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Depersonalization disorder
Last reviewed: 07.07.2025
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Depersonalization disorder is a persistent or recurring feeling of detachment from one's own body or mental processes; the person usually feels like an outside observer of one's own life. The trigger for this disorder is often severe stress. Diagnosis is based on anamnestic information. Treatment consists of psychotherapy.
The feeling of depersonalization is a common phenomenon, often associated with life-threatening situations such as accidents, violence, serious illnesses and injuries; depersonalization can also be a symptom of many mental disorders and paroxysmal states. Depersonalization disorder can be considered if depersonalization is persistent or recurring and is not associated with other mental or physical illnesses. This disorder occurs in approximately 2% of people in the general population.
[ Symptoms of Depersonalization Disorder
Patients have a disturbed perception of themselves, their bodies, and their lives, which can cause them significant discomfort. A person may feel unreal, like an automaton, or perceive themselves as in a dream. Often, the symptoms are short-lived and are accompanied by anxiety, panic, or phobic manifestations. However, the symptoms can also be chronic.
The patient often has great difficulty describing the symptoms and may fear going crazy. Patients always keep in mind that their "unreal" experience is not real, but rather a peculiarity of perception.
Diagnostics
The diagnosis is made based on the symptoms present after ruling out physical illness, substance abuse, other mental disorders (especially anxiety and depression), and other dissociative disorders. Psychological tests and a special interview are helpful.
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Treatment of depersonalization disorder
Treatment should address all stresses associated with the onset of the disorder, including earlier ones such as childhood abuse or emotional neglect, which may predispose to the development of a mental disorder in later life, the onset of depersonalization. A number of patients are successfully helped by various psychotherapy techniques (e.g., psychodynamic, cognitive-behavioral, hypnosis). Cognitive techniques help block obsessive thoughts about the unreality of existence. Behavioral techniques help engage the patient in activities that distract from depersonalization. Grounding techniques can help the patient feel as if he or she really exists in the present moment.
Other mental disorders that often accompany or complicate depersonalization also need to be treated. Anxiolytics and antidepressants help some patients, especially those whose coexisting anxiety and depression exacerbate depersonalization.
Forecast
The feeling of depersonalization is often short-lived and self-limiting. Even if depersonalization is present constantly or intermittently, some patients do not experience serious problems if they suppress the feeling by focusing on other thoughts, thinking about something. Other patients decompensate due to chronic feelings of detachment or due to accompanying anxiety and depression.
Many patients recover completely, especially if symptoms are due to stress that can be managed during treatment and if symptoms are not protracted. Some patients recover gradually without any intervention. In some patients, depersonalization becomes chronic and refractory to treatment.