Depersonalization/Derealization Disorder

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Depersonalization/Derealization Disorder

Medically reviewed · Ratel Health editorial team · Sunday, 16 August 2026

A dissociative condition involving persistent or recurrent experiences of feeling detached from oneself or one’s surroundings.

Overview

Depersonalization/derealization disorder involves persistent or recurrent experiences of depersonalization (feeling detached from one’s own thoughts, body, or actions) or derealization (feeling that surroundings are unreal), while reality testing remains intact.

Signs and Symptoms

Symptoms can include feeling like an outside observer of oneself, emotional or physical numbing, or perceiving the world as dreamlike, foggy, or visually distorted. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.

Causes and Risk Factors

The exact cause is not fully understood. Severe stress, trauma, and anxiety are each associated with depersonalization and derealization experiences.

Diagnosis

A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.

Treatment

Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.

Psychotherapy

Psychotherapy, including cognitive behavioral approaches, may help address underlying anxiety or trauma contributing to symptoms.

Living With Depersonalization/Derealization Disorder

Grounding techniques and stress reduction strategies may help manage symptoms day to day.

When to Seek Professional Help

Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.

Emergency Situations

If a person may be in immediate danger, is experiencing a medical or psychiatric emergency, or may harm themselves or another person, seek immediate assistance through appropriate local emergency services.

Outlook

The course varies; some people experience brief episodes while others have more persistent symptoms that improve with treatment.

Related Conditions

Dissociative Identity Disorder

A dissociative condition involving disruption of identity marked by two or more distinct personality states, along with recurrent gaps in memory.

Generalized Anxiety Disorder

A persistent pattern of excessive, difficult-to-control worry about everyday events and activities.

Medical Information Disclaimer

Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.

References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
  • National Institute of Mental Health.
  • World Health Organization. International Classification of Diseases, 11th Revision.