Depersonalization and derealization

These are two related dissociative disorders. Depersonalization makes a person feel disconnected from their thoughts, feelings, and body, whereas derealization makes them feel disconnected from their environment.

What are they?

The feelings that result from these two conditions can be very disturbing and seriously interfere with a person’s ability to function. Some people fear they are going mad, or become depressed, anxious, or panicky. People with depersonalization describe feeling like a robot and not in control of their speech or movement, as if they are an outside observer of their own thoughts or memories. They may also feel that their body is distorted. With derealization a person can feel alienated and disconnected from their surroundings. In some, the symptoms for these disorders are mild and short-lived, whereas in others they may persist for months or even years. Little is known about what causes these disorders,
but biological and environmental factors may play a role. Some people appear to be more prone to them, because they are neurologically less reactive to emotions or they may have a personality disorder (pp.102–107). The disorders can be triggered by intense stress, trauma, or violence. If symptoms are present, a clinical assessment will
include a full medical history and physical examination to rule out illness or side effects of medication, and questionnaires will be completed to identify associated symptoms and possible triggers. An individual is diagnosed with depersonalization and/or derealization disorder only when they persistently or repeatedly suffer from distorted perceptions of detachment from themselves or their environment. Many people experience a temporary feeling of dissociation from their thoughts or surroundings at some point in their lifetime, but fewer than 2 percent of people will be identified as having one, or both, of these disorders.

Out-of-body experience

A person can be so dissociated from reality that they feel as if they are observing themselves in a movie and cannot relate to the individual in the real world.

TREATMENT

❯ Psychotherapies, particularly cognitive behavioral therapy , psychodynamic therapy , or mindfulness meditation can help a person understand why the feelings occur, learn coping strategies to manage the situations that trigger them, and gain control over symptoms.

❯ Medication, such as antidepressants , can be prescribed to treat any associated disorders, including anxiety and depression.