Depersonalization disorder is also called derealization disorder or DDD, according to the Cleveland Clinic. It notes that both disorders are dissociative conditions that involve a disruption or breakdown in consciousness, awareness, and memory. Those with this disorder feel detached from their feelings, thoughts, and body. They can also be disconnected from their environment, which is derealization. People struggling with DDD don’t lose touch with reality. They know their perceptions are not real. This is the difference between DDD and other psychotic disorders, like schizophrenia.
What Are the Differences Between Derealization and Depersonalization Disorder?
Often, derealization and depersonalization disorder is diagnosed as one diagnosis, per Verywell Mind. However, there are two very distinct aspects that could or could not apply to a person.
Derealization Disorder and Its Symptoms
The Mayo Clinic lists the following symptoms of derealization disorder:
- You feel alienated from or not familiar with your surroundings.
- You feel disconnected from the people in your life.
- Your surroundings appear blurry, distorted, colorless, artificial, or two-dimensional. Or you could have a heightened awareness and clarity of your surroundings.
- You have distortions of time, like feeling like recent events are in the distant past.
- You have distortions of the size, shape, and distance of objects.
Depersonalization Disorder Symptoms
Per Healthline, symptoms of depersonalization disorder may include:
- Feeling like you are outside of your body or looking down at yourself from above
- Feeling detached from yourself
- Feeling like your senses are turned off or feeling numbness in mind or body
- Feeling like you can’t control what you’re saying
- Feeling like your body is the wrong size
- Trouble attaching emotion to your memories
When you have episodes of depersonalization-derealization disorder, the episodes may last for a few hours, days, weeks, and perhaps a month. When you feel the symptoms of this disorder, and it doesn’t seem to wane, it may be time to consult with your doctor.
DDD is diagnosed when the symptoms start to interfere with your daily life. Your physician may ask you if you are using prescription or recreational drugs that could cause you to experience derealization and depersonalization symptoms. They might also inquire if you are experiencing the symptoms of other mental health disorders, like post-traumatic stress disorder (PTSD), panic disorder, or schizophrenia, or if there is a history of these in your family. These are part of the diagnostic criteria for DDD.
Causes for Depersonalization Disorder
The causes for this disorder are not known to medical researchers. It is thought that environmental and biological factors may have some role. Some people may have a higher chance of developing for different reasons, such as:
- Specific personality or mental health disorders
- A less reactive nervous system
- Certain physical conditions, like a seizure disorder
- Heightened states of stress
In addition, some risk factors might increase the risk of developing depersonalization-derealization disorder:
- Severe childhood or adult trauma
- Depression or anxiety that is prolonged or anxiety with panic attacks
- Specific personality traits that cause you to deny or avoid challenging situations or adapt to them
- Using recreational drugs that can cause dissociative episodes
Depersonalization-derealization disorder is not considered a psychotic disorder because those with it know their feelings of detachment are not real. However, people with a psychotic disorder believe their feelings are real.
Is Depersonalization Disorder Common?
Many people from different age groups and backgrounds can have a dissociative disorder, like depersonalization disorder, according to the National Alliance on Mental Illness. Medical research has found that about 75 percent of people have at least one episode in their lives, and 2 percent have met the criteria for chronic episodes. Verywell Mind also says that stress can bring on DDD 25 percent to 50 percent of the time, but it tends to be minor.
DDD usually develops in adolescence as a means of coping with stress. Teens and children may use depersonalization and derealization to remove themselves from intense stress or distressing situations, like conflict in the home or parental abuse. Teens can have a lifelong course of DDD because it is the only strategy they know to use for highly troubling circumstances. Again, a professional diagnosis from a physician is needed before treatment can begin for children.
How Is DDD Treated?
DDD can be treated in several ways, both professionally and by yourself. Psychotherapy involving cognitive behavioral therapy (CBT) is an evidence-based treatment for many mental health disorders, including DDD. CBT with a licensed therapist can teach you how to block obsessive thinking that can lead to feeling like things are not real.
Psychology Today states that it focuses on changing dysfunctional emotions, behaviors, and thoughts by “interrogating and uprooting negative and irrational beliefs.” It is a short-term therapy, meaning you may only need from five to 20 sessions before it’s done. It is a solution-focused type of therapy where you will learn how to challenge, restructure, and problem-solve the issues that cause DDD. Anti-anxiety medication may also be prescribed.
There are some steps to take on your own to deal with DDD. Consider some of these to help you get back to reality when you feel like you are not really present:
Grounding exercises: Remind yourself that this is temporary, the feeling will go away, it feels odd, but you’re OK. Turn on some loud music or hold an ice cube in your hand to bring you back to engage your hearing and the sensation of cold to bring you back to reality.
Be Present in the Moment: Bring yourself back to your immediate surroundings by noticing the room temperature, holding an object that is near, or making a list of everything you see, hear, and touch.
Breathing exercises: Deep diaphragmatic breathing is known to help calm and relax people. Lie on your back with your knees bent. Put one hand on your chest and one below the rib cage to feel the movement of your diaphragm. Inhale slowly and deeply through the nose. Exhale slowly. Repeat a few times. Notice how your stomach pushes your hand out, and the other hand holds still.
Physical exercise: Go outside and feel the sun on your face, listen to the sounds of nature, and take a walk around your area.
Substance Abuse and DDD
People with mental health disorders may engage in substance use to self-medicate their symptoms. Alcohol and drug use might alleviate the symptoms, but it is only a temporary fix. Once you begin feeling the symptoms again, it is possible to consume more alcohol and/or drugs to make them fade away.
The longer you use substances to assuage the symptoms of DDD, the more likely your system will become tolerant of the substances, and the more you will need to feel the same effects as before, as defined by the National Institute on Drug Abuse. If you begin to feel withdrawal effects once the substance(s) are out of your body, you’ve reached dependence on the substance(s). When you seek and use the substance(s) without regard to the consequences, you are addicted to the substance(s).
Successful, Effective DDD and Substance Use Treatment
The most effective way to treat derealization and depersonalization disorder is with professional psychological help. Vista Pines Health, a mental health facility in South Florida, treats people with DDD and other mental health disorders. Our caring, dedicated, and educated mental health professionals can work with you in finding healthy, positive strategies when DDD symptoms wreak havoc in your daily life.
You could be struggling with DDD and a substance use disorder, which, in clinical terms, is called dual diagnosis. A reputable treatment center should treat both the mental health disorder and substance use disorder. You may not be fully addicted to the substance(s) you’re abusing, but in any case, using alcohol or drugs to ease your DDD symptoms will only lead to short-term relief, as mentioned previously.
The most effective way to treat dual diagnosis is with psychotherapies and education. Otherwise, a relapse that could be potentially fatal is possible. Dual diagnosis is nothing to be ashamed or fearful of. Many people have co-occurring mental health and substance use disorders and have been successful in managing their mental health disorder and overcoming substance use.
Mental health disorder therapies provided at Vista Pines Health include individual and group therapy, recreational therapies, educational sessions in mental health and medication, coping and life skills, family dynamics, as well as offering detox services and residential treatment. Our sister facility, Arete Recovery, which is right next door, provides therapies that are focused on emotions, solutions, and mindfulness. Both Vista Pines Health and Arete accredited treatment centers that accept most major insurance plans. Derealization and depersonalization disorder does not have to derail your life. You can get your life back with help.