Depersonalization Disorder: An Out of Body Experience
Depersonalization disorder may be described as an out of body experience as the main symptom of depersonalization is a feeling of detachment or a feeling that one is an observer of one's thoughts, feelings or body. While most people do experience symptoms of depersonalization in their lives at some time, depersonalisation becomes a dissociative disorder when it begins to interrupt daily living and becomes very upsetting. Living with depersonalization disorder may feel like you're watching a movie of your own life, like you're in a dream or that the whole world is "unreal."
Derealisation is associated with depersonalisation and it is where a person feels like the objects in his or her environment are changing shape or size, like their surroundings aren't real or that people are inhuman or automated. Derealisation is not a diagnosis in its own right but, rather, is considered part of depersonalisation.
People living with depersonalisation or derealisation symptoms may feel like they're "going crazy" and may try to check to see if things are actually real.
Define Depersonalisation Disorder
The Diagnostic and Statistical Mental Disorders, Fifth Edition (DSM-5) defines depersonalisation disorder as the occurrence of persistent or recurrent episodes of depersonalisation and/or derealisation that are not associated with another illness and cause significant distress. Depersonalisation symptoms must not be attributable to substance use.
According to Medscape, the signs of depersonalisation disorder also include:
- Alertness and orientation in some areas (but not others)
- Limited relatedness and eye contact
- Preoccupation and irritability
- Distressed facial expression with constricted emotion
- Limited to fair reasoning and judgement
A person with depersonalisation disorder may feel like a robot, like his or her body is distorted or like he or she can't control his or her own actions.
What Causes Depersonalisation Disorder?
What causes depersonalisation disorder is not fully understood, but it is thought that it is linked to a chemical imbalance in the neurotransmitters of the brain. This imbalance may make the brain vulnerable to depersonalisation disorder when in states of extreme stress.
According to the Mayo Clinic, causes of depersonalisation disorder may include:
- Childhood trauma such as witnessing domestic violence or being abused
- Growing up with a significantly impaired parent, such as by mental illness
- Suicide or unexpected death of a loved one
- Severe stress such as relationship, financial or work-related pressures
- Severe trauma such as a car accident
Depersonalisation Disorder Treatment
Treatment for depersonalisation disorder typically consists of psychotherapy (sometimes called "talk" therapy) but may also include medication to treat some of the depersonalisation disorder symptoms. Therapy aims to help an individual understand why he or she experiences depersonalisation symptoms in the first place and helps the individual gain control over his or her symptoms. According to the Mayo Clinic, two types of psychotherapy that can treat depersonalisation disorder include cognitive behavioral therapy and psychodynamic therapy, although some sources say that psychotherapy is not beneficial.
No medications are Food and Drug Administration approved for the treatment of depersonalisation or derealisation symptoms, but some medications have been shown to help. Typically, medications include antidepressants and tranquilizers.
Last Updated: 16 October 2018
Reviewed by Harry Croft, MD