Transient experiences of depersonalization/derealization in otherwise healthy individuals are common in response to trauma, fatigue, or substance use.

Transient Experiences of Depersonalization-Derealization

Long-term and more enduring experiences that are characteristic of depersonalization-derealization disorder are more frequently triggered by one’s response to situations that provoke anxiety. It can also be an acute trauma response to motor vehicle accidents, various forms of abuse, and imprisonment. 

Enduring Experiences of Depersonalization-Derealization

- Transient experiences (NOT depersonalization-derealization disorder)
- Long-term/enduring experiences (depersonalization-derealization disorder)

Boston University

Sense of feeling detached from the body and environment. Individual feels as if they are an observer in their own body, as if thoughts and feelings aren't their own. Objects, people, and surroundings feel unnatural to them.

Depersonalization/ Derealization

Gentile, J. P., Snyder, M., & Gillig, P. M. (2014). STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/ Derealization Disorder. Innovations in Clinical Neuroscience, 11(7–8), 37–41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204471/pdf/icns_11_7-8_37.pdf

STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder

Sierra, M., & David, A. S. (2011). Depersonalization: A selective impairment of self-awareness. Consciousness and Cognition, 20(1), 99–108. https://doi.org/10.1016/j.concog.2010.10.018

Depersonalization: A selective impairment of self-awareness

- Depersonalization: pronounced distinctions from the self
- Derealization: disconnections from external environment/reality

Depersonalization vs. Derealization

- Physiological or emotional numbing
- Sensory impairments feelings of disembodiment
- Distorted experience of time
- Feeling as if one is in a dream
- Visual perceptual distortions
- An unreal/absent sense of self
- May hear voices (dissociative episodes; distinct from the auditory hallucinations experienced in psychosis)
- DON’T have psychosis and HAVE intact reality testing
- Symptoms often overlap with both anxiety and other dissociative disorders (PTSD or panic disorder, OCD, depression, schizophrenia)

Depersonalization-Derealization Disorder Symptoms

- Psychotherapy
- Supportive interventions
- Psychodynamic approach
- Pharmacotherapy

The most effective treatment for DDD is specifically adapted to address the complex traumas and high level of dissociation among DDD patients.

Depersonalization-Derealization Disorder Treatments

Dysfunction in frontolimbic systems are found in individuals with DPD. This has shown a relationship with hyperactivity in the fronto regions of the brain compared to non DPD controls.

Brain Abnormalities in DPD

Sierk, A., Daniels, J. K., Manthey, A., Kok, J. G., Leemans, A., Gaebler, M., Lamke, J.-P., Kruschwitz, J., & Walter, H. (2018). White matter network alterations in patients with depersonalization/derealization disorder. Journal of Psychiatry and Neuroscience, 43(5), 347–357. https://doi.org/10.1503/jpn.170110

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