Depersonalization / Derealization Disorder

GinaMarie Guarino, LMHC

Condition updated on August 5th, 2020

Depersonalization/Derealization Disorder

Depersonalization/derealization disorder (DDD) is a mental health condition. The experience DDD causes a person to suffer from 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 with DDD 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. This dream-like state can happen at any time and in any situation. The sensation of DDD tends to occur most often when an affected person is feeling stressed or overwhelmed.

Most people who suffer from DDD will develop the disorder as a coping mechanism for stress. The sensation of DDD is intended to dissociate from the stressor. This helps the affected person get through the situation without feeling distressed. While it may be helpful in the moment, it can have long term consequences on an affected person’s mental health. Many people with DDD tend to not enjoy the experience.

Symptoms of Depersonalization/Derealization Disorder

Most people with DDD will experience one of the two primary sensations at some point in their lives. They will either feel like they are outside of their own body or will feel like they are not real. The experience is uncomfortable, but for most people it will pass and will not significantly impact their lives. For those who suffer from DDD, the symptoms will be recurring and uncomfortable.

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

Depersonalization / derealization disorder develops as a response to stress. A person who suffers from DDD may have poor stress management skills. They may also struggle with feeling like they fit in or feeling comfortable in their own skin.

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

Co-occurring Mental Health Disorders

Research supports that there is a connection between co-occurring mental health disorders. This means that people with DDD also suffer from other mental health conditions.

Such mental health conditions may include:

It is common for people who suffer from DDD to also suffer from another mental health disorder. People who struggle with anxiety, depression, stress management issues and trauma tend to be at higher risk of DDD.

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. It is important to note that stress is subjective.

What may be high-risk situations for stress for a person with DDD may not be high-risk for someone without DDD.

Environmental Factors

Environmental factors can cause an affected person to be more vulnerable to stress. Stressful environments can cause a person to develop DDD as a means to cope with the stress. The sensation of being removed from the stressful situation may serve the purpose of minimizing the stress response.

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

  • Growing up in an abusive, neglectful or chaotic environment
  • Being a victim of sexual abuse or violence
  • Feeling like you do not fit in to your peer group or family
  • Not being taught stress management or distress tolerance skills by parents
  • Growing up in an unsafe or hostile community

Treatment Options for Depersonalization/Derealization Disorder

Depersonalization / derealization disorder 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 supports that cognitive behavioral therapy (CBT) is especially effective in reducing symptoms of DDD. 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. This can be helpful by replacing DDD symptoms with healthy coping skills. Once an affected person learns coping skills for stress, their need to dissociate from the stressful situation minimizes. This results in the need for DDD symptoms to reduce into dormancy.

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