Feeling detached from reality can be one of the most unsettling human experiences. Some people describe watching themselves from outside their body, almost as if they were observing a stranger. Others report that the world around them feels foggy and dreamlike.
Depersonalization and derealization symptoms can create major distress precisely because they’re so difficult to describe. The disconnect from your own thoughts, body, or surroundings doesn’t seem to follow any logic. You know intellectually that you’re real, yet your sense of reality has vanished.
This condition falls under dissociative disorders, a category of mental health conditions where normal consciousness fragments. Depersonalization disorder involves ongoing detachment from yourself, while derealization disorder centers on experiencing your environment as “strange” or seemingly artificial.
Though disturbing, these symptoms can respond quite well to specialized treatment. Finding out how dissociative mental health challenges and accessing the appropriate therapy for depersonalization and derealization can reconnect you with yourself and your life.
This page can also help you better understand depersonalization and derealization symptoms and treatment by exploring:
Depersonalization/derealization symptoms might sound a lot like psychosis, but they differ in one critical way: people with DPDR maintain their ability to reality-test themselves. This means that they know their perceptions are distorted. They recognize their experiences aren’t typical, which can often increase their distress. Someone experiencing psychosis, on the other hand, usually believes their altered perceptions are reflective of reality.
Episodes of dissociation can last for minutes, hours, days, or become chronic. Some people experience brief episodes that are triggered by stress, whereas others live in a constant state of detachment.
Next, we take a look at how both conditions can differ.
Depersonalization vs. Derealization
Depersonalization specifically involves feeling estranged or otherwise separated from yourself.2 You might feel robotic, going through the motions of life without having any genuine, human experiences. You might also sense that you’re watching yourself from outside your body, or feel as if you’ve lost ownership of your thoughts, emotions, or physical sensations.
In contrast, derealization means that the world outside you has lost its sense of being real.2 Familiar places might look strange or unreal, more like a movie set than a real place. Others might seem lifeless or two-dimensional to you, with colors feeling muted (or overly vivid). Time can distort as well, with some people describing “living behind glass” and “separated” from everything and everyone around them.
These dissociative disorders exist on a spectrum. Nearly everyone experiences brief symptoms similar to these during extreme stress or sleep deprivation, but these conditions can persist and go unrecognized for years. This can often make someone feel like they’re losing their mind.
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
Symptoms include:
Emotional numbness: Feeling unable to access or experience emotions, or feeling emotions that seem to belong to others instead.
For one, prolonged and severe stress can cause dissociative responses.3 Work demands, relationship conflicts, financial pressures, or major life changes can overwhelm the nervous system’s capacity to process experiences normally. The disconnection can function as a sort of psychological circuit breaker, creating distance from overwhelming circumstances.
Additionally, anxiety-related dissociation can occur during or after a panic attack.2 Intense fear can activate a protective detachment mechanism that separates you from the terrifying experience. Likewise, trauma-related dissociation can happen when a current situation resembles past traumatic experiences.
Furthermore, sleep deprivation and extremely crowded environments can overwhelm the sensory system, pushing you into a detached state of mind.4 Paradoxically, extremely boring situations (like driving on a long stretch of road) can also induce dissociation when the mind isn’t anchored to your present-moment experience.
Studies have shown that anywhere from 5 to 20% of outpatient mental health clients experience these symptoms at some point, along with anywhere from 17 to 41% of inpatient participants.4
Dissociative disorders, on the whole, occur at higher rates in people with specific mental health conditions; around half of people with depression experience depersonalization at the same time.4
Other prevalence rates with dissociative disorders and symptoms include:4
3-20% among those with anxiety disorders
Further, dissociative disorders appear most commonly in adolescents and young adults, though people of any age can feel detached from reality at times.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Depression support is a phone call away – call 866-478-4383 to learn about our current treatment options.
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Therapy for dissociative disorders and DPDR symptoms aims to simultaneously treat the dissociation itself and its underlying causes. Your treatment will focus on reducing the frequency of dissociative experiences, improving your connection to reality, and processing the impact of your experiences.
Psychodynamic therapy can help to explore how depersonalization and derealization symptoms function as protective mechanisms. This approach examines both when and why your disconnection first emerged, as understanding these origins helps you recognize that it once served a purpose but is now creating more problems than it solves.
Additionally, EMDR treatment can be uniquely effective for trauma-related dissociation. Many people with DPDR have experienced traumatic events that established dissociation as an automatic response to any perceived threats.
EMDR helps you reprocess those difficult memories, reducing their emotional charge and breaking the association between specific triggers and dissociative responses.
CBT can also help you target thought patterns that perpetuate feeling detached from your day-to-day life. People with these conditions can develop catastrophic beliefs about their symptoms, fearing they’re losing their mind or won’t ever feel “normal.”
CBT helps to challenge these thoughts and reduce the fear response they create, helping to untangle your experience and gradually introduce exposure elements to help face long-avoided situations.
Yes, grounding techniques can help you practice anchoring yourself in the present moment, countering the disconnection of dissociative disorders.
Techniques can include focusing on physical sensations, naming objects you see in your field of vision, holding onto something cold, or engaging your senses with strong tastes or smells.
Depersonalization and derealization symptoms can be incredibly hard to explain to others. AMFM understands what you’re going through, and we’re standing at the ready to help those with dissociative challenges.
Our clinical teams have a wealth of experience treating dissociative disorders, trauma-related dissociation, anxiety-related dissociation, and the complex relationships between depression and depersonalization.
AMFM’s clinical programs – encompassing a full spectrum of care, from residential dissociative disorder treatment to outpatient and aftercare – integrate unique, holistic, and evidence-based therapies and treatments. Therefore, they can address the root causes of your issues and teach you practical daily skills for recovery.
Let us help you start healing. Contact our admissions team today to verify your insurance and get started.
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We hope that this article has been helpful in increasing your understanding of DPDR and dissociative symptoms. If you have some ongoing queries, the following responses to frequently asked questions may help.
Most people engaging in treatment for dissociative disorders and symptoms feel improvements in or resolution of their symptoms with the appropriate care. While some people may still have occasional, mild episodes during periods of high stress, therapy for depersonalization and derealization can help eliminate the ongoing dissociation they experience.
Your recovery timeline can vary based on many different factors, but accessing specialized care like the offerings at AMFM is a steady first step toward healing.
No, DPDR symptoms are distinct from those of schizophrenia and other psychotic-related disorders. People dealing with these conditions usually believe their perceptions reflect reality itself, lacking insight into the distortions and why they’re occurring.
Having said that, the two conditions can co-occur together, which is why it’s important to be fully assessed to get the help you need. Proper DPDR treatment will be able to distinguish between the two conditions and illuminate any other mental health issues you may be having.
Anxiety-related dissociation happens because the intense fear you feel activates the nervous system’s shutdown response.
When perceived levels of threat go beyond what you can psychologically and emotionally tolerate, the brain creates distance with dissociative symptoms. Anxieties can trigger these same responses, even without any direct or physical threats present.
This dissociative response can provide some relief from overwhelming fear, but it can also become habitual. You might then develop anxiety around the dissociation itself, creating an ongoing cycle where the fear of detachment triggers it to happen more.
Depersonalization/derealization disorder can develop without any history of trauma, though trauma is a common cause. Additionally, what defines trauma is not the same for everyone – emotional neglect, bullying, and medical procedures can be traumatic without meeting the criteria for any DSM trauma-related diagnoses.
Regardless of its origins, help for depersonalization and derealization symptoms is available to help you ground yourself back in the present and live the life you were meant to.
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At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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