Depersonalization Disorder Explained - Identifying the Disorder's Characteristics and Symptoms

Depersonalization-Derealization Disorder (DPDR) is a mental health condition characterized by persistent or recurring feelings of derealization or depersonalization. This disorder can be challenging to understand, but we're here to help clarify its symptoms, diagnosis, and treatment.

DPDR involves feeling detached from one's self, thoughts, feelings, and even body. Symptoms include feeling detached from one's body, difficulty connecting emotions to memories, feeling a lack of control over one's movements, and difficulty identifying and labeling one's emotions. Derealization, on the other hand, involves feeling detached from one's surroundings, other people, or the world. Symptoms of derealization include feeling like you're in a dream or watching a movie of yourself, having a distorted sense of time, and experiencing objects as different in size, shape, color, or distance.

Anxiety disorders often precede dissociative disorders and are often accompanied by symptoms of depersonalization. DPDR is rarely diagnosed and often misdiagnosed, but nearly one in four people have experienced a dissociative episode involving depersonalization or derealization. Only about 2% of people meet the full criteria for DPDR.

A diagnosis of DPDR is made based on the person's symptoms and clinical observations, and may involve the use of questionnaires and assessment tools such as the Dissociative Experiences Scale (DES). The DSM-5 lists the following diagnostic criteria for DPDR: episodes of depersonalization, derealization, or both occur repeatedly or continuously; the person is aware that the experiences are not real; symptoms are severe enough to cause significant distress or impairment; symptoms are not due to the direct physiological effects of a substance or another medical condition; symptoms are not better explained by another mental disorder.

The causes of DPDR are not fully understood, but it is often associated with severe trauma, such as violence, war, or child abuse. Childhood experiences of neglect or abuse significantly increase the likelihood of developing DPDR. Substances that alter mental or emotional states, such as alcohol and marijuana, can also cause symptoms of depersonalization or derealization.

Psychotherapy is the most effective approach for managing DPDR, with cognitive-behavioral therapy (CBT) being particularly useful. There is no medication approved by the FDA specifically for treating dissociative symptoms, but medications can be used to address other symptoms that contribute to dissociative disorders.

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Researchers like Daphne Simeon and institutions such as Harvard Medical School and King's College London have conducted studies in recent years on the causes, therapeutic approaches, and diagnostic methods for DPDR. The prognosis for individuals with DPDR varies, with some individuals fully recovering and others experiencing chronic symptoms.

It's important to remember that if you or someone you know is experiencing symptoms of DPDR, seeking help from a mental health professional is crucial. With understanding, support, and treatment, it's possible to manage and overcome DPDR.