Depersonalization/Derealization Disorder
Persistent or recurrent experiences of depersonalization, derealization, or both, with intact reality testing and significant distress.
Prevalence: Approximately 1-2% lifetime prevalence; transient symptoms are much more common.
Common Symptoms
- Feeling detached from one’s thoughts or body
- Sense of being an outside observer of oneself
- Emotional or physical numbing
- Perceiving surroundings as unreal or dreamlike
- Altered perception of time
- Distorted size or distance of objects
- Hyperfocus on bodily sensations
- Anxiety about going crazy
- Intact awareness that experiences are not truly real
- Functional impairment from persistent episodes
Risk Factors
- History of panic attacks
- Childhood trauma
- High anxiety sensitivity
- Depression
- Substance use
- Sleep deprivation
Treatment Approaches
- CBT for depersonalization and anxiety
- Psychoeducation and normalization
- Trauma-focused therapy when indicated
- Mindfulness-based interventions
- Medication for comorbid anxiety/depression
- Acceptance and Commitment Therapy
- Relapse prevention planning
Self-Help & Natural Approaches
- Grounding through sensory cues
- Limit caffeine and cannabis
- Regular sleep schedule
- Mindfulness with external focus
- Breathing retraining
- Gradual exposure to avoided situations
- Routine physical activity
- Reduce reassurance-seeking online
- Journaling triggers
- Structured daily routine
When to Seek Professional Help
- Symptoms persist for weeks or months
- Frequent panic with dissociation
- Work or school functioning declines
- Avoidance of normal activities
- Depression or hopelessness develops
- Self-harm or suicidal thoughts
Crisis Resources
- 988 Suicide & Crisis Lifeline
- Crisis Text Line: Text HELLO to 741741
- SAMHSA National Helpline: 1-800-662-4357
- NAMI HelpLine: 1-800-950-6264
- Anxiety and Depression Association: adaa.org
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.