal or distorted
- Persistent symptoms that cause distress
- Difficulty functioning in important areas of life
Treatment primarily involves psychotherapy (talk therapy), with medication sometimes used as a supplementary approach. With proper treatment, many people can manage their symptoms effectively and improve their quality of life.
Signs and Symptoms
Feelings of Being Outside Yourself
Depersonalization involves a sense of disconnection from one’s own body or thoughts. You might feel like you’re watching yourself from outside, as if floating above your body.
Some people describe moving like a robot, with no control over their actions or words. Your body parts might seem distorted, larger, smaller, or shaped differently.
Sometimes people feel emotionally numb or physically unable to sense things normally. Memories may seem flat or emotionless, making you question if they’re really yours.
Sense of Unreality About Surroundings
With derealization, the world around you seems unreal or dreamlike. You might feel separated from loved ones, as though an invisible barrier exists between you. Your surroundings can appear distorted—either blurry, flat, lacking color, or sometimes unusually clear.
Time perception often changes, with recent events feeling like they happened long ago. Objects may look wrong in size, distance, or shape.
When to Seek Medical Help
Brief feelings of being disconnected from yourself or reality happen to many people and aren’t always serious. However, you should talk to a healthcare provider if you experience these symptoms and they:
- Cause significant distress
- Keep returning or never fully go away
- Interfere with your daily life, work, or relationships
These episodes might last hours, days, weeks, or months. For some people, these feelings become ongoing, but vary in intensity over time. This condition usually starts in the teenage years or early adulthood and is rare in young children and older adults.
During these experiences, you typically remain aware that these feelings aren’t reality. Many people worry about “losing their mind” and become preoccupied with checking what’s real or confirming their own existence.
If you’re experiencing these symptoms, remember that effective treatments exist, and a proper diagnosis can help determine the best approach for your situation.
Causes
The exact cause of depersonalization-derealization disorder remains unclear. Both genetic and environmental factors likely play a role, making some individuals more susceptible than others. High stress levels and fear often trigger episodes of this condition.
Childhood trauma and severely stressful experiences may contribute to the development of symptoms. Emotional distress or trauma can greatly affect the brain’s processing of experiences, often resulting in feelings of detachment.
Risk Factors
Several factors may increase your chance of developing depersonalization-derealization disorder:
- Personality traits that lead to avoidance of stressful situations or difficulty expressing emotions.
- Trauma history from childhood or adulthood, including experiencing or witnessing violence or abuse.
- High stress levels related to important relationships, money problems, or work challenges.
- Mental health conditions like severe or long-lasting depression, or anxiety disorders with panic attacks.
- Substance use, which can trigger episodes of feeling detached from yourself or your surroundings.
Complications
Depersonalization or derealization episodes can create significant challenges in daily life. These experiences may:
- Interfere with concentration and memory function
- Disrupt work performance and daily routines
- Damage important personal relationships
- Lead to feelings of anxiety, depression, or hopelessness
These symptoms can hinder daily activities, leading to distress and difficulty in various areas of life.
Feeling Disconnected from Reality
Depersonalization-derealization disorder involves persistent feelings of unreality and detachment. People with this condition may feel separated from their body, thoughts, or surroundings.
Key symptoms include:
- Feeling like you’re observing yourself from outside your body
- Emotional or physical numbness
- Feeling that your surroundings aren’t real
- Distorted perception of time
- Anxiety about these unusual experiences
These symptoms often begin during the teenage years or early adulthood. Stress can trigger episodes, but symptoms may persist even after the stressful period ends.
Diagnosis and management typically involves:
- A medical evaluation to rule out other conditions
- A psychological assessment
- Therapy approaches, especially cognitive behavioral therapy
- Stress reduction techniques
- Sometimes medication to treat related anxiety or depression
Many people experience brief episodes of depersonalization or derealization during high stress.
