Published on: November 28, 2022
Updated on: November 28, 2025
Author: Kentucky Counseling Center
Have you ever felt like you’re not quite yourself—like you’re drifting through your day on autopilot, disconnected from your thoughts, your environment, or even your own body? You might be experiencing depersonalization or derealization. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), depersonalization involves persistent feelings of detachment from oneself, while derealization is the sensation that the world around you isn’t real. When these symptoms occur together on a regular basis, it’s called depersonalization/derealization disorder (DPDR).
As the Mayo Clinic notes, depersonalization/derealization disorder can be unsettling, leading to panic attacks, anxiety, and significant distress. The good news is that with proper treatment and coping strategies, you can regain a sense of control and feel more grounded in your daily life.
What Causes Depersonalization/Derealization Disorder?
Although the exact causes of depersonalization/derealization disorder aren’t fully understood, researchers and mental health professionals identify a variety of risk factors that may increase the chances of developing DPDR:
- Traumatic experiences: Witnessing or experiencing abuse, accidents, assault, or the death of a loved one.
- Chronic stress: Strain from work, relationships, or other major life changes.
- Underlying mental health conditions: Anxiety, depression, or panic disorders may heighten the risk.
- Alcohol or substance use: Drugs or alcohol can trigger episodes or worsen existing symptoms.
Some individuals experience short, fleeting moments of depersonalization or derealization, which may pass without long-term effects. However, if these episodes become frequent, distressing, or disruptive to your daily life, you may be dealing with a diagnosable disorder that requires professional support.
Common Symptoms of Depersonalization/Derealization Disorder
People with depersonalization/derealization disorder often describe the experience as “feeling crazy” or as if they’re observing themselves from the outside. The symptoms can include:
- Feeling like an observer of your own life (out-of-body experiences).
- Emotional numbness, where you don’t feel pain, sadness, or joy as you normally would.
- Distorted perception of body parts, time, or space (e.g., feeling like your limbs are too large or too small).
- Memory confusion, doubting whether past events actually happened.
- Disconnect from surroundings, feeling as though people or objects around you aren’t real.
- Autopilot sensation, as if your actions and words are happening without conscious direction.
Episodes can vary from hours to days, weeks, or even months. Some individuals notice a clear trigger, while others may feel symptoms arise unexpectedly. If any of these resonate with you, consider seeking medical advice for a thorough evaluation.
Does Depersonalization Go Away?
In certain cases, depersonalization or derealization might subside on its own, especially if the episodes are brief or triggered by acute stress. But for many, these symptoms can persist or return repeatedly over time.
- Symptom Recurrence: Without addressing underlying triggers—such as trauma, stress, or other mental health issues—DPDR symptoms can resurface whenever you encounter similar stressors.
- Distress and Impact on Daily Life: Even if the episodes occasionally disappear, the anxiety of not knowing when they’ll reappear can itself lead to further stress.
Early recognition and a proper diagnosis are vital. By working with a mental health professional, you can learn how to manage symptoms more effectively and minimize the chances of recurrence.
Treatment for Depersonalization/Derealization Disorder
The primary goal of treatment is to control symptoms, reduce recurrence, and help you regain a strong sense of self. Most mental health providers recommend a combination of psychotherapy and, if necessary, medication.
Psychotherapy
- Cognitive Behavioral Therapy (CBT) or Talk Therapy: A mental health professional will help you explore stressors, emotional triggers, and any trauma contributing to your dissociative symptoms.
- Identifying Underlying Issues: Therapy offers a safe space to dissect life events, set coping strategies, and challenge negative thought patterns.
- Regaining Connection: Therapists often guide you in grounding exercises—techniques to reconnect with your body and surroundings when a wave of depersonalization sets in.
Medications
- Anti-Anxiety Medications: Can help alleviate panic attacks or constant worry, which in turn reduces dissociative symptoms.
- Antidepressants: May support individuals dealing with co-occurring depression or anxiety.
- No Direct “Cure”: While there’s no medication specifically designed to “cure” DPDR, these prescriptions can offer relief from the underlying triggers, making dissociative episodes less frequent or severe.
Coping Strategies: Taking Control of Your Life
Beyond professional treatment, you can implement self-help techniques to reduce DPDR’s impact on your day-to-day routines. Here are some actionable tips:
1. Acknowledge Your Symptoms
Recognizing that you’re experiencing depersonalization/derealization is a powerful first step. Awareness helps you respond quickly—whether that means using a grounding technique or reaching out to someone you trust.
2. Challenge Intrusive Thoughts
Intrusive thoughts often accompany depersonalization:
- Mindfulness Breathing: Find a quiet space, close your eyes, and take slow, deep breaths. This can interrupt racing or negative thoughts and bring you back to the present moment.
- Listen to Music: Create a playlist of songs that calm or uplift you. Music therapy can refocus your mind when you feel an episode coming on.
- Read a Book: Immersing yourself in a story or informative material distracts intrusive thoughts, helping you regain mental clarity.
3. Journal Your Experience
Writing out your feelings, thoughts, or daily triggers can help you observe patterns. Keeping a journal also provides an outlet to process intense emotions and track what coping methods work best for you.
4. Reach Out to Someone You Trust
Isolation can worsen dissociative symptoms. Having a support system—be it friends, family, or a mental health hotline—offers reassurance and practical help when episodes become overwhelming.
5. Manage Stress Effectively
Chronic stress can be a major DPDR trigger:
- Prioritize Sleep
- Exercise Regularly
- Maintain a Balanced Diet
- Take Breaks or vacations from work or daily routines
- Seek social support through trusted friends, family, or support groups
Small, consistent lifestyle changes can significantly reduce the frequency and severity of episodes.
How Can I Prevent Depersonalization/Derealization Disorder?
Complete prevention may not be possible, especially in the face of unpredictable traumatic events or genetic predispositions. However, you can lower your vulnerability by:
- Seeking Help Early: If you experience a traumatic event, talk to a counselor or therapist right away. Early intervention can address emotional wounds before they escalate.
- Staying Alert to Warning Signs: If you notice any pattern of feeling detached or “out of body,” take it seriously. Early recognition often leads to more effective treatment outcomes.
Seek Treatment for Depersonalization/Derealization Disorder
Don’t let feelings of unreality take over your life. If symptoms of depersonalization/derealization disorder are affecting you, reach out for help as soon as possible. Here at Kentucky Counseling Center, we have a team of dedicated mental health professionals offering psychotherapy, counseling, and case management services. The earlier you seek support, the sooner you can start regaining control and feeling more like yourself again.
