Depersonalization disorder is marked by periods of feeling disconnected or detached from one's body and thoughts (depersonalization). The disorder is sometimes described as feeling like you are observing yourself from outside your body or like being in a dream. However, people with this disorder do not lose contact with reality; they realize that things are not as they appear. An episode of depersonalization can last anywhere from a few minutes to (rarely) many years. Depersonalization also might be a symptom of other disorders, including some forms of substance abuse, certain personality disorders, seizure disorders, and certain other brain diseases.
Depersonalization disorder is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, consciousness, awareness, identity, and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person's general functioning, including social and work activities and relationships.
What Are the Symptoms of Depersonalization Disorder?
The primary symptom of depersonalization disorder is a distorted perception of the body. The person might feel like he or she is a robot or in a dream. Some people might fear they are going crazy and might become depressed, anxious, or panicky. For some people, the symptoms are mild and last for just a short time. For others, however, symptoms can be chronic (ongoing) and last or recur for many years, leading to problems with daily functioning or even to disability.
What Causes Depersonalization Disorder?
Little is known about the causes of depersonalization disorder, but biological, psychological, and environmental factors might play a role. Like other dissociative disorders, depersonalization disorder often is triggered by intense stress or a traumatic event -- such as war, abuse, accidents, disasters, or extreme violence -- that the person has experienced or witnessed.
How Common Is Depersonalization Disorder?
Depersonalization can be a rare symptom in several psychiatric disorders and sometimes occurs after experiencing a dangerous situation, such as an assault, accident, or serious illness. Depersonalization as a separate disorder is quite rare.
How Is Depersonalization Disorder Diagnosed?
If symptoms of depersonalization disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose dissociative disorders, the doctor might use various diagnostic tests, such as imaging studies and blood tests, to rule out physical illness or medication side effects as the cause of the symptoms.
If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a dissociative disorder.
How Is Depersonalization Disorder Treated?
Most people with depersonalization disorder who seek treatment are concerned about symptoms such as depression or anxiety, rather than the disorder itself. In many cases, the symptoms will go away over time. Treatment usually is needed only when the disorder is lasting or recurrent, or if the symptoms are particularly distressing to the person.
The goal of treatment, when needed, is to address all stresses associated with the onset of the disorder. The best treatment approach depends on the individual and the severity of his or her symptoms. Psychotherapy, or talk therapy, is usually the treatment of choice for depersonalization disorder. Treatment approaches for depersonalization disorder may include the following:
- Psychotherapy: This kind of therapy for mental and emotional disorders uses psychological techniques designed to help a person better recognize and communicate their thoughts and feelings about psychological conflicts that could lead to depersonalization experiences. Cognitive therapy is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns.
- Medication: Medications are generally not used to treat dissociative disorders. However, if a person with a dissociative disorder also suffers from depression or anxiety, they might benefit from an antidepressant or anti-anxiety drug. Antipsychotic medications are also sometimes used to help with disordered thinking and perception related to depersonalization.
- Family therapy: This kind of therapy helps to educate the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.
- Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express his or her thoughts and feelings in a safe and creative way.
- Clinical hypnosis: This is a treatment technique that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness or awareness, allowing people to explore thoughts, feelings, and memories they might have hidden from their conscious minds.
What Is the Outlook for People With Depersonalization Disorder?
Complete recovery from depersonalization disorder is possible for many patients. The symptoms associated with this disorder often go away on their own or after treatment that help the person deal with the stress or trauma that triggered the symptoms. However, without treatment, additional episodes of depersonalization can occur.
Can Depersonalization Disorder Be Prevented?
Although it might not be possible to prevent depersonalization disorder, it might be helpful to begin treatment in people as soon as they begin to show symptoms. Furthermore, quick intervention following a traumatic event or emotionally distressing experience might help reduce the risk of developing dissociative disorders.