Depersonalization Derealization Disorder: A Comprehensive Guide

Depersonalization Derealization Disorder (DDD) is a dissociative disorder that affects an individual’s perception of reality. This disorder is characterized by feelings of detachment from oneself and the environment, and a sense of unreality or surrealness.

Symptoms of DDD

The symptoms of DDD can range from mild to severe and can last for days, weeks, or even years. The hallmark features of DDD are:

  • Depersonalization: Feeling disconnected from oneself, as if observing one’s own thoughts, feelings, and actions from a distance
  • Derealization: Feeling disconnected from the external world, as if everything is unreal, dreamlike, foggy, or artificial.

Other symptoms may include:

  • Difficulty concentrating or focusing
  • Memory problems
  • Feeling emotionally numb, empty, or disconnected from loved ones
  • Feeling like being in a trance, or like in a movie, without a sense of control over one’s own actions and decisions
  • Anxiety, panic attacks, or depression, due to the distressing and disruptive nature of the symptoms.

Causes of DDD

The exact causes of DDD are not fully understood, but several factors may contribute to its development. These include:

  • Trauma, such as physical or sexual abuse, or witnessing violence or death
  • Stress, such as work or relationship problems, financial difficulties, or major life changes
  • Mental health conditions, such as anxiety, depression, or post-traumatic stress disorder (PTSD), which may co-occur with DDD
  • Drug abuse, particularly marijuana, hallucinogens, or dissociative drugs, which can trigger or worsen DDD symptoms
  • Personality traits, such as being prone to introspection, self-doubt, or a sense of unreality even before the onset of DDD.

Diagnosis of DDD

DDD is diagnosed based on the presence of depersonalization and/or derealization symptoms that cause significant distress or impairment in social, occupational, or other areas of functioning, and are not better accounted for by another mental disorder or a medical condition.

The diagnosis is usually made by a mental health professional, such as a psychiatrist, psychologist, or clinical social worker, who can conduct a comprehensive clinical interview, review the person’s medical and psychiatric history, and perform any relevant laboratory or imaging tests to rule out other conditions that may mimic or co-occur with DDD.

Treatment of DDD

Currently, there is no cure for DDD, but several treatment options are available to alleviate the symptoms and improve the quality of life:

  • Psychotherapy: Talk therapy, such as cognitive-behavioral therapy (CBT), can help a person with DDD identify and challenge negative thought patterns and behaviors that contribute to the symptoms. CBT can also teach coping and relaxation skills, improve social skills and communication, and address any co-occurring mental health conditions.
  • Medication: Antidepressants, anxiolytics, or antipsychotics may be prescribed to reduce anxiety, depression, or psychosis-like symptoms that can coexist with DDD. However, medication should be used with caution and under close monitoring, as some drugs may worsen the dissociation or cause side effects such as drowsiness, sedation, or addiction.
  • Lifestyle changes: Simple measures such as getting enough sleep, exercising regularly, eating a balanced diet, avoiding drugs and alcohol, and reducing stress can help a person with DDD manage the symptoms and improve overall well-being.

Living with DDD

DDD can be a challenging disorder to live with, but with proper diagnosis, treatment, and support, many people with DDD can experience meaningful and fulfilling lives.

Some tips for coping with DDD include:

  • Be patient and compassionate towards yourself. Remember that the symptoms are not your fault and do not define you as a person.
  • Reach out for help and support from trusted friends or family members, or join a support group to connect with others who have similar experiences.
  • Practice self-care and relaxation techniques, such as meditation, mindfulness, deep breathing, yoga, or art therapy.
  • Set realistic goals and priorities, and break them down into small, manageable steps.
  • Seek professional help if the symptoms worsen or interfere with daily activities, or if you experience suicidal thoughts or behavior.


Depersonalization Derealization Disorder is a dissociative disorder that can cause profound feelings of detachment, unreality, and anxiety. While the exact causes and mechanisms of DDD are still not fully understood, several treatment options are available to alleviate the symptoms and improve the quality of life. With proper diagnosis, treatment, and support, many people with DDD can learn to manage the symptoms and lead fulfilling lives.


What is Depersonalization Derealization Disorder?

Depersonalization Derealization Disorder is a dissociative disorder where a person experiences a feeling of detachment from oneself and the surrounding environment. This can lead them to feel as though they are watching themselves from a third-person perspective, or that the world around them is not real.

What are the Symptoms of Depersonalization Derealization Disorder?

The symptoms of Depersonalization Derealization Disorder include a persistent feeling of detachment from one’s thoughts, feelings, and surroundings. Other common symptoms include feeling like you are in a dream or that time is passing abnormally slowly or quickly. Some people may also experience physical symptoms like numbness or tingling in their extremities or around their mouth.

How is Depersonalization Derealization Disorder Treated?

Treatment for Depersonalization Derealization Disorder typically involves therapy aimed at helping the person identify and manage their symptoms. This may include cognitive behavioral therapy (CBT) or psychodynamic therapy. Medications like antidepressants or anti-anxiety medications may also be prescribed to help manage symptoms. Lifestyle changes, such as better sleep habits and stress reduction techniques, can also be helpful in managing symptoms.


1. Simeon, D., Guralnik, O., Hazlett, E. A., Spiegel-Cohen, J., Hollander, E., & Buchsbaum, M. S. (2001). Feeling Unreal: A PET study of depersonalization disorder. American Journal of Psychiatry, 158(12), 1992-1998.
2. Sierra, M., & Berrios, G. E. (2000). Depersonalization: A conceptual history. History of Psychiatry, 11(44), 457-476.
3. Medford, N., Baker, D., & Hunter, E. (2013). Depersonalisation disorder: Clinical features of 204 cases. The British Journal of Psychiatry, 202(5), 385-392.