Depersonalization-derealization disorder is a condition where you frequently or persistently feel as though you're observing yourself from outside your body or perceive that your surroundings are unreal, or both[1]. These sensations often give people the feeling of living in a dream[1]. Depersonalization and derealization become a disorder when depersonalization and derealization symptoms are persistent, interfere with daily functioning, and don't fully subside[1]. This disorder is more common in individuals who have undergone trauma, such as violence, abuse, or severe stress[1]. The primary treatment is psychotherapy, and in some cases, medication may also be prescribed[1].
Depersonalization is a dissociative symptom where an individual feels detached from their thoughts, body, and sensations as if they are an external observer[2]. There may be a sense of being like a robot, with a lack of control over what you say or how you move[1]. Your perception of your body might become distorted, with your arms or legs seeming twisted, unusually large or small, or out of shape, and your head might feel as if it's wrapped in cotton[1]. Additionally, you might feel emotionally or physically numb, with a reduced response to the world around you[1]. Your memories may also seem to lack emotion, leaving you uncertain if they truly belong to you[1].
Derealization is characterized by a sense of unreality and disconnection from the environment [3]. There could be a sense of emotional disconnection from loved ones, as if a glass wall separates you from them[1]. Your surroundings might appear distorted, blurry, or colorless, or they may seem flat, lacking depth, as if they only have two dimensions[1]. Alternatively, you might become hyper-aware of your environment, with everything appearing unusually clear[1]. You could also experience distorted perceptions of time, with recent events feeling as though they happened long ago[1]. Similarly, you might have unrealistic perceptions of distance and the size or shape of objects[1].
Depersonalization-derealization disorder has a lifetime prevalence of around 2% [3]. It typically begins at an average age of 16 [4], affecting men and women equally[5].
References
Depersonalization-derealization disorder - Symptoms and causes - Mayo Clinic. (2024, January 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911#:~:text=Overview,re%20living%20in%20a%20dream.
Sierra, M. (2009). Depersonalization: A new look at a neglected syndrome. Cambridge University Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
Simeon, D., Knutelska, M., Nelson, D., & Others. (2003). Feeling unreal: A depersonalization disorder update of 117 cases. Journal of Clinical Psychiatry, 64(9), 990–997.
Simeon, D., & Abugel, J. (2006). Feeling unreal: Depersonalization disorder and the loss of the self. Oxford University Press.
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