Depersonalization/Derealization Disorder

GinaMarie Guarino, LMHC

Depersonalization/Derealization Disorder

Depersonalization/derealization disorder (DDD) is when a person suffers from the feeling like they are outside of their own body. This can be also that they feel that the world around them is not real. A person can suffer from one or both of these sensations.

Each of these sensations is very uncomfortable for the affected person. It causes a feeling of being in a dream-like state. It can happen at any time and in any situation.

Most people who suffer from DDD will develop the disorder as a coping mechanism for stress. This coping mechanism is maladaptive. It can significantly impact the affected person’s ability to function.

Symptoms of Depersonalization/Derealization Disorder

Most people will experience one of the two primary sensations at some point in their lives. The experience is uncomfortable, but for most people it will pass quickly and will not significantly impact their lives.

For those who suffer from DDD, the symptoms will be recurring and distressing.

Symptoms of depersonalization/derealization disorder include:

  • The feeling of not existing in reality
  • Feeling distress at the questioning of reality
  • Anxiety
  • Depression
  • Feeling out of control with one’s interactions with the world
  • Checking and testing one’s own existence and reality
  • Out-of-body sensations
  • Feeling like an observer of one’s own life, feelings, and interactions with others
  • Panicked feeling that comes from uncomfortable symptoms
  • Feeling a break from reality in unexpected situations
  • Distorted perception and orientation of time and place
  • Emotional distress as a result of symptoms

Causes of Derealization/Depersonalization Disorder

There are common factors that may put a person at higher risk of DDD. Such causal factors include:

Co-occurring Mental Health Disorders

Research supports that there is a connection between co-occurring mental health disorders, like:

Poor Stress Management Skills

People who struggle with stress management tend to be at higher risk of suffering from DDD. High-stress situations tend to trigger the symptoms of the disorder.

People who struggle with anxiety, depression, stress management issues and trauma tend to be at higher risk of DDD.

Environmental Factors

Environmental factors can cause an affected person to be vulnerable to stress. Stressful environments can cause a person to develop DDD as a means to cope with the stress.

The following environmental factors put a person at higher risk of suffering from DDD:

  • Growing up in an abusive, negligent or chaotic environment
  • Being a victim of sexual abuse or violence
  • Growing up in an unsafe or hostile community

Treatment Options for Depersonalization/Derealization Disorder

DDD is challenging to cope with on a daily basis. A critical part to feeling better is making sure to get the therapeutic treatment needed to minimize symptoms.

People who suffer from DDD should seek individual therapy to address episodes. This will help to reduce the intensity of symptoms.

Research supports that cognitive behavioral therapy (CBT) is especially effective in reducing symptoms. CBT helps to identify triggers for episodes. It also teaches stress management skills to prevent recurring episodes.

Dialectical behavioral therapy (DBT) may also be incorporated into therapy. DBT helps to teach acceptance and mindfulness skills to manage stress and emotions.

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