Depersonalisation & Derealisation Disorder

Updated: July 23, 2022

Depersonalisation and derealisation disorder (DPDR) involves recurring or persistent feelings of detachment, dissociation, and disconnect from oneself and one’s surroundings. This can interfere with daily functioning and can feel very distressing.


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What Is DPDR?

Depersonalisation and derealisation can happen in various contexts and may sometimes be a symptom of another mental health disorder. For example, either or both may occur as part of depression, anxiety, or post-traumatic stress disorder (PTSD). In some instances however, they can occur on their own, as depersonalisation and derealisation disorder.


Depersonalisation is characterised by feelings of detachment from oneself, a bit like an outer body experience when one observes oneself from outside the body. It can make individuals feel as if they aren’t a real person, and sometimes they may feel as if they’re in a dreamlike state. Thoughts, feelings and sensations can feel unreal and faraway as if they belong to someone else.


Derealisation is the feeling of disconnection from one’s environment, and the world can feel unreal or distorted. An individual may experience their surroundings as surreal, hazy, or dreamlike. Objects can seem smaller or bigger than they actually are, or may seem to be changing shape or moving.


What Are The Symptoms?

Cognitive Problems

One can experience difficulty with memory, concentration, and may find it hard to remember things or focus on tasks.


Individuals can often feel a sense of detachment or disconnection from themselves, their thoughts, feelings, or sensations.


There is a feeling of observing one’s own thoughts, feelings, body, or surroundings from outside.

Emotional Blunting

People can experience a decrease in the ability to experience emotions and may feel emotionally numb.


Some individuals will experience anxiety or panic attacks.


Some people experience a sense of being unable to control their thoughts or behaviour.

Surreal Feeling

Individuals can experience a sense of unreality, this can feel like as though they are watching themselves and their life in a film or dream.

Temporal Issues

Some people may feel like time is passing too slowly or too fast.

What Causes DPDR?

Although the exact causes of DPDR are not clear, research suggests several potential factors that may contribute to the development of the disorder. The factors below do not necessarily mean someone will develop DPDR, and some who develop it may not have experienced the issues listed. In addition, sometimes DPDR can happen as a symptom of other mental health problems.

Genetic predisposition: Research suggests a possible genetic component, with some people being more predisposed to developing DPDR.


Brain chemistry: Neurotransmitters such as dopamine and serotonin regulate mood and emotional states, an imbalance may contribute to the development of DPDR.

Trauma: It is thought that traumatic life events may trigger DPDR. This includes emotional or physical, accidents, neglect, or witnessing a traumatic event.

Stress and anxiety: Prolonged and high levels of stress and anxiety can create a vulnerability to DPDR. When individuals are anxious or stressed over a long period, they are more susceptible to the condition.

Substance abuse: The use of drugs, including alcohol can trigger DPDR, especially if the drug has psychoactive properties.

Sleep deprivation: Poor quality sleep, or a lack of it can also trigger the development of DPDR.

Physical health conditions: DPDR is sometimes associated with some medical conditions. For example, migraines, epilepsy, and Lyme disease.

How Phinity Therapy Can Help

If you’re experiencing DPDR it’s important to seek professional help. This may entail a visit to your GP, as well as psychotherapy. At Phinity we will start by conducting a thorough psychological and lifestyle assessment, this will help us to assess the best course of treatment with you.

Treatment may involve addressing issues around lifestyle, for example, improving sleep, eating a healthy diet, exercising regularly, and avoiding substances, including alcohol.

We may also suggest a course of cognitive-behavioural therapy (CBT). This can help identify and change negative or irrational thought patterns that might be contributing to DPDR symptoms.

Sometimes ERP or exposure and response prevention therapy can be effective. This involves gradually exposing you to situations that normally trigger your symptoms.

We may also suggest mindfulness and other relaxation techniques which can aid stress management and anxiety, and therefore the triggers of DPDR symptoms.

There is also the option of depth work, which can help address other issues that might have contributed to, or caused DPDR to develop.

Ultimately, we will always discuss our recommendations with you so that your care is collaborative and suited to your needs.

What Causes DPDR?How Phinity Therapy Can Help


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