Symptoms and causes

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 usually begin in the mid- to late teens or early adulthood. Depersonalization-derealization disorder is rare in children and older adults.

The exact cause of depersonalization-derealization disorder isn't well-understood. Some people may be more vulnerable to experiencing depersonalization and derealization than others, 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.

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

Episodes of depersonalization or derealization can be frightening and disabling. They can cause:

  • 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
May 16, 2017
References
  1. 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 20, 2017.
  2. Spiegel D, et al. Depersonalization/derealization disorder. Merck Manual Professional Version. http://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/depersonalization-derealization-disorder. Accessed March 20, 2017.
  3. Gentile JP, et al. Stress and trauma: Psychotherapy and pharmacotherapy for depersonalization/derealization disorder. Innovations in Clinical Neuroscience. 2014;11:37.
  4. Gabbard GO, ed. Depersonalization/derealization disorder. In: Gabbard's Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; 2014. http://www.psychiatryonline.org. Accessed March 20, 2017.
  5. Simeon D. Depersonalization/derealization disorder: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis. http://www.uptodate.com/home. Accessed March 20, 2017.
  6. Simeon D. Pharmacotherapy of depersonalization/derealization disorder. http://www.uptodate.com/home. Accessed March 20, 2017.
  7. Simeon D. Psychotherapy of depersonalization/derealization disorder. http://www.uptodate.com/home. Accessed March 20, 2017.
  8. Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. March 24, 2017.

Depersonalization-derealization disorder