Depersonalization-derealization disorder is a type of mental health condition where you may feel detached from your environment or yourself. It can alter your self-awareness and make you feel disconnected from your body and surroundings. 

In high-stress circumstances, a temporary feeling of depersonalization or derealization may be natural. This feeling can occur in response to a perceived overwhelming threat or extreme circumstances. However, these feelings are usually transient and don’t last long. If symptoms of depersonalization or derealization are long-term, make it much harder for you to live your life normally or continue to recur, you may be dealing with a mental health disorder. 

Depersonalization-derealization disorder occurs in about 1% of the population and can be caused by:

• Severe stress
• Depression
• Trauma
• Anxiety

Depersonalization and derealization often occur together. However, there are a few key differences between them. Let’s walk through the differences between these two conditions and how this mental health disorder can be treated.

The differences between depersonalization and derealization

Depersonalization and derealization both distance you from the world around you. However, they do so in different ways. Depersonalization means you feel as if you’re watching yourself from a distance, almost like a movie. Derealization, however, can make you feel as though the world around you isn’t real or is severely distorted from how it should be.

Symptoms of depersonalization can make you feel:

• Like you’re cut off from reality
• As if you’re observing yourself and your emotions from an outside perspective
• Out of control, or like your words and thoughts aren’t yours
• As if your self-image is distorted or wrong
• Doubt about whether your memories are real or your own
• Like you’re in a dream
• As if you’re living on autopilot or are a robot
• That something is really wrong

Depersonalization separates you from your own thoughts, feelings and the world around you. While there is plenty of overlap, derealization is a little bit different. Symptoms of derealization can make you feel: 

• As if you’re in a dream or a dreamlike trance that’s very different from your regular life
• Like your perception of time has been distorted, slowing down or speeding up much faster than usual
• That sounds are too loud, too soft or otherwise distorted
• As if the outside world is fake, colorless or lifeless
• Like the objects around you are distorted or unusual in size or color 

There are a lot of similarities between depersonalization and derealization. However, the main difference between them is whether your awareness is external or internal. Depersonalization can make you feel disconnected from your body, thoughts, emotions and sensations. Derealization is more likely to make you feel disconnected from other people, time, objects and your location in the world around you. 

If someone experiences both depersonalization and derealization, they may feel completely detached from themselves and the outside world.

How to treat depersonalization-derealization disorder

Depersonalization-derealization disorder does not have a specific test to diagnose it. However, your health care provider may administer mental or physical health exams to exclude other conditions. They may also recommend that you have a psychiatric evaluation. This evaluation can also help determine what specific symptoms you have and how long they have been happening. Some conditions your health care provider may want to rule out include:

• Anxiety
• A traumatic brain injury
• Depression
• Medication withdrawal
• Obsessive-compulsive disorder
• Personality disorders
• Post-traumatic stress disorder
• Substance use disorder for mood-altering substances such as drugs or alcohol
• Withdrawal from medication

If your condition can’t be attributed to one of these causes, your health care provider may diagnose you with depersonalization-derealization disorder.

For many people, symptoms of depersonalization or derealization due to trauma are temporary. In that case, you may not need specific treatment for your condition unless they are distressing you or impairing your ability to go about your day-to-day life. However, if you’ve been diagnosed with depersonalization-derealization disorder, you may need professional help. Here are some things that can help you manage your symptoms:

• Therapy — Psychotherapy can be a useful tool for depersonalization-derealization disorder. It’s also the primary treatment for this condition. Therapy can help you:
• • Understand your symptoms
  • Discover techniques and coping strategies
  • Learn to manage any other mental health challenges you may have

Your therapist can work with you to help you navigate your disorder in a healthy and manageable way.

• Medication — There isn’t currently a proven medication to treat depersonalization-derealization disorder. However, there are studies being done to find a medication that can treat this condition, and medication may be used to treat some of this disorder’s specific symptoms. Also, if you have other mental health conditions related to depersonalization-derealization disorder, such as depression or anxiety, medication can help treat those issues.
• Coping mechanisms — When you feel depersonalization or derealization setting in, the following coping mechanisms can help you deal with those feelings and manage your symptoms: 
  • Following your treatment plan
  • Learning what triggers your symptoms
  • Figuring out how to work through them 

At Lightfully Behavioral Health, our licensed clinical experts use our Precision Care Model (PCM) to create a personalized treatment plan for your depersonalization-derealization disorder, comprising a combination of therapies, such as:

• Cognitive behavioral therapy (CBT)
• Lifestyle changes
• Medication management 

With continuous monitoring from our clinical experts, a specialized treatment plan can help you learn to manage your depersonalization and derealization. You can learn how to live with depersonalization-derealization disorder. When you’re ready to take the first step, reach out to our Admissions Concierge Team. We’ll take the next steps together, toward the fullest, brightest version of you.