How to Cope with Depersonalization and Derealization

Many people at some point feel like they are outside of their own body or that everything around them seems strange or unreal. These experiences usually come and go quickly. When these feelings become frequent or don’t disappear, they may signal depersonalization-derealization disorder, which affects about one percent of people. This disorder can be unsettling, but it does not mean someone is losing touch with reality. Treatments and support can help manage and reduce these symptoms.

Distinguishing Depersonalization from Derealization

Depersonalization and derealization are two separate but related symptoms involving changes in how a person experiences themselves or the outside world. In depersonalization, someone may feel detached from their own thoughts, feelings, or body, almost as if they are observing themselves from afar. Derealization, however, involves a sense that the world around them feels strange or unreal, often described as foggy, dreamlike, or distant.

Table: Key Differences

Feature	Depersonalization	Derealization
What changes?	Sense of self	Perception of environment
Common feelings	Floating outside body, robotic actions	Dreamlike surroundings, world feels artificial
Awareness of reality	Knows it is a feeling, not truth	Knows things are real but feels “off”

Signs and Symptoms

The symptoms of these conditions can vary, but both involve a change in how a person sees themselves or their environment.

Depersonalization Features

Feeling like their arms, legs, or body are the wrong size or shape.
Numbness, with emotions or body sensations dulled.
Doubts about memories, which may seem flat or not their own.

Derealization Features

Sights look blurry, colorless, or two-dimensional.
Time feels slowed down, fast, or somehow wrong.
Objects seem too big, too small, or at the wrong distance.

Symptoms Quick List

Sense of distance from people and surroundings.
Emotional flatness or numbness.
Distorted perceptions of self or time.

What It Feels Like During an Episode

People who experience depersonalization or derealization often say these episodes are unsettling. They might know deep down that these feelings are not actually true, which can add a layer of frustration or worry. The episodes may last only a few hours, but for some, they persist for months.

Examples of Personal Feelings

Feeling like floating above the body, watching oneself.
Moving and speaking as though another person is in control.
Experiencing the world as if it is a movie, separated from others by a barrier.

People usually recognize that their experiences are not reality, which can make these episodes less confusing than other mental health conditions where someone may lose touch with reality completely.

How Dissociation, Depersonalization, and Derealization Are Related

Depersonalization and derealization both fall under the broader term of dissociation. Dissociation includes any experience where a person becomes disconnected from their surroundings, thoughts, or sense of identity. Mild dissociation is common and can happen to anyone, like daydreaming or getting lost in a book.

Severe dissociative experiences go beyond daydreaming and may interrupt daily life. Other main types of dissociative disorders include dissociative amnesia (memory loss) and dissociative identity disorder (where someone may have different identities).

List of Dissociative Symptoms

Memory gaps or confusion
Feeling separated from emotions or thoughts
Sensing two or more identities

Trauma or ongoing stress, especially in childhood, can make someone more likely to develop depersonalization-derealization disorder. Dissociation can sometimes help a person cope with overwhelming feelings or events by mentally distancing themselves from those feelings.

How Derealization and Depersonalization Relate to Anxiety and Depression

Many people with anxiety or depression also experience signs of depersonalization or derealization. For instance, up to 1 in 5 people with anxiety may also have these symptoms, and around half of people with depression report similar experiences. Panic attacks are another time when these symptoms often appear. During a panic attack, people often feel disconnected or like the world is not real.

People may worry about what these strange feelings mean and fear “losing their mind” or that something is seriously wrong, which can lead to further anxiety. However, depersonalization-derealization disorder does not turn into psychosis and does not cause permanent damage.

Key Points

Anxiety and depression often include depersonalization or derealization.
Symptoms may cause worry, but do not lead to more severe mental illness.
Panic attacks are a common trigger.

Depersonalization-Derealization Self-Assessment

Some people search for online tests or quizzes to check for depersonalization-derealization disorder. However, these tools are not enough to confirm a diagnosis. A mental health professional needs to assess symptoms and compare them with criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). A proper evaluation may include:

A clinical interview about symptoms, thoughts, and feelings.
A physical exam.
Lab tests to rule out medical or substance-related causes.

If feelings of detachment or reality distortion are severe or long-lasting, you should visit a healthcare provider.

Depersonalization-Derealization Disorder Treatment

Therapists usually treat depersonalization-derealization disorder with psychotherapy (talk therapy). One popular approach, cognitive behavioral therapy (CBT), helps people notice unhelpful thoughts and learn healthier ways to react. Psychotherapy can help by:

Increasing understanding of the disorder.
Teaching skills to feel more connected to reality and emotions.
Providing coping techniques for distressing symptoms.
Addressing other mental health concerns, such as anxiety or past trauma.

Doctors sometimes prescribe medicine to help with related problems, such as anxiety or depression. In many cases, combining medication with therapy gives people more support.

Managing and Reducing Depersonalization-Derealization Disorder

Stopping depersonalization-derealization disorder quickly is uncommon, but you can take steps to help manage symptoms. Realizing that these experiences are mental, not physical, helps provide reassurance.

Key Strategies

Follow a Treatment Plan: Work closely with health care professionals and stick to the recommended therapy or medications to ease symptoms.
Education: Learn about the disorder to better understand your experiences and feel more in control.
Support Network: Talk to family, friends, or others who understand these feelings to find comfort and reduce isolation.

Step	Action
Treatment	Follow professional recommendations.
Learn	Understand the disorder and symptoms.
Connection	Reach out for support when needed.