Persistent and recurrent episodes of depersonalization or derealization or both cause distress and problems functioning at work or school or in other important areas of your life. During these episodes, you are aware that your sense of detachment is only a feeling, and not reality.
The experience and feelings of the disorder can be difficult to describe. Worry about "going crazy" can cause you to become preoccupied with checking that you exist and determining what's actually real.
Symptoms of depersonalization include:
- Feelings that you're an outside observer of your thoughts, feelings, your body or parts of your body, perhaps 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
Symptoms of derealization include:
- Feelings of being alienated from or unfamiliar with your surroundings, perhaps like you're living in a movie
- 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
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.
In this disorder, feelings of depersonalization and derealization aren't directly caused by drugs, alcohol, a mental health disorder or a medical condition.
When to see a doctor
Passing feelings of depersonalization or derealization are common and aren't necessarily a cause for concern. But ongoing or severe feelings of detachment and distortion of your surroundings can be a sign of depersonalization-derealization disorder or another physical or mental health disorder.
See a doctor if you have feelings of depersonalization or derealization that:
May 24, 2014
- Are disturbing you or are emotionally disruptive
- Don't go away or keep coming back
- Interfere with work, relationships or daily activities
- Depersonalization/derealization disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed March 18, 2014.
- Highlights of changes from DSM-IV-TR to DSM-5. American Psychiatric Association. http://www.dsm5.org/Pages/Default.aspx. Accessed March 23. 2013.
- Somer E, et al. Evidence-based treatment for depersonalisation-derealisation disorder (DPRD). BMC Psychology. 2013;1:20.
- Simeon D. Depersonalization derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis. http://www.uptodate.com/home. Accessed March 24, 2014.
- Simeon D. Treatment of depersonalization derealization disorder. http://www.uptodate.com/home. Accessed March 24, 2014.
- Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. April 1, 2014.