Depersonalization Derealization Disorder

Some wounds never show on the body, but they are deeper and more hurtful than anything that bleeds. So, People tend to focus on physical illness, physical betterment. But they kind of neglect their inner pain. People believe that what we cannot see, do not exist in real life also. Doing so, they ignore one of the most crucial sectors of their life: mental health. There are several mental illnesses that people are not even aware of it. As a result, these illnesses can even cause death. Depersonalization derealization disorder is such an illness. So, This disorder is kind of unknown among general people.

Moreover, people are oblivious about this disorder and refrain from treatment. In this article, we will focus on depersonalization derealization disorder. Our goal is to help the readers to detect whether they are suffering from this disorder or not and take the necessary initiative.

What is Mental Health?

Mental health is similar to physical health. Besides, it includes our emotional, psychological well being. While physical health affects our activities, mental health affects our behaviour patterns. So, mental health is quite essential in every stage of our life. But some gruesome reasons break our mental serenity. Such reasons are-

  • Biological factors like genes, brain chemistry.
  • Life experience, trauma, abuse.
  • Family history of mental health problem.

Overall there are various types of mental diseases with their unique symptoms and treatment procedures.

What is Depersonalization Derealization Disorder?

Depersonalization derealization disorder(DPDR) is a mental disorder. In this disorder, the patient has persistent or reluctant feelings of depersonalization or derealization. Nevertheless, this disorder consists of two sections. These two sections are-

  1. Depersonalization: Depersonalization is the feeling of disconnection or toughness. In this case, the patients often report feeling like an outside observer of their thoughts or body. But, They start to think as they have no control over their thoughts and actions.
  2. Derealization: Derealization is the detachment from one’s surroundings. In this case, patients report experiencing a world perception as foggy, surreal, and visually distorted.

However, this disease is considered a rare kind. It occurs in about 1-2% of the general population. According to a study, this disease’s chronic form has a prevalence of 0.8 to 1.9%.

Symptoms of Depersonalization Derealization Disorder:

We can cure most of the conditions if we can detect the disease at its beginning phase. So, knowing the symptoms play a vital role. However, persistent and recurrent depersonalization episodes or derealization can cause distress and, hence, the disorder. Furthermore, we can categorize the symptoms as follows-

  • Symptoms of Depersonalization: The depersonalization symptoms include-
  1. An outcast feeling. Individuals often feel that they are an outside observer of their activities. As a result, they cannot own themselves.
  2. Feeling like a robot and, in some cases behaving like one. Robots cannot control their actions, speech, chain of thoughts. In this case, the individual also experiences this feeling like robots.
  3. Emotional and physical numbness. The individual seems to shut down themselves from the outside world.
  4. Sometimes individual feels as if their body, legs or arms are distorted, enlarged, shrunken.
  5. The individual starts to doubt their memory, and also, they are not emotionally attached to their memories.
  • Symptoms of Derealization: The derealization symptoms are as follows-
  1. Unfamiliarity with the surroundings. An individual feel like an alien in their surrounding environment.
  2. Moreover, Emotional disconnection with close people. An individual feels like a glass wall separates them.
  3. Surrounding appear distorted, blurry, colourless, artificial.
  4. Distortion in the perception of time.
  5. Besides, Distortion of distance.
  6. We face distortion of the size and shape of objects.

In reality, symptoms usually begin in mid to late teens or early adulthood. Besides, It is rare in children and older adults and frequent in adults.

Causes of Depersonalization Derealization Disorder:

Interpersonal trauma is the main reason behind this disorder. This interpersonal trauma includes childhood abuse. Adverse early childhood experiences such as emotional abuse and neglect also work as a prime reason behind this. Furthermore, triggers may include stress, panic attacks, drug use. However, the specialists categorize the causes as follows-

  1. Psychosocial: Childhood interpersonal trauma, emotional abuse, physical and sexual abuse is the most significant reasons. According to a study, more incredible emotional abuse and lower physical abuse predict depersonalization in adult women with PTSD. Apart from this, patients with high interpersonal abuse histories (HIA) show higher scores. Besides traumatic experiences, there are other common precipitators of the disorder that include –

Stress, major depressive disorder, panic attacks, external locus of control, threat hypersensitivity.

  1. Neurobiology: There is evidence that the prefrontal cortex inhibits neural circuits that form the base of emotional experience. An fMRI study on the patients shows that emotionally aversive scenes activate the right ventral prefrontal cortex. According to several studies on DPDR patients, the straight middle temporal gyrus cortical thickness decreases.

Besides, there is a grey matter reduction, the volume of the right caudate, thalamus, occipital gyri, lower white matter integrity in the left temporal regions. According to a PET scan, there are functional abnormalities in the visual, auditory, somatosensory cortex. Likewise, according to EEG reading, there is overactivation of frontal alpha wave and increment of theta activity in the temporal region.


Now it is time to focus on the diagnosis process. Moreover, we can diagnose the disorder with the help of the following interviews and scales-

  • Structured Clinical Interview: We can use this method in a research setting. The interview takes about 30 minutes to 1.5 hours. The timing may differ based on an individual’s experience.
  • Dissociative Experiences Scale: This process can measure dissociative symptoms. This process can detect depersonalization and derealization experiences.
  • Dissociative disorder Interview: This interview technique makes diagnoses of the following-

Somatization disorder, borderline personality disorder, depressive disorder.

It inquires about symptoms of schizophrenia, dissociative identity disorder, extrasensory experiences, substance abuse. This interview process takes around 30 to 45 minutes to complete.

  • Cambridge Depersonalization Scale: It is a method for determining the severity of depersonalization disorder. So, The specialists use it to differentiate minor episodes from actual symptoms.

Differential Diagnosis:

DPDR differentials include neurologic and psychiatric conditions. These conditions are-

  • Neurologic: In the neurologic disorder section, we can notice-
  1. Brain tumour.
  2. Post-concussion syndrome.
  3. Metabolic abnormalities.
  4. Migraines
  5. Meniere’s disease.
  • Psychiatric: It is time for psychiatric illness. In this condition, we can see some symptoms, such as-
  1. Panic attack.
  2. Acute stress syndrome.
  3. Borderline personality disorder.
  4. Dissociative disorder.

However, besides all of these conditions, sometimes a withdrawal from illicit substances like marijuana, hallucinogens, MDMA, ketamine also works as a catalyst in DPDR.


There is a saying, “Prevention is better than cure.” All together, we can prevent DPDR by merely connecting the children that have faced abused with professional mental health. Moreover, we need to help them overcome their trauma, not to develop any further symptoms.


To provide our respected readers with a detailed treatment procedure, our research team has worked hard and gathered some compelling data and methods that we are going to present now. Treatment is primarily non-pharmacological and can include-Paradoxical intention, record keeping, positive reward, flooding, psychotherapy, cognitive-behavioural therapy, psychoeducation, self-hypnosis, meditation. On the other hand, clinical therapeutic approach research explores several positive options, including -Selective serotonin reuptake inhibitors, benzodiazepines, stimulants, opioid antagonists.


There are no specific medications available. However, we can still use medicine to treat specific symptoms of depression and anxiety.

FAQs for Depersonalization Derealization Disorder:

The human mind is full of curiosity. So, even though we have discussed DPDR briefly, there are still some doubts regarding this disorder. With this in mind, we have decided to answer all the possible questions regarding DPDR. Let’s have a glance at those doubts-

Question No 01: Is there any risk factor?

Answer: We are afraid to say that there are undoubtedly some risk factors. These factors increase the risk of DPDR. The elements Such as:

  1. Certain personality traits make us want to avoid difficult situations.
  2. Severe trauma.
  3. Severe stress.
  4. Usage of recreational drugs.

Question No 02:  Are there any complications that this disorder can cause?

Answer: This disorder can frighten us. Admittedly it can cause-

  1. Difficulty focusing on tasks.
  2. Difficulty in remembering things.
  3. We face interference with our work and other routine activities.
  4.  Moreover, Problems in the relationship.

Question No 03: Is there any suggestion for the DPDR  patients?

Answer: According to the psychiatrists, if we want to cope with DPDR, we need to follow some steps. Such as-

  1. Follow the treatment plan.
  2. We are taking psychotherapy regularly.
  3. Learn about our mental state.
  4. Stay connected with the close one.

Question No 04: What is the duration of this disorder?

Answer: This disorder can last for hours, days, weeks, even months. For some individuals, such episodes become chronic. In most cases, they evolve into persistent feelings of DPDR that can get better or worse.

Types of Dissociative Disorder:

Dissociative disorder is one of the mental illnesses available in medical science. Generally, there are four types of dissociative disorder. DPDR is one of them. However, the other classes are-

  1. Dissociative Amnesia: It is a condition that involves the inability to remember important information.
  2. Fugue: This is a form of reversible amnesia that involves personality, memories, personal identity.
  3. Dissociative Identity Disorder: It is a condition that marks two or more distinct personalities within one individual.

Early Warning Signs of Mental Illness:

Every mental illness shows some warning signs in its early stages. Moreover, these signs act as an indicator of our mental health. These signs are-

  1. We are eating too much or too little.
  2. Sleeping too much or too little.
  3. We are pulling away from people.
  4. Having low or no energy.
  5. We are feeling numb.
  6. We have unexplained aches.
  7. Smoking and drinking.
  8. We are consuming drugs more than usual.
  • We are feeling angry, confused, on edge, forgetful, upset, worried as well as, scared.
  • Yelling and fighting with family and friends.
  • We are experiencing mood swings.
  • We are having persistent thoughts.
  • Constant recalling of specific memories.
  • We hear voices.
  • We are thinking of harming our own life.
  • Inability to perform daily tasks.

Impact of Positive Mental Health:

Positive mental health is essential for a healthy life. Apart from this, it has a substantial impact on our daily life. However, positive mental health allows us-

  1. Realize our full potential.
  2. We realize self-worth.
  3. Cope with the stresses of life.
  4. Work productively.
  5. Make meaningful contributions to society.

Ways to Maintain Positive Mental Health:

Positive mental health is vital to maintain a happy life. Hence, there are some ways by following which we can support positive mental health. These ways are-

  1. Getting professional health is we need it.
  2. We need to connect with others.
  3. Besides that, Stay positive.
  4. We need to get physically active.
  5. Also, Help others.
  6. We need to get enough sleep.
  7. Develop coping skills.


Dissociating symptoms:

Dissociating disorder is an indicator of mental illness. Therefore, this disorder has some identifying symptoms that help us to identify whether someone is dissociating or not. Some of the symptoms of dissociating includes-

  1. Amnesia.
  2. Depersonalization.
  3. Derealization.
  4. Identity Confusion.

Complications of Mental Illness:

As a result, mental illness is a leading cause of disability. If we ignore our mental illness, it can cause severe emotional, behavioural, and physical health problems. However, there are some complications of mental illness, and they are-

  1. Unhappiness
  2. Decreased enjoyment of life
  3. Family conflicts.
  4. Relationship difficulties.
  5. Social isolation
  6.  Also, Problems with tobacco, alcohol, and other drugs
  7. We often miss work or school or other problems related to work or school.
  8. Legal and financial problems as well as.
  9. Poverty
  • Homelessness
  • Self-harm
  • Harm to others
  • Weakened immune system
  • We suffer from heart disease and other medical conditions.

Things That Trigger DPDR:

Like other dissociative disorders, intense stress, a traumatic event such as war, abuse, accidents, disasters, extreme violence can trigger DPDR. In short, any trauma act as the most impacting trigger of DPDR.

From the above discussion, we can briefly know about depersonalization derealization disorder. Depersonalization derealization disorder is a hindrance to our daily improvement. Once upon a time, people considered mental health as a myth and called crazy patients people. But with time, it has now become an alarming issue that requires our proper attention. So, we hope that our readers will understand the importance of positive mental health and take care of themselves, thus will lead both physically and mentally healthy life.

By NMK Pro