Depersonalization/derealization disorder

What causes depersonalization-derealization disorder?


The exact cause of depersonalization-derealization disorder isn't well-understood. Some people may be more vulnerable to experiencing depersonalization and derealization than others, possibly due to genetic and environmental factors. Heightened states of stress and fear may trigger episodes.

Symptoms of depersonalization-derealization disorder may be related to childhood trauma or other experiences or events that cause severe emotional stress or trauma.

Risk factors

Factors that may increase the risk of depersonalization-derealization disorder include:

  • Certain personality traits that make you want to avoid or deny difficult situations or make it hard to adapt to difficult situations
  • Severe trauma, during childhood or as an adult, such as experiencing or witnessing a traumatic event or abuse
  • Severe stress, such as major relationship, financial or work-related issues
  • Depression or anxiety, especially severe or prolonged depression, or anxiety with panic attacks
  • Using recreational drugs, which can trigger episodes of depersonalization or derealization


Episodes of depersonalization or derealization can be frightening and disabling. They can cause:

  • Difficulty focusing on tasks or remembering things
  • Interference with work and other routine activities
  • Problems in relationships with your family and friends
  • Anxiety or depression
  • A sense of hopelessness

Last updated on 09-08-20

How is depersonalization-derealization disorder diagnosed?

Your doctor may determine or rule out a diagnosis of depersonalization-derealization disorder based on:

  • Physical exam. In some cases, symptoms of depersonalization or derealization may be linked to an underlying physical health problem, medications, recreational drugs or alcohol.
  • Lab tests. Some lab tests may help determine whether your symptoms are related to medical or other issues.
  • Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns, which can help determine if you have depersonalization-derealization disorder or other mental health disorders.
  • DSM-5. Your mental health professional may use the criteria for depersonalization-derealization disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Last updated on 09-08-20

How is depersonalization-derealization disorder treated?

Treatment of depersonalization-derealization disorder is primarily psychotherapy. However, sometimes medications may be added to your treatment plan.


Psychotherapy, also called counseling or talk therapy, is the main treatment. The goal is to gain control over the symptoms so that they lessen or go away. Two such psychotherapies include cognitive behavioral therapy and psychodynamic therapy.

Psychotherapy can help you:

  • Understand why depersonalization and derealization occur
  • Learn techniques that distract from your symptoms and make you feel more connected to your world and feelings
  • Learn coping strategies to deal with stressful situations and times of extreme stress
  • Address the emotions related to past trauma you've experienced
  • Address other mental health conditions such as anxiety or depression


There are no medications specifically approved to treat depersonalization-derealization disorder. However, medications may be used to treat specific symptoms or to treat depression and anxiety that are often associated with the disorder.

Coping and support

While depersonalization and derealization disorder can feel frightening, realizing that it's treatable may be reassuring. To help you cope with depersonalization-derealization disorder:

  • Follow your treatment plan. Psychotherapy may involve practicing certain techniques on a daily basis to help resolve feelings of depersonalization and derealization. Seeking treatment early can improve your chances of successfully using these techniques.
  • Learn about the condition. Books and internet resources are available that discuss why depersonalization and derealization occur and how to cope. Ask your mental health professional to suggest educational materials and resources.
  • Connect with others. Stay connected with supportive and caring people — family, friends, faith leaders or others.

Last updated on 09-08-20

Where To Start

American Psychiatric Association

The American Psychiatric Association has information about Depersonalization/derealization disorder.

Last updated on 04-27-20

Name: Mental Health America 2000 N. Beauregard Street, 6th Floor
Alexandria, VA, 22311, United States
Phone: 703-684-7722 Toll Free: 800-969-6642 Fax : 703-684-5968 Url:
Name: National Alliance on Mental Illness (NAMI) 3803 N. Fairfax Dr., Ste. 100
Arlington, VA, 22203, United States
Phone: +1-703-524-7600 Toll Free: 1-800-950-6264 (Helpline) Fax : +1-703-524-9094 Url:
Mayo Clinic. Depersonalization-derealization disorder Reference Link

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