Depersonalization-Derealization Disorder (DDD)

What is Depersonalization-Derealization Disorder?

Depersonalization-derealization disorder is a condition where one has the feeling that they are watching themselves from outside their own body. It can happen repeatedly over time or it can be persistent.

Some feel that they sense things that are not real. People with depersonalization-derealization disorder often feel like they are living in a dream. It is a common condition among people who have had a traumatic experience. When it is severe it can affect daily life, including personal relationships and work.

What are the Symptoms of Depersonalization-Derealization Disorder?

One of most invasive side effects of the symptoms of depersonalization-derealization disorder is that it affects work, school, and relationships. People often worry that they are losing control over themselves and their life and becoming insane.

Symptoms of depersonalization include

Feeling like you are an observer of what is going on, feeling like a robot, feeling out of control of your actions, an emotional and sometimes physical sense of body parts being distorted (bigger, smaller, shrunken), and numbness of senses and emotions.

Symptoms of derealization include

Feelings of alienation to your surroundings, a distortion of surroundings (colors, blurriness) or the opposite heightened awareness, disconnection from people, and distortion of time.

Episodes can last for hours or as long as months at a time.

Depersonalization-Derealization Disorder Causes

The causes of DDD are not known. In the vast majority of cases, the disorder has its roots in traumatic events. Due to trauma, an individual learns to enter a dissociated state where they are detached from their feelings, emotions, and sometimes even their body, in order to tolerate the difficult experience. However, in some individuals, this coping mechanism becomes chronic and is triggered by events of a much less distressing nature or even completely non-threatening events.

It is not known why some people develop DDD in response to traumatic events and others do not, nor is it known why some DDD sufferers experience the dissociated state in response to normal events.

Some neuroscientists have studied the brains of DDD sufferers using brain-imaging technology. This research field is in its early phases, but so far scientists have documented issues with connectivity between three parts of the brain, known as the insulate cortex, the anterior cingulate cortex, and the somatosensory cortex. These brain areas are involved in self-awareness and interoception (awareness of your own body).

These defects may play a role in the dissociative experience of DDD, but it is not known how or why they occur, or who is at risk of them.

How is Depersonalization-Derealization Disorder Treated?

Depersonalization-derealization disorder is most often treated with what is commonly called talk therapy or psychological counseling; however, medications may be prescribes, as well.

Psychological counseling helps you to gain control over the symptoms by understanding why the condition exists and what it really is. Counseling can include psychodynamic therapy or behavioral therapy.

Medications that usually treat anxiety or depression may be prescribed. Fluoxetine, clomipramine and clonazepam are some of the medications that have been used to treat depersonalization-derealization disorder.

Depersonalization-Derealization Disorder Prevention

There are no known measures that can be taken to prevent DDD. Although researchers are investigating several potential avenues such as the brain defects that are associated with DDD, they do not know how these defects come about, and therefore cannot be sure how to prevent them.

Symptoms similar to DDD can be experienced in people with other conditions. For example, sufferers of certain types of seizures may also experience depersonalization and derealization. Likewise, people under the acute influence of some drugs, or people who suffer from substance abuse disorders, may also experience depersonalization. Therefore, although such individuals would not come under the technical definition of DDD, the successful treatment of these conditions may prevent DDD-like symptoms from occurring in these people.

Last Reviewed:
October 05, 2016
Last Updated:
December 13, 2017