What is Depersonalization Disorder? Symptoms and Causes

Have you ever felt profoundly disconnected from yourself or your surroundings, as if you were detached from your body or your environment? Most of us have at one point in our lives, or on occasion when we are overtired or stressed.

However, some people experience this phenomenon recurrently and to such a degree that it is highly distressing and interferes with everyday functioning. It’s called depersonalization or, in formal diagnostic terms, depersonalization-derealization disorder (DPDRD).

Frequently overlooked and often misdiagnosed, this mental health condition is a type of dissociative disorder. More common than you may think, it affects roughly 2.5 % of the population, according to research estimates.

Too often, those who may struggle with depersonalization are unaware of it. They may go months or years before getting a proper diagnosis. Feeling detached in this way can diminish your quality of life.

Here’s what depersonalization is, how to recognize it, and what can be done to treat it.

WHAT IS DEPERSONALIZATION-DEREALIZATION DISORDER?

The term “depersonalization” was originally coined in 1898. In 2013, depersonalization disorder was classified as a type of dissociative disorder and named “depersonalization-derealization disorder.”

Depersonalization describes a form of dissociation, which is characterized by a feeling of disconnectedness or detachment, particularly from oneself (behaviors, bodily sensations, emotions) or one’s identity. The phenomenon has been described as feeling like you are outside of your body watching events happen.

Closely related to depersonalization, the detached feeling or an altered perception can extend to one’s surroundings too, which is called derealization. With derealization, one’s environment may be perceived as visually distorted, lifeless, empty, or dreamlike. When an individual has DPDRD, they may experience one or both these aspects of dissociation.

An episode of depersonalization can last for minutes, hours, or days. Depersonalization-derealization disorder is usually diagnosed when an individual experiences a chronic, unremitting progression of symptoms that last months or years, and the symptoms are associated with marked problems at work, school, or with social functioning.

A lack of understanding, recognition and treatment for the condition exists today, so it is important to note a few additional defining distinctions of the disorder. First, an individual is aware that they are having the symptoms. Although the feelings are of “unreality” the person is very much in reality.

Additionally, the symptoms are not better explained by another mental health disorder, such as schizophrenia, panic disorder, major depressive disorder, post-traumatic stress disorder (PTSD), stress, or other types of dissociative disorders. Nor are the symptoms due to the physiological effects of substances (drugs, alcohol, or medication) or another medical issue.

Symptoms of depersonalization disorder can begin in early childhood, but the average age an individual first experiences the disorder is 16. Less than 20% of cases begin experiencing symptoms after age 20 and only 5% over the age of 25. Symptoms rarely occur over the age of 40.

Without understanding the disorder, some individuals will make inaccurate assumptions. They may quietly carry a fear that they don’t really exist or that they have brain damage or are losing their mind. It takes an average of 7-12 years for an individual to get a correct diagnosis of DPDRD.

11 COMMON DEPERSONALIZATION SYMPTOMS

You cannot physically observe the symptoms of depersonalization-derealization disorder. They are invisible and only involve changes in subjective experience. As a dissociative disorder, symptoms of DPDRD are believed to result from a disruption in the healthy integration of consciousness, perception, memory, identity, behavior, and motor control.

Depersonalization symptoms may include:

• Experiencing your thoughts, behavior, and feelings from a dreamlike, detached state
• A feeling of observing yourself outside your body
• Feeling emotionally and physically numb
• Feeling robotic or mechanical
• Detached from sensations such as hunger, thirst, and touch
• Feeling mistrustful of your memories
• Feelings of sadness or anxiousness

Derealization symptoms may include:

• Feeling as though people and your surroundings are not real, like you’re living in a dream
• Feeling emotionally detached from loved ones
• Perceiving surroundings as unusually shaped, distorted, colorless, or two-dimensional without depth – or being hyperaware of your surroundings, where things appear clearer than usual
• Feeling like the world has no meaning

WHAT CAUSES DEPERSONALIZATION?

The specific causes of DPDRD are not well understood. That said, experts have found that episodes of depersonalization may result from:

• Severe stress (interpersonal, financial, occupational)
• Lack of sleep/severe fatigue
• Depression
• Anxiety disorders (particularly panic attacks)
• PTSD
• Substance use

Depersonalization-derealization disorder is more complex and highly associated with trauma—particularly childhood emotional trauma, according to research. Indeed, having a history of physical or emotional abuse, severe stress, or neglect can lead to the development of DPDRD. Other traumas such as exposure to combat, natural disasters, or violence may trigger depersonalization symptoms as well.

There are theories as to why this is. Many experts believe depersonalization offers a protective barrier against trauma. In the face of an overwhelming experience, the dissociative state of depersonalization provides a psychic escape in situations where there’s no physical escape.

Yet, over time, and especially in cases of repeated trauma during childhood, the use of dissociation can be an automatic response to stress.

Neuroimaging research suggests there are neurobiological factors in dissociative disorders in general. With DPDRD, research has discovered white matter network alterations, although its implications are not yet fully understood.

TREATMENT FOR DEPERSONALIZATION-DEREALIZATION DISORDER

There’s real hope for people who struggle with this condition. Some of the most common treatment options include the following:

• Psychotherapy: Also known as talk therapy or cognitive behavioral therapy (CBT), psychotherapy can help by addressing co-existing mental health issues such as anxiety and clinical depression.

Through therapy, individuals can also learn about the nature of their distressing symptoms. They can learn to avoid triggers and use behavioral techniques such as grounding exercises (turning on music, chanting, touching objects, etc.) to counter symptoms.

• Eye movement desensitization and reprocessing: EMDR is special type of psychotherapy that can be very beneficial for individuals who have experienced trauma.
• Hypnosis: Medical hypnosis can be helpful in overcoming issues such as anxiety, depression, and PTSD that contribute to DPDRD.
• Medications: When necessary, medications can be a powerful part of a comprehensive treatment plan. Types of medications recommended may include antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), antipsychotic medications, or mood stabilizers.

Some physicians recommend anti-anxiety pills, such as benzodiazepines. However, brain-imaging studies using single photon emission computed tomography (SPECT) scans at Amen Clinics show that these medications harm the brain. In addition, once you start taking benzodiazepines it can be hard to stop taking them.

• Additional natural therapies: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness meditation may reduce anxiety, which contributes to depersonalization symptoms.

If you or someone you love is experiencing symptoms of DPDRD, reach out to a qualified mental health professional for a psychiatric evaluation as soon as possible.

Depersonalization-derealization symptoms, dissociative disorders, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here