Have you ever felt that you were having an out of body experience and were not living your life but viewing it from outside?
Have you ever been sleep deprived to the point of feeling that you were not you but watching yourself?
When you feel disconnected from reality does this mean you suffer from depersonalization disorder?
The following will give you more information about this disorder and how to determine what is going on….
Depersonalization/Derealization Disorder: What Does It Mean?
Depersonalization/Derealization disorder is a psychological disorder that is characterized by persistent or recurrent episodes of depersonalization, derealization, or both.
What is Derealization?
Derealization is an experience when an individual has a sense of unreality or a detachment concerning his or her surroundings. An individual that experiences this feels that some individuals or objects are unreal, dreamlike, foggy, lifeless, or visually distorted. The individual could feel that they were in a bubble or there was a glass wall between them and the world around them.
What is Depersonalization?
Depersonalization is an experience where an individual may have experiences of unreality, detachment, or feeling that they are an outside observer concerning one’s thoughts, feelings, sensations, body, or actions. Some of these outside observer thoughts could be perceptual alterations, having a distorted sense of time, feeling unreal or absent from his or her self, and having feelings of emotional or physical numbing.
For the disorder to be diagnosed, the individual may have these experiences separately or together.
Stats: How Many Suffer from this Disorder?
Individuals can experience symptoms of this disorder hours to days and this is common in the general population. This short time prevalence is called transient symptoms. It has been found that one-half of all adults have experienced an episode of these transient symptoms. For the disorder to be diagnosed the symptoms have to be present for a long period.
Lifetime prevalence of this disorder only affects about two percent of the worldwide population. The commonality of an out of body experience or episode is much more common than the prevalence of this disorder.
What Causes Depersonalization?
There has not been a definite case of personalization and it has been thought to be caused due to a chemical imbalance in the brain. Dissociative disorders and feelings of depersonalization are usually triggered by past trauma or life-threatening event.
History of Abuse
If an individual experiences a history of abuse or trauma during his or her childhood or adulthood they could be more prone to experience this disorder. The abuse could range from emotional, physical, sexual, verbal, or physical neglect.
If an individual has been abused it does not mean that he or she will experience this disorder but a history of abuse and exposure to trauma gives an individual a higher risk of prevalence.
It has been found that use of recreational drugs such as hallucinogens and other substances may trigger feelings of depersonalization. Cannabis use has been found to cause episodes of depersonalization and dissociation as well as withdrawal from this substance. If an individual is withdrawing from benzodiazepines he or she could experience perceptual disturbances or depersonalization. Alcohol use can also induce depersonalization in some individuals.
Acquired Brain Injury
Individuals that have experienced a brain injury or significant trauma have a high prevalence of experiencing occasional episodes of depersonalization. It has been found that at least half of individuals with a brain injury experience these symptoms.
Signs and Symptoms of Depersonalization/Derealization Disorder
The feelings of depersonalization/derealization can occur for an individual on a short-term basis and this can come from sleep deprivation, substance use or withdrawal, exposure to trauma and abuse, and brain injury. For a true diagnosis of this disorder, the symptoms and experiences must cause significant distress or impairment in social, occupational, or other important areas of daily functioning.
What are Common Behaviors/Characteristics?
Some common features of depersonalization are feeling that you are looking at yourself from the outside or feeling as though you are not having your own emotions or feelings but are watching yourself have them; you could feel like a robot and are not in control of your speech or movements; you feel that your body, legs, or arms appear distorted and either larger or smaller; having a feeling of numbness and cannot feel your own senses or responses to the world; and feeling that your memories lack emotion or that they are not your memories but someone else’s.
Some common features of derealization are feelings of being alienated from or unfamiliar with your surroundings like you are living in a movie; feeling emotionally disconnected from people that you care about; your surroundings appear distorted, blurry, colorless, two-dimensional or artificial, or you experience a heightened awareness and clarity of your surroundings; having distortions in the perception of time or feeling like recent events were really like a distant past; or experiencing a distortion of distance, size, and shape of objects.
Testing: What are the Diagnostic Criteria Per the DSM 5?
For an individual to be diagnosed with this disorder they need to meet the following criteria:
- The presence of persistent or recurrent experiences of depersonalization, derealization or both:
- Depersonalization: Experiences of unreality, detachment, or being an outside observer concerning one’s thoughts, feelings, sensations, body, or actions
- Derealization: Experiences of unreality or detachment concerning surroundings.
- During the depersonalization or derealization experiences, reality testing remains intact.
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The disturbance is not attributable to the physiological effects of a substance or another medical condition
- The disturbance is not better explained by another mental disorder, such as schizophrenia, panic disorder, major depressive disorder, acute stress disorder, posttraumatic stress disorder, or another dissociative disorder.
- (American Psychiatric Association, 2013)
Depersonalization/Disorder and Other Conditions
Depersonalization/Derealization Disorder vs Out of Body Experiences
If an individual is experiencing an out of body experience they are feeling that they are floating outside of their body. They may feel like they are an observer or on the outside looking in. This can happen when a person is falling asleep or almost asleep.
This differs from depersonalization/derealization because when an individual experiences this they are no longer in reality and are detached from their feelings and self and also a detachment from their surroundings. This happens in different places and not just when an individual is sleeping or attempting to go to sleep.
Depersonalization Disorder vs Dissociative Identity Disorder
Dissociative identity disorder is a disorder where an individual feels that they have two or more distinct personality states. They do not feel detached but when one personality is present the other personalities are hidden. Each personality has a chance to live and be active with the individual. This differs from depersonalization because this is a detachment from self and not a change from one personality to another.
Depersonalization vs Dissociative Fugue
Dissociative fugue is a condition where an individual participates in sudden and unplanned travel away from home, cannot recall past events or important information, and experiences a loss of memory of his or her identity and possibly assumes a new identity. This differs from depersonalization because it involves the person physically leaving and not just emotionally or rationally detaching as an individual would if they experienced depersonalization.
Some of the disorders that could be related to depersonalization are illness anxiety disorder, major depressive disorder, obsessive-compulsive disorder, other dissociative disorders, anxiety disorders, psychotic disorders, substance/medication-induced disorders, and mental disorders due to another medical condition.
Depersonalization/Derealization Disorder in Adults/Children
The average age of an individual that experiences depersonalization is 22 years old. One-third of individuals that experience this disorder have had some symptoms present before the age of 16. It is more likely to occur with adolescents or young adults. Children have not been known to experience this disorder.
Example Case of Depersonalization/Derealization Disorder
Some individuals experience depersonalization/derealization disorder and try to cope with the feelings of the detachment and not being emotionally connected to themselves and their surroundings.
A therapist worked with a woman in her mid-30s who started counseling due to feelings of depression and feeling that she was not living life but just surviving. She presented with feelings of being a robot and not having any connection to herself, her surroundings, or people.
She thought it was due to being depressed but could not identify feelings of hopelessness, changes in appetite and sleep, or other depressive symptoms. She reported that she wanted to live and not just be present.
Throughout counseling, she were able to determine that she experienced depersonalization/derealization disorder and had her first symptoms when she was a late teenager. Using Cognitive Behavioral Therapy and Impact Therapy, she was able to learn how to connect and become more open to her feelings.
She participated in counseling for about two years and maintained her medication regimen prescribed by her doctor throughout treatment. She did struggle some throughout therapy but consistency and being able to become more connected to feelings and the “here and now” she was able to develop the skills needed for her to live and not just exist.
How to Deal/Coping with Depersonalization
If you start to experience symptoms of depersonalization the first thing that you can do is identify what is going on. Work to reshape the negative thoughts of being detached and try to become more present with yourself. Try to become more present in your surroundings becoming aware of the sounds and smells that are present, these can help you try to connect more.
You can attempt to communicate more with others and become connected to others through verbal and nonverbal communication. Trying to attach to yourself, your surroundings, and others is a great way to work on reducing the negative symptoms and help you to feel better.
Look out for These Complications/Risk Factors
An individual that already experiences depression, dissociative personality disorder, schizophrenia, and obsessive-compulsive disorder is at a higher risk of experiencing depersonalization. If an individual has experienced trauma and abuse and suffered from posttraumatic stress disorder they will have a higher risk of depersonalization and dissociation disorders. Anxiety disorders can cause depersonalization in many individuals. If a person does not get adequate sleep and nourishment they may have a higher risk of experiencing depersonalization episodes.
Depersonalization/Derealization Disorder Treatment
There is currently no distinct treatment for depersonalization or dissociation.
Possible Medications for Depersonalization/Derealization Disorder
Medications that can be used to help relieve symptoms include antidepressants and mood stabilizers. Experts suggest that a combination of medications like Lamotrigine and a selective serotonin reuptake inhibitor (SSRI) can help an individual experiencing this disorder
Home Remedies to help Depersonalization/Derealization Disorder
Mindfulness activities have been found to help an individual become more present in the “here and now”. These activities include yoga, meditation, or other relaxation activities. Doing these activities can help a person become more present which can help them become more attached. Another way to manage this disorder is to identify triggers to the symptoms.
This can be done through journaling and can help an individual develop a safety plan to help negative reactions to symptoms. If possible reducing stress can help an individual feel better because it can reduce the negative symptoms and help the individual feel more balanced.
Living with Depersonalization/Derealization Disorder
One of the most important things a person can do to help themselves feel better overall is to make healthy lifestyle choices. This can be done by getting adequate rest, eating healthy, avoiding addictive substances like caffeine, and working to develop a healthy work/life/family balance. It is important that an individual who experiences depersonalization/derealization works to feel present and attached to their life and also their surroundings.
Insurance Coverage for Depersonalization/Derealization Disorder
Most all insurance providers should cover this disorder. If you are experiencing symptoms that affect your daily activities, social, relationship, and occupational functioning it is important you reach out and seek assistance. If you have insurance, you can contact your insurance provider and locate clinicians in your area that are covered.
How to Find a Therapist?
There are many local resources to find counseling. Psychology Today has a list of providers in local areas and also identifies the modalities of the providers. Word of mouth is a great way to seek a counselor. More people are getting help and asking a trusted friend could assist you in finding the provider that is right for you.
What Should I be Looking for in an LMHP?
Looking for a counselor with experience with cognitive behavioral therapy and trauma therapy would be beneficial because they can help reshape negative feelings and process any past trauma or experiences that have occurred to trigger this disorder.
Questions to ask for Potential Therapist?
Do you have experience treating dissociative disorders, depression, anxiety, and provide trauma-informed care. Do you utilize homework and assist in the development of skills to assist in reshaping negative thinking?
Depersonalization/Derealization Disorder Resources and Support Helpline
There are many local and online support groups for depersonalization/derealization disorders. Throughout social media, you can locate support groups and resources to assist individuals that are experiencing this disorder.
Depersonalization/derealization is a rare disorder that only affects 2% of the population. Half of all individuals experience depersonalization/derealization episodes but only a few experience the hindrances in daily functioning that is needed for a DSM-5 diagnosis. Individuals that have experienced trauma and abuse, substance users, or those with a history of brain injury are more likely to experience these episodes.
There is not a distinct treatment for this disorder but through therapy and an appropriate medication regimen a person can work to reduce the symptoms and help them to form a better quality of life. Help is out there but the first step is admitting there is a problem. The second is locating support and actively participating in the help that has been determined.
American Psychiatric Association. (2013). Diagnostic and statistical mental of mental disorders (5th ed.).