Understanding Depersonalization-Derealization Disorder

Danielle returned to her office after a stressful meeting and started to feel a strange sensation all over her body – a sensation that she couldn’t explain and had certainly never felt before. As she sat in her chair, Danielle felt as though she was having an out-of-body experience, detached, as if she were in a dream or watching herself in a movie.

If one of Danielle’s colleagues had entered her office at that moment, they might have assumed she was either ill or under the influence of some kind of drug.

But Danielle was neither ill or on drugs. She was experiencing a little-known condition called depersonalization-derealization disorder.

What is Depersonalization and Derealization Disorder?

Depersonalization disorder describes a recurring sensation where you feel you are detached from your body and observing yourself from the outside – as if you’re watching yourself on video. It has to do with detachment from self.

Derealization disorder is similar in some ways, but has more to do with detachment from your surroundings. A person with derealization disorder may feel they are living in a dream, despite being fully awake.

Episodes of both depersonalization and derealization can last anywhere from a few hours to a few months. While some mental health experts see these as separate disorders, others see them as one condition representing different symptoms on a single continuum.  

Symptoms of Depersonalization Disorder

• Feeling as though you are detached from your body, feelings and thoughts
• Not in control of your speech or movement
• Feeling as though your senses are emotionally or physically numb
• Memories that lack emotion

Symptoms of Derealization Disorder

• Feeling as though you are unfamiliar with your surroundings or in a distorted environment
• Having the sense that you are emotionally disconnected from people you care about
• Distortions in your perception of time
• Distortions in the size and shape of objects

Causes of Depersonalization-Derealization

The exact cause of this disorder has not been identified but current research points to an imbalance of neurotransmitters (chemicals in the brain) that make the brain vulnerable to heightened responses when exposed to severe stress. Events that may increase the risk of neurotransmitter imbalance and lead to this condition might include:  

• Exposure to trauma in childhood – directly or indirectly
• Severe stress, such as unexpected death of a loved one, car accident or other crisis
• Being brought up in a home with a mentally ill parent

The Depersonalization-Derealization and Addiction Connection 

Depersonalization-derealization disorder can also occur during active drug use. Although current research does not link the cause of depersonalization-derealization to the use of drugs, alcohol or any single mental health or medical condition, it’s commonly experienced both during and after drug usage has ended. Studies have shown that between 25 and 40 percent of former drug addicts either currently or previously suffered from significant episodes of severe depersonalization disorder.

Treatment

The typically recommended treatment for depersonalization-derealization disorder is cognitive behavioral therapy with an experienced clinician. The focus of this unique therapy is to help you manage the symptoms and how they may be affecting your relationships, work or decision-making.  

There are no medications that specifically target the symptoms of depersonalization-derealization disorder, but antidepressants and/or anti-anxiety drugs are often prescribed to help manage the emotional responses that go hand-in-hand with the disorder.