Depersonalization / Derealization Disorder

Published on December 5th, 2018

Updated on January 3rd, 2024

Depersonalization/derealization disorder (DDD) causes a person to suffer from feeling like they are outside of their own body or that the world around them is not real. It is a mental health condition that is triggered by stress. It is treatable, and the first step of seeking treatment is identifying the signs of the disorder.

DDD causes sensations that are very uncomfortable for the affected person. It causes a feeling of being in a dream-like state. This dream-like state can happen at any time and in any situation. The sensation of DDD tends to occur most often when an affected person is feeling stressed or overwhelmed.

Most people who suffer from DDD will develop the disorder as a means to cope with stress. It causes a person to dissociate from a stressor. This helps the affected person get through the challenging situation without falling into distress.

Symptoms of Depersonalization/Derealization Disorder

Most people with DDD will experience one of the two primary sensations at some point in their lives. They will either feel like they are outside of their own body or will feel like they are not real. The experience is uncomfortable, but once the stress has dissipated the sensations fade as well.

The symptoms of DDD are recurring and uncomfortable. They are most often triggered in a time of stress, but can also occur unexpectedly. Symptoms of depersonalization/derealization disorder include:

The feeling of not existing in reality
Feeling distress at the questioning of reality
Anxiety
Depression
Feeling out of control with one’s interactions with the world
Checking and testing one’s own existence and reality
Out-of-body sensations
Feeling like an observer of one’s own life, feelings, and interactions with others
Panicked feeling that comes from uncomfortable symptoms
Feeling a break from reality in unexpected situations
Distorted perception and orientation of time and place
Emotional distress as a result of symptoms

Causes of Derealization/Depersonalization Disorder

Depersonalization / derealization disorder develops as a response to stress. A person who suffers from DDD may have poor stress management skills. They may also struggle with feeling like they fit in or feeling comfortable in their own skin.

There are common factors that may put a person at higher risk of DDD. Such common factors that cause an increased risk of DDD include:

Co-occurring Mental Health Disorders

Research supports that there is a connection between co-occurring mental health disorders. This means that people with DDD also suffer from other mental health conditions.

Such mental health conditions may include:

Anxiety
Depression
Post-traumatic stress disorder
Bipolar disorder
Panic disorder
Obsessive-compulsive disorder
Borderline personality disorder
Substance use
Alcoholism
Personality Disorders

It is common for people who suffer from DDD to also suffer from another mental health disorder. People who struggle with anxiety, depression, trauma, and stress management issues tend to be at higher risk of DDD.

Poor Stress Management Skills

People who struggle with stress management tend to be at higher risk of suffering from DDD. High-stress situations tend to trigger the symptoms of the disorder.

It is important to note that stress is subjective. What may be high-risk situations for stress for a person with DDD may not be high-risk for someone without DDD.

Environmental Factors

Environmental factors can cause an affected person to be more vulnerable to stress. Stressful environments can cause a person to develop DDD as a means to cope with the stress.

The sensation of being removed from the stressful situation may serve the purpose of minimizing the stress response. The following environmental factors put a person at higher risk of suffering from DDD:

Growing up in an abusive, neglectful or chaotic environment
Being a victim of sexual abuse or violence
Feeling like you do not fit in to your peer group or family
Not being taught stress management or distress tolerance skills during childhood
Growing up in an unsafe or hostile community

Treatment Options for Depersonalization/Derealization Disorder

Depersonalization / derealization disorder is challenging to cope with daily. A critical part of feeling better is being sure to get the treatment needed to minimize symptoms.

People who suffer from DDD should seek individual therapy to address episodes. This will help to reduce the intensity of symptoms. Types of therapy that help people with DDD include:

Cognitive-Behavioral Therapy (CBT)

Research supports that cognitive behavioral therapy (CBT) is effective in reducing symptoms of DDD. CBT helps to identify triggers for episodes. It also teaches stress management skills to prevent recurring episodes.

Dialectical behavioral therapy (DBT)

DBT may also be incorporated into counseling. DBT helps to teach acceptance and mindfulness skills to manage stress and other emotions. This helps by replacing DDD reactions with healthy coping skills.

Once an affected person learns coping skills for stress, there is less need to dissociate from the stressful situation. This can result in the need for DDD symptoms to reduce into dormancy.