What is Depersonalization-Derealization Disorder? 

Depersonalization-derealisation disorder (DPRD) is a distressing and impairing condition that is not well understood and is believed to be quite rare by many psychologists. However, studies show that DPRD affects 1% to 2.4% of the population and that 34-70% of all individuals have, at some point in life, experienced temporary transient symptoms of depersonalization and derealization. Depersonalization and derealisation symptoms are often experienced during times of extreme stress, fatigue, interpersonal difficulties or drug use. During meditative practices that are a part of many religions and cultures, depersonalization or derealization is voluntarily induced. Thus, the experience of depersonalization or derealization is thought to be part of the normal range of human experience.

Psychological research has found that there is a high degree of overlap between depersonalization-derealization disorder and other anxiety disorders. DPDR and anxiety disorders share many similar symptoms such as increased arousal, feelings of dizziness or faintness, racing thoughts, a sense of detachment, and avoidance of uncomfortable situations. The research states individuals who experience anxiety disorders such as Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder and Obsessive Compulsive Disorder (OCD) often also experience depersonalization and derealization symptoms. Individuals with Panic disorder demonstrate high rates (22-34%) of depersonalization and derealization.

The average age of onset for DPDR is age 16 and it is equally prevalent among men and women. Several psychological studies found that a subtle relationship may exist between childhood trauma and depersonalization-derealization disorder. There appears to be overlap between depersonalization and anhedonia or the inability to experience pleasure.

Hunter et al. (2003) define DPRD as follows:

  • Depersonalization (DP): “An experience in which the individual feels a sense of unreality and detachment from themselves”
  • Derealization (DR): “An experience in which the individual feels a sense of unreality and detachment from the external world”

Depersonalization and derealization can be frightening and confusing. Individuals experiencing DPDR often describe DPDR as being “cut-off from reality”, “being in a bubble”, “living in a dream”, “living in the ‘Truman Show’”, or “looking at life through a mirror or a pane of glass”. Individuals with DPDR often report a strange experience of time, and vision that is either pale and fuzzy or vivid and bright.

Symptoms on depersonalization and derealization include:

Perceptual and physiological difficulties

  • Feelings of hollowness or weightlessness
  • Partial or total physiological or emotional numbness
  • Absence of a sense of physical boundaries
  • Impaired or distorted senses (e.g., touch, sound, taste, color)
  • Dizziness
  • A sense that one’s environment feels flat or 2 dimensional
  • Change in one’s perception of time
  • One’s reflection or voice doesn’t seem real
  • Objects do not appear solid

Cognitive difficulties

  • Difficulty concentrating
  • Racing thoughts
  • Mind feels “empty”
  • Forgetfulness
  • Difficulty with visual imagery
  • Difficulty in processing new information

Emotional difficulties

  • Feeling emotionally “numb”
  • Lack of emphathy
  • Loss of motivation
  • Feeling isolated
  • Feelings of depression and/or anxiety
  • Feeling like one is in a dream-like state

Strange physical experiences

  • Feeling like body parts aren’t one’s own “I feel like my head doesn’t exist”
  • Feeling like a robot or automaton
  • Feeling like the self is living someone else’s memories
  • “Out of body” experiences (feeling like the self is behind or to the side of themselves)
  • Feeling like body parts (typically hands) have grown large or small
  • Feelings of weightlessness
  • Mind emptiness

Depersonalization-derealization has been clinically proven to respond well to Cognitive Behavioral Therapy (CBT) methods, when a clinician has training and understanding of the disorder. At GroundWork Counseling in Orlando, our CBT therapists utilize effective CBT methods to treat DPDR as well as anxiety disorders, OCD, and depression.


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