"I feel like I am out of my own body"....

Depersonalization-Derealization Disorder

 

Did you ever had a feeling that you're observing yourself from outside your body? or do you have a sense that things around you aren't real? If so, you may have depersonalization-derealization disorder. It can be very disturbing and you may feel like you're living in a dream.

Many people have a passing experience of depersonalization or derealization at some point. But when these feelings keep occurring or never completely go away and interfere with your ability to function, it's considered depersonalization-derealization disorder. This disorder is more common in people who've had traumatic experiences. 

What are the symptoms?

Depersonalization symptoms

• Feelings that you're an outside observer of your thoughts, feelings, your body or parts of your body — for example, as if you were floating in air above yourself
• Feeling like a robot or that you're not in control of your speech or movements
• The sense that your body, legs or arms appear distorted, enlarged or shrunken, or that your head is wrapped in cotton
• Emotional or physical numbness of your senses or responses to the world around you
• A sense that your memories lack emotion, and that they may or may not be your own memories

Derealization symptoms

• Feelings of being alienated from or unfamiliar with your surroundings — for example, like you're living in a movie or a dream
• Feeling emotionally disconnected from people you care about, as if you were separated by a glass wall
• Surroundings that appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings
• Distortions in perception of time, such as recent events feeling like distant past
• Distortions of distance and the size and shape of objects

What are the complications?

• Difficulty focusing on tasks or remembering things
• Interference with work and other routine activities
• Problems in relationships with your family and friends
• Anxiety or depression
• A sense of hopelessness

How long does it last?

Episodes of depersonalization-derealization disorder may last hours, days, weeks or even months at a time. In some people, these episodes turn into ongoing feelings of depersonalization or derealization that may periodically get better or worse.

What causes it?

The exact cause of depersonalization-derealization disorder isn't well-understood. Some people may be more vulnerable possibly due to genetic and environmental factors. Heightened states of stress and fear may trigger episodes.

Symptoms of depersonalization-derealization disorder may be related to childhood trauma or other experiences or events that cause severe emotional stress or trauma.

Are you at risk?

Factors that may increase the risk of depersonalization-derealization disorder include:

• Certain personality traits that make you want to avoid or deny difficult situations or make it hard to adapt to difficult situations
• Severe trauma, during childhood or as an adult, such as experiencing or witnessing a traumatic event or abuse
• Severe stress, such as major relationship, financial or work-related issues
• Depression or anxiety, especially severe or prolonged depression, or anxiety with panic attacks
• Using recreational drugs, which can trigger episodes of depersonalization or derealization

How is it diagnosed?

• Physical exam. In some cases, symptoms of depersonalization or derealization may be linked to an underlying physical health problem, medications, recreational drugs or alcohol.
• Lab tests. Some lab tests may help determine whether your symptoms are related to medical or other issues.
• Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns, which can help determine if you have depersonalization-derealization disorder or other mental health disorders.
• DSM-5. Your mental health professional may use the criteria for depersonalization-derealization disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
• According to the DSM-5, other dissociative conditions include:
• Dissociative amnesia: A condition that involves the inability to remember important information about your life
• Dissociative Fugue: A form of reversible amnesia that involves personality, memories, and personal identity
• Dissociative identity disorder (DID): A condition marked by the presence of two or more distinct personalities within one individual

How to get treated?

Psychotherapy

Psychotherapy, also called counseling or talk therapy, is the main treatment. The goal is to gain control over the symptoms so that they lessen or go away. Two such psychotherapies include cognitive behavioral therapy (CBT) and psychodynamic therapy. CBT also teaches distraction techniques, including:

• Grounding techniques that call on the senses to help you feel more in touch with reality—playing loud music to engage hearing, for instance, or holding an ice cube to feel connected to the sensation
• Psychodynamic techniques that focus on working through conflicts and negative feelings that people tend to detach from, and moment-to-moment tracking (focusing on what's happening in the moment) along with labeling of dissociation and effect

 Medications

There are no medications specifically approved to treat depersonalization-derealization disorder. However, medications may be used to treat specific symptoms or to treat depression and anxiety that are often associated with the disorder.

Learn more

1. Cognitive behavioral therapy

2. Psychotherapy