Depersonalization can be a symptom of schizophrenia but feeling disconnected from your sense of self doesn’t mean you’re developing a schizophrenia spectrum disorder.
Schizophrenia is a progressive, lifelong mental health disorder that primarily involves symptoms of psychosis — episodes of false reality perception like hallucinations or delusions.
Symptoms of psychosis are diagnostic features in schizophrenia, but many other symptoms can accompany this condition. It’s not uncommon to feel detached from yourself, as though you’re an outsider looking in.
This sensation of separation from your identity is known as depersonalization, a part of a larger psychological experience called dissociation.
Depersonalization, derealization, and dissociation
Dissociation is an umbrella term for a psychological sense of disconnection. It involves 5 areas of perception:
- identity confusion
- identity alteration
Depersonalization is a part of dissociation that suggests a lack of connection to your sense of self. It’s sometimes confused with derealization, which is a lack of connection to the environment around you.
A 2016 comparative study found depersonalization appears to happen most frequently in the early stages of schizophrenia, lessening as the disorder becomes chronic.
Depersonalization isn’t unique to schizophrenia, however.
“This can be a symptom of schizophrenia, but it could also be its own disorder,” explains Dr. Carolina Estevez, a clinical psychologist from Miami, Florida. “People who experience depersonalization do not necessarily have schizophrenia. Instead, they might have depersonalization-derealization disorder (DDD) or an anxiety disorder.”
She adds that many people have passing feelings of depersonalization without the presence of any disorder.
Examples of depersonalization in schizophrenia
Depersonalization’s effects can be very individual. You may have experiences such as:
- feeling robotic or unable to control your motor function or speech
- a sense of floating around your body or out-of-body experiences
- watching yourself as though you’re in a movie
- an inability to describe or identify your emotions (alexithymia)
- distorted sense of time
- feeling as though your inner self is absent or unreal
- numbing of natural sensations like hunger, thirst, or libido
- perceptual changes about your body parts, as though they’re shrunken or enlarged
- feeling as though your memories belong to someone else
Can depersonalization lead to schizophrenia?
Depersonalization isn’t a cause of schizophrenia.
“The former is not a precursor to the latter,” Estevez explains. “Schizophrenia is a type of organic brain disorder characterized by a dysfunction in neurotransmitters and brain tissue. On the other hand, depersonalization is psychological.”
Depersonalization is a psychological experience where you feel separated from your sense of self. It can involve perceptual changes to things that make you “you” such as your memories, emotions, cravings, interests, or bodily functions.
It’s not a form of psychosis. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5-TR), indicates reality remains intact in depersonalization.
Depersonalization also isn’t the same as identity confusion or alteration, other components of dissociation. Experiencing depersonalization means your identity remains even if you feel separated from your sensations.
Identity dissociation, on the other hand, involves not knowing or believing who you are is actually who you are.
What causes depersonalization?
Anyone can experience passing moments of depersonalization, especially during times of high stress or anxiety.
Like other forms of dissociation, however, it’s a symptom often linked to a traumatic experience.
“Depersonalization can be caused by anxiety, stress, or traumatic experiences,” says Estevez. “It can also be a side effect of drug use, such as psychedelics or [cannabis].”
She explains depersonalization is most commonly associated with DDD and anxiety disorders, but it can be a symptom of other mental health conditions like schizophrenia and depression.
“But it does not necessarily mean that the individual has any of these disorders,” she points out. “As mentioned earlier, many people experience feelings of depersonalization without having any diagnosable mental illness.”
The exact mechanism behind dissociative feelings, like depersonalization, may be linked to atypical nerve firing in the posteromedial cortex of the brain.
Why these nerves initially alter their function remains unknown, and a 2021 review of the research indicates more follow-up work is necessary to solidify the connection between nerve pathways and dissociation.
Dissociative schizophrenia isn’t a formal diagnosis, though it may be a general term used to describe schizophrenia with regular experiences of dissociation.
Joan Hampton, a licensed professional counselor and CEO of Oasis Mental Wellness, explains, “The term dissociative is used to describe a wide range of symptoms and disorders, including dissociative amnesia, dissociative identity disorder, and depersonalization disorder, that involve disruptions in consciousness, memory, identity, emotion, or sense of self.”
When dissociation is prominent, one of these conditions is typically diagnosed separately from schizophrenia.
Depersonalization schizophrenia isn’t a formal diagnosis, though feeling detached from yourself can be a common feature of early-stage schizophrenia.
It’s also natural to experience passing moments of depersonalization without the presence of a disorder. Stress, anxiety, medications, and substance use can all create this type of sensation.
If you’re concerned about symptoms of depersonalization or would like to learn more, consider speaking with a mental health professional or calling the SAMHSA National Helpline at 1-800-662-4357.