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Depersonalization/Derealization Disorder

Kathryn Patricelli, MA

What is Depersonalization/Derealization Disorder?

Symptoms include:

  • Either one or both of the following happens:
    • Depersonalization - ongoing experiences of feeling like you are separate from your thoughts, feelings or body. You may feel emotionally or physically numb or like things that you are experiencing are not quite real/happening.
    • Derealization - ongoing experiences where other people or objects around you don't feel real, seem distorted, or like they are in a dream/foggy state.
  • During these episodes, the person knows who they are and where they are, but things just don't feel/seem quite right.
  • these issues cause stress in the person's life or trouble at work, in relationships with others, or other daily activities.
  • these issues aren't happening because of the effects of a substance (medication or drug of abuse).
  • there isn't another medical or mental health issue that explains the symptoms.

How common is Depersonalization/Derealization Disorder?

Occasional episodes that occur for hours or even days are fairly common in the general population. As many as 50% of all adults have experienced one of these states at least once in their life.

Only about 2% meet all the criteria for this condition though. It usually doesn't happen before about age 7 and most people are teens or up to about 30 years old when they are diagnosed. It is pretty rate after age 40.

What are the risk factors for Depersonalization/Derealization Disorder?

People that try to avoid harm and have immature defenses, like acting out and not adapting well to stress or difficult situations are at risk for this condition.

Also, those that had trauma as a child is also at risk. This could include physical or emotional abuse or neglect, growing up with someone that is seriously ill (physically or mentally), the unexpected death of a parent or close family member, or witnessing domestic violence in the home.

The most common situations occurring right before an episode include a lot of stress, depression, anxiety or drug use.

What other disorders or conditions often occur with Depersonalization/ Derealization Disorder?

Those with this condition often also have depression, anxiety disorders, and personality disorders.

How is Depersonalization/Derealization Disorder treated?

The main treatment for this condition is psychotherapy. The therapist will help the person deal with what happened and understand the causes of the condition. Stress management techniques will also be used to help the person handle the situation and to better cope with stressful situations that they face in the future. Once the person has learned coping skills, the therapist may then begin working with the person on the traumatic memories and experiences that came before the condition.

Medication can be also used to treat symptoms such as anxiety, depression or trouble sleeping, but does not cure the overall condition.