Depersonalization disorder is a mental health condition that’s now formally known as depersonalization-derealization disorder (DDD).
This updated name reflects the two major issues people with DDD experience:
- Depersonalization affects how you relate to yourself. It can make you feel as if you aren’t real.
- Derealization affects how you relate to other people and things. It can make you feel like your surroundings or other people aren’t real.
Together, these issues can leave you feeling distanced or disconnected from yourself and the world around you.
It’s not unusual to feel this way from time to time. But if you have DDD, these feelings can linger for long periods of time and get in the way of day-to-day activities.
Read on to learn more about DDD, including its symptoms and available treatment options.
DDD symptoms generally fall into two categories: symptoms of depersonalization and symptoms of derealization. People with DDD can experience symptoms of just one or the other or both.
Depersonalization symptoms include:
- feeling like you’re outside your body, sometimes as if you’re looking down on yourself from above
- feeling detached from yourself, as if you have no actual self
- numbness in your mind or body, as if your senses are turned off
- feeling as if you can’t control what you do or say
- feeling as if parts of your body are the wrong size
- difficulty attaching emotion to memories
Derealization symptoms include:
- having trouble recognizing surroundings or finding your surroundings hazy and almost dreamlike
- feeling like a glass wall separates you from the world — you can see what’s beyond but can’t connect
- feeling like your surroundings aren’t real or seem flat, blurry, too far, too close, too big, or too small
- experiencing a distorted sense of time — the past may feel very recent, while recent events feel as if they happened long ago
YOU’RE NOT ALONE
For many people, DDD symptoms are hard to put into words and communicate to others. This can add to feeling like you don’t exist or are simply “going crazy.”
But these feelings are likely more common than you think. According to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, close to 50 percent of adults in the United States will have an episode of depersonalization or derealization at some point in their lives, though only 2 percent meet criteria for a DDD diagnosis.
No one’s sure about the exact cause of DDD. But for some people, it seems to be linked to experiencing stress and trauma, especially at a young age.
For example, if you grew up around a lot of violence or yelling, you may have mentally removed yourself from those situations as a coping mechanism. As an adult, you might fall back on these disassociating tendencies in stressful situations.
Using certain drugs may also cause symptoms very similar to those of DDD in some people. These drugs include:
A small 2015 study compared 68 people in recovery from substance use disorders who were abstinent for at least six months with 59 people who had never experienced a substance use disorder. More than 40 percent of those in recovery had at least mild symptoms of DDD.
Remember, it’s normal to feel a little “off” or removed from the world sometimes. But at what point do these feelings start to signal a mental health condition?
Generally, your symptoms may be a sign of DDD if they start to interfere with your daily life.
Before making a diagnosis of DDD, your primary care provider (PCP) will first ask if you:
- have regular episodes of depersonalization, derealization, or both
- are distressed by your symptoms
They’ll also likely ask you whether you’re aware of reality when you experience symptoms. People with DDD are generally aware that what they’re feeling isn’t quite real. If you aren’t aware of reality in those moments, you may have another condition.
They’ll also want to confirm that your symptoms:
- can’t be explained by ingestion of prescribed or recreational drugs or a health condition
- aren’t caused by a different mental health condition, such as panic disorder, PTSD, schizophrenia, or another dissociative disorder
Keep in mind that mental health conditions can take some time to properly diagnose. To help the process along, make sure to tell your PCP about any other mental health conditions you have, especially depression or anxiety.
A examining 117 cases of DDD found that people with DDD often also had depression, anxiety, or both.
The most effective treatment for DDD usually involves some type of therapy, especially psychodynamic therapy or cognitive behavioral therapy (CBT).
With the help of a therapist, you can learn about DDD, uncover and work through any past trauma or risk factors, and explore coping strategies to get through future episodes.
Concerned about the cost? Our guide to affordable therapy can help.
Finding a therapist can feel daunting, but it doesn’t have to be. Start by asking yourself a few basic questions:
- What issues do you want to address? These can be specific or vague.
- Are there any specific traits you’d like in a therapist? For example, are you more comfortable with someone who shares your gender?
- How much can you realistically afford to spend per session? Do you want someone who offers sliding-scale prices or payment plans?
- Where will therapy fit into your schedule? Do you need a therapist who can see you on a specific day of the week? Or someone who has nighttime sessions?
Once you’ve jotted down some notes about what you’re looking for, you can start to narrow in on your search. If you live in the United States, you can search for local therapists here.
If you find yourself in a situation where you feel your symptoms starting to creep up on you, try engaging all of your senses. This can help ground you in your body and surroundings.
- holding a few ice cubes
- smelling spices or an essential oil
- sucking on a hard candy
- listening to and singing along with a familiar song
For some, medication may also be helpful, but there isn’t a specific medication that’s known to treat DDD. Antidepressants may be helpful, especially if you also have underlying depression or anxiety.
But for some people, these can actually increase DDD symptoms, so it’s important to keep in close contact with your PCP or therapist about any changes in your symptoms.
Feeling disconnected from reality can be unsettling and overwhelming, especially if you experience it on a regular basis. You might start to think your symptoms will never go away.
In these situations, it can be helpful to connect with others facing similar issues. This is especially helpful between therapy appointments.
Consider joining an online support group, such as:
If someone close to you is experiencing symptoms of DDD, there are several things you can do to offer support:
- Read up on the condition. If you’ve made it to this point in the article, you’re probably already doing this. There’s no need to become an expert on the subject, but having a little background info can help. This is especially true for DDD, as its symptoms are often hard for people experiencing them to put into words.
- Validate their experience. You can do this even if you don’t understand what they’re feeling. A simple “That must feel very uncomfortable, I’m sorry you’re dealing with this” can go a long way.
- Offer to go to a therapy session with them. During the session, you can learn more about the symptoms they experience or what triggers them. If they’re unsure about therapy, offering to join them for the first session may help.
- Understand it might be hard for them to reach out for help. It doesn’t hurt to make sure they know you’re available for support if they need you. Don’t assume silence means they don’t need or want help.
- Respect their boundaries. If they tell you they don’t want to talk about their symptoms or any past trauma, don’t push the subject or take it personally.