Have you ever felt like you were watching yourself from the outside? Or perhaps as though real life is closer to a movie or a representation of life than real? Maybe you’ve looked at your own legs and thought, “those doesn’t feel like mine”? Or felt like a zombie, moving through life detached from things?
These are some of the ways people describe the feelings of depersonalization and derealization.
What Are Depersonalization and Derealization?
Derealization and depersonalization are perceptual disturbances that involve feeling detached from your environment. They are similar to one another, but also distinct. Defining each of these terms can make them easier to understand and distinguish:
Depersonalization – feelings of being detached from yourself, like an outside observer. This can be with respect to your thoughts, feelings, sensations, body, or actions. You might also feel like a robot or on “auto-pilot” that you aren’t in control of. It can be help to think of this term as “de” + “person,” = “being outside yourself”
Derealization – feelings of detachment from reality or your surroundings, like you’re living in a movie or a dream. It can be help to think of this term as “de” + “real,” = “things not seeming real”
Most people have passing moments of feeling either depersonalization, derealization, or both. But for some people these experiences can last, happen over and over, or never go away fully. When these perceptual disturbances are so persistent, they can be upsetting and disruptive to day-to-day life. When this happens, it is called depersonalization-derealization disorder.
It’s important to note that depersonalization and derealization are not the same as losing touch with reality, as can happen when you’re experiencing symptoms of psychosis. Because depersonalization and derealization alter your perceptions and can be upsetting, many people who experience them fear “going crazy.” Despite this fear, even when people are experiencing depersonalization and derealization symptoms, they describe it as feeling detached, weird, or unreal. This is distinct from not knowing what day it is, who they are, becoming suspicious or feeling someone is after them, or seeing or hearing things that aren’t there.
With depersonalization and derealization, knowing that your perceptions aren’t real but still feeling upset by them can lead to even more anxiety and frustration.
Causes of Depersonalization/Derealization Disorder
The causes of depersonalization-derealization disorder aren’t always clear. Anxiety is the biggest factor that predicts depersonalization or derealization. In fact, both of these feelings are common in people who also experience panic attacks or have panic disorder. They may also be more common if you’ve had symptoms of anxiety or depression for a long time. Depersonalization and derealization can also happen more often for people who have experienced traumatic events or abuse.
Substance use can also contribute to feeling depersonalization or derealization. Some recreational substances (e.g., hallucinogens) have the effect of changing or altering your perceptions of yourself and your surroundings. While these effects can be what makes these substances enjoyable to use, they can also set the stage for depersonalization, derealization, or both. In fact, many people with sustained depersonalization or derealization trace the start of their symptoms back to an instance of marijuana (or other hallucinogen) use.
Fortunately, it is possible to recover fully from depersonalization-derealization disorder. Read on to learn about treatment that can help.
Treatment for Depersonalization/Derealization Disorder
The best treatment for depersonalization-derealization disorder is psychotherapy. Cognitive-behavioral therapy (CBT) is one type of therapy that can be particularly helpful. CBT is proven effective and it uses a variety of proven techniques to help treat anxiety. As mentioned above, anxiety plays a major role in leading to depersonalization or derealization, and these experiences often further lead to anxiety and fear.
Factual information about depersonalization and derealization can be very helpful in treating them. These experiences are often difficult for people to describe, and health care professionals less familiar with them may also not identify them from a patient’s description. Helping people know that what they’re experiencing has a name, isn’t unique to them, and is treatable can help a lot in reducing anxiety about the condition.
CBT teaches you how to change the way you respond to depersonalization or derealization, so that you don’t inadvertently worsen your anxiety. Some of the helpful techniques used in CBT include:
Reducing safety behaviors and avoidance
This helps you stop doing things that can amplify the feelings of depersonalization and derealization and keep them going over time, like monitoring your symptoms closely, or avoiding activities or situations you fear will lead to depersonalization or derealization.
Exposure therapy
This helps you become less reactive to uncomfortable experiences like depersonalization and derealization, as well as approach the situations that cause anxiety and fear about these sensations. This way, you can learn to withstand the feelings of anxiety and over time desensitizes you to those things so they no longer trigger anxiety.
Helping you change your thinking about depersonalization and derealization
CBT can help you identify and change unhelpful patterns in your thinking that keep you anxious about these perceptual disturbances. Over time, this helps you you see these experiences as non-threatening and pay less attention to them.
If depersonalization, derealization, or both are getting in the way of your day-to-day life, contact us to find out about getting relief.
