Diseases & Conditions

Depersonalization disorder

Depersonalization is a sense that things around you aren't real, or the feeling that you're observing yourself from outside your body. Feelings of depersonalization can be very disturbing and may feel like you're losing your grip on reality or living in a dream. Many people have a passing experience of depersonalization at some point. But when feelings of depersonalization keep occurring, or never completely go away, it's considered depersonalization disorder. Depersonalization disorder can be severe and may interfere with relationships, work and other daily activities.

Feeling of depersonalization may:

• Begin with no apparent trigger
• Start after a life-threatening event, such as an accident or assault
• Be triggered by fear of having another depersonalization experience

With depersonalization disorder, feelings of depersonalization aren't directly caused by drugs, alcohol or a medical condition. However, depersonalization may be triggered by stress or trauma, and it often occurs along with other mental health conditions such as anxiety, depression or schizophrenia. In some cases, it starts suddenly without an apparent cause.

While the exact cause of depersonalization disorder isn't well understood, it appears to be linked to the balance of certain brain chemicals (neurotransmitters).

To be diagnosed with depersonalization disorder, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. To be diagnosed with depersonalization disorder, you must have the following signs and symptoms:

• You have persistent or recurrent experiences of feeling detached from your thinking, emotions or your body. You may feel like an outside observer watching yourself, or as if you were in a dream.
• During the depersonalization experience, you are aware that the experience is not "real."
• Depersonalization causes significant distress or interferes with your social life, job, or other important areas of your life.
• The depersonalization experience isn't directly caused by another mental disorder, such as schizophrenia, panic disorder, acute stress disorder, or another dissociative disorder, and is not due to the direct physiological effects of alcohol, drugs or a medical condition (such as epilepsy, for example).

Your doctor will want to make sure your feelings of depersonalization aren't due to some other disorder, such as depression, schizophrenia or epilepsy. You may need further evaluation or tests to rule out these and other causes.