What to Know About DPDR (Depersonalization/Derealization Disorder)

Table of ContentsView AllTable of ContentsDerealization vs. DepersonalizationWhat Does Derealization Feel Like?DiagnosisCausesRisk FactorsTypesTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Derealization vs. Depersonalization

What Does Derealization Feel Like?

Diagnosis

Causes

Risk Factors

Types

Treatment

Coping

Depersonalization/derealization disorder (DPDR), sometimes referred to as depersonalization/derealization syndrome, is a mental health condition that involves feeling distant or detached from yourself, mentally or physically, and/or having a reduced sense of reality.

DPDR can cause you to experience a persistent or recurring feeling of being outside of your body (depersonalization), a sense that what’s happening around you isn’t real (derealization), or both.

Unlike with other psychotic disorders, people with DPDR know that their experiences ofdetachmentaren’t real. This can leave them feeling concerned about their mental health.

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What Is Derealization vs. Depersonalization?

Although DPDR is considered a single diagnosis, it has two distinct aspects that may or may not apply to one person. Therefore, DPDR symptoms can vary depending on whether depersonalization or derealization are experienced.

Derealization Symptoms

Derealization is a sense of feeling detached from your environment and the objects and people in it.

DPDR symptoms of derealization can include:

Episodes of depersonalization/derealization disorder can last for hours, days, weeks, or even months. For some, such episodes become chronic, evolving into ongoing feelings of depersonalization or derealization that can periodically get better or worse.

What Does Derealization Feel Like?Someone who is experiencing derealization may feel like the world seems distorted and unreal, as if they’re observing it through a veil. They may feel as if a glass wall is separating them from people they care about. This aspect of disassociation can also create distortions in vision and other senses.

Someone who is experiencing derealization may feel like the world seems distorted and unreal, as if they’re observing it through a veil. They may feel as if a glass wall is separating them from people they care about. This aspect of disassociation can also create distortions in vision and other senses.

Depersonalization Symptoms

Depersonalization refers to feeling detached from yourself. It may feel as if you’re watching your life take place from the sidelines or like you are viewing yourself on a movie screen.

DPDR symptoms of depersonalization can include:

Diagnosis of DPDR

According to the National Alliance on Mental Illness (NAMI), roughly three in four adults have had adissociative episodein their lives, but only around 2% meet the criteria for DPDR.

To diagnose DPDR, a doctor first makes sure there aren’t other reasons for symptoms. DPDR symptoms can appear with drug use, a seizure disorder, or other mental health problems like depression, anxiety, post-traumatic stress disorder (PTSD), or borderline personality disorder.

Sometimes, imaging and other tests are done to rule out physical issues.Psychological tests, special structured interviews, and questionnaires can also help to diagnose DPDR.

Once other potential causes are ruled out, a clinician considers DPDR criteria as outlined in theDiagnostic and Statistical Manual of Mental Disorders(DSM-5), including:

Main Causes of DPDR

Often, people with DPDR have experienced past trauma in their lives, including:

Severe stress,anxiety, and depression are common triggers for DPDR. A lack of sleep or an overstimulating environment can also make DPDR symptoms worse.

Link Between Trauma, PTSD, and Dissociative Disorders

Risk Factors of DPDR

Some people are more vulnerable to psychiatric disorders than others. For instance, women are more likely than men to experience depersonalization/derealization or some other type of dissociative occurrence.

Other risk factors for DPDR include:

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Types of DPDR

DPDR is one of four types of dissociative disorders. These disorders are diagnosable conditions in which there’s a fragmented sense of identity, memories, and/or consciousness. If left untreated, dissociative disorders can lead to depression and anxiety and are believed to be linked to a history of trauma.

According to the DSM-5, other dissociative conditions include:

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Treatment of DPDR

For some, recovery takes place organically, without formal treatment. Others require targeted, personalized treatments to completely recover from DPDR. Chances of this recovery are best when the underlying stressors that contributed to and triggered the depersonalization and derealization are successfully dealt with.

Psychotherapy

The most effective way to deal with DPDR is withpsychotherapy.Cognitive behavioral therapy(CBT), for instance, teaches strategies for blocking obsessive thinking about feeling things that aren’t real. CBT also teaches distraction techniques, including:

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EMDR

While eye movement desensitization and reprocessing (EDMR) therapy was originally designed to treat PTSD, it is often used to treat a variety of mental health conditions, including DPDR.

What Is EMDR Therapy?

Medications

There are no medications approved specifically for treating depersonalization/derealization disorder. However, your healthcare professional may prescribeanti-anxiety drugsandantidepressantsto help ease or relieve DPDR symptoms.

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Coping With DPDR

In addition to psychotherapy, there are a few strategies that can help keep you grounded and/or bring you back to reality when you’re experiencing symptoms of DPDR.

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Supporting a Loved One With DPDR

If your loved one has DPDR, do your best to remain supportive. Additionally, encourage them to seek treatment, whether through psychotherapy, medication, self-help, or a combination of these options.

A diagnosis of depersonalization/derealization disorder can be upsetting and confusing. However, once you understand that the symptoms you’re experiencing have a recognizable and reasonable cause, you may begin to feel less worried and anxious. It’s also important to remind yourself that psychotherapy and perhaps medication can help treat DPDR.

If you or a loved one are struggling with depersonalization/derealization disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with depersonalization/derealization disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

4 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brewer R, Cook R, Bird G.Alexithymia: A general deficit of interoception.R Soc Open Sci. 2016;3(10):150664. doi:10.1098/rsos.150664National Alliance on Mental Illness.Dissociative disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.2013. doi:10.1176/appi.books.9780890425596Gentile JP, Snyder M, Marie Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41. PMID:25337444Additional ReadingSpiegel D, Loewenstein RJ, Lewis-Fernández R, et al.Dissociative disorders in DSM-5.Depress Anxiety. 2011;28(9):824-52. doi:10.1002/da.20874

4 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Brewer R, Cook R, Bird G.Alexithymia: A general deficit of interoception.R Soc Open Sci. 2016;3(10):150664. doi:10.1098/rsos.150664National Alliance on Mental Illness.Dissociative disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.2013. doi:10.1176/appi.books.9780890425596Gentile JP, Snyder M, Marie Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41. PMID:25337444Additional ReadingSpiegel D, Loewenstein RJ, Lewis-Fernández R, et al.Dissociative disorders in DSM-5.Depress Anxiety. 2011;28(9):824-52. doi:10.1002/da.20874

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Brewer R, Cook R, Bird G.Alexithymia: A general deficit of interoception.R Soc Open Sci. 2016;3(10):150664. doi:10.1098/rsos.150664National Alliance on Mental Illness.Dissociative disorders.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.2013. doi:10.1176/appi.books.9780890425596Gentile JP, Snyder M, Marie Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41. PMID:25337444

Brewer R, Cook R, Bird G.Alexithymia: A general deficit of interoception.R Soc Open Sci. 2016;3(10):150664. doi:10.1098/rsos.150664

National Alliance on Mental Illness.Dissociative disorders.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.2013. doi:10.1176/appi.books.9780890425596

Gentile JP, Snyder M, Marie Gillig P.Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder.Innov Clin Neurosci. 2014;11(7-8):37-41. PMID:25337444

Spiegel D, Loewenstein RJ, Lewis-Fernández R, et al.Dissociative disorders in DSM-5.Depress Anxiety. 2011;28(9):824-52. doi:10.1002/da.20874

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