Causes

While the exact cause of DPDR is unclear, it often arises as a response to severe stress or trauma, such as abuse, neglect, relationship problems, or the death of a loved one. Other conditions like anxiety, panic attacks, depression, or substance misuse can trigger episodes. Biological factors like genetics and differences in brain chemistry may also contribute. 

If you or a loved one is experiencing severe symptoms, especially self-harm or suicidal thoughts, please seek immediate help by calling or texting 988 to reach the Suicide & Crisis Lifeline in the US, or calling your local emergency services number (such as 911). 

depersonalization-derealization disorder

Depersonalization-derealization disorder (DPDR) is a mental health condition characterized by persistent or recurrent feelings of being detached from one's own body and thoughts (depersonalization) and/or the surrounding world (derealization). Individuals with DPDR maintain an awareness that these feelings are not reality, but the experiences can be very disturbing and interfere with daily functioning. 

Symptoms

Symptoms can vary in intensity and duration and often begin in the middle or late teenage years. 

Depersonalization Symptoms

  • Feeling like an outside observer of your own thoughts, feelings, body, or actions.

  • Emotional or physical numbness to the world around you.

  • A sense of being a robot or not in control of what you say or how you move.

  • Perceiving your body or body parts as distorted in shape or size. 

Derealization Symptoms

Derealization symptoms include feeling that people and surroundings are unreal, like being in a dream or movie. Individuals may feel emotionally disconnected from loved ones and perceive their environment as blurry, colorless, or distorted. A distorted sense of time is also possible. 

Treatments

Treatment for DPDR typically involves psychotherapy and sometimes medication for related symptoms. 

  • Psychotherapy: Aims to help manage symptoms, address trauma, and develop coping skills. Therapies like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR) can be beneficial. Grounding techniques, which use the senses to help an individual feel present, are also practical strategies.

  • Medication: There is no specific medication for DPDR itself, but doctors may prescribe medication to treat co-occurring anxiety or depression. This can include SSRIs or anti-anxiety medications. Some studies have shown promise with the supplement N-acetylcysteine (NAC).

  • Lifestyle Adjustments: Healthy habits like sufficient sleep, exercise, a balanced diet, and stress-reduction techniques may help manage symptoms.