Depersonalization vs Derealization

Have you ever felt detached from the world or felt like you don't belong in your own body when you look down at your hands? Depersonalization and derealization is a psychological disorder in which this experience is intense and prolonged. About 50% of the general population have come across at least one of these experiences in their lifetime, but only roughly 2% are actually diagnosed with the disorder. It occurs equally in men and women and can start as early as one's early or middle years.

The two terms depersonalization and derealization are often mixed up and misunderstood even though they're often grouped together. So what's the difference?

Depersonalization

Depersonalization is when you feel cut off from yourself, like a robot or like you're not in control of your own movements. People with depersonalization disorder don't feel like themselves and struggle with feeling in tune with their emotions. These patients may feel like they're an outside observer of their own lives. They feel disconnected from their memories and may not remember them clearly. Most of the time, they have out-of-body experiences because they don't feel grounded in their own bodies. Symptoms of out-of-body experiences include hearing undefined sounds such as a train going by or soft murmurs, and feeling like you're sinking into a bed while your body feels numb and out of control.

Derealization

Derealization is when you feel cut off from the world. Patients who experience symptoms of derealization feel as if they're in a dream or as if there's a glass wall or veil that's separating them from their surroundings. The world feels funny and distorted. Objects around them can feel and appear smaller or larger than they actually are. Surroundings may also be blurry or unusually clear. Sounds can seem louder and more overwhelming, and time can feel like it's slowing down or going too fast.

The causes and treatment methods for both depersonalization and derealization are similar. Anxiety and depression are common in patients with depersonalization and derealization. They're often developed in people who have experienced severe stress in their lifetime, which includes but not limited to being emotionally abused or neglected during childhood, physical abuse, witnessing domestic violence, having a severely impaired or mentally ill parent, and having a loved one die unexpectedly. Symptoms of this disorder can also be triggered by severe stress from toxic relationships, financial concerns, and work.

To get diagnosed for this disorder, one may get a doctor's evaluation, take questionnaires or tests, and undergo specifically structured interviews. A physical examination and urine tests are also done to make sure other mental health disorders, seizure disorders, and substance abuse are ruled out. This disorder is diagnosed when symptoms last for a long time or recur over time. It's important to note that getting brief and temporary episodes of these symptoms does not necessarily mean you have depersonalization or derealization. Instead, you may just be going through a highly stressful situation.

Treatment

To get treated for depersonalization and derealization, many patients undergo psychotherapy. Treatment of this disorder must address all stresses associated with an individual's triggers. This may help the patient become self-aware and give them the ability to take careful measures to prevent the next stressful episode in their life. Cognitive techniques can also be used to help lock obsessive thinking about the unreal state of being, and grounding techniques can encourage the individual to use their five senses to feel more connected with themselves in the real world.

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