Depersonalisation & Derealisation

What is the prognosis for depersonalisation and derealisation? Our approach to treating depersonalisation and derealisation What is depersonalisation? What is derealisation?
“Is there something wrong with my eyes?”
”Have I got dementia?”
”Is this a dream or am I going crazy?”
These are some of the questions you may be asking yourself if you are experiencing derealisation or depersonalisation symptoms. Reliable and familiar settings, such as being in your kitchen at home or playing in the garden with your kids suddenly become profoundly and unsettlingly unfamiliar. You might feel dream-like as if you cannot pull your surroundings close enough. This condition is characterised by a persistent failure to connect with your environment or your emotions. Despite trying to think logically and rationally you can’t stop feeling unreal, detached or emotionally distant.

What is the prognosis for depersonalisation and derealisation?

Depersonalisation and derealisation can be deeply unsettling for a number of reasons, but one of the greatest difficulties of these conditions is explaining the experience to others.

Many of our patients report a fear of being perceived as ‘mad’ or ‘losing their marbles’ as they try to convey their sense of disconnection and hazy thinking. In other cases, patients may be convinced that they’re experiencing psychosis or losing touch with reality completely.

While these beliefs are entirely understandable, they are not the case. The prognosis for derealisation and depersonalisation is, in fact, hopeful. A large number of people get better from the condition as a matter of course, others respond positively to medication and better still to psychotherapeutic intervention.

Our approach to treating depersonalisation and derealisation

At the London Psychiatry Clinic, we are aware that there is no single cause of depersonalisation and derealisation (often referred to as DP & DR). We have had the opportunity to help a significant number of people with DP/DR and we’ve seen how distressing it is to experience these symptoms. We take a personalised approach, working with you to understand what it is, why it’s happening to you and what you can do to prevent it from being a major cause of distress in your life.

Many of our patients experience derealisation or depersonalisation symptoms due to traumatic events, and studies have estimated that about half of people who experience trauma will develop some degree of depersonalisation, derealisation or both. Anxiety and depression are also common triggers for these symptoms.

What is depersonalisation?

Depersonalisation essentially means that you don’t feel like yourself anymore. It is quite difficult to explain unless you have experienced it for yourself, but it might seem as though your mind and body are operating separately from one another.

You might feel empty, like there is a void inside of you or your mind is no longer connected to your body. You could have thoughts like ‘I don’t feel real’ or ‘I feel like I am dreaming when I am awake.’

What is derealisation?

Derealisation is slightly different, in that you feel detached from reality. You might look at yourself in the mirror and feel an intense detachment from the person looking back. While your body moves through the phases of daily function, the mind feels like it’s watching from a distance, as though you are experiencing life through a lens or different angle to how you would normally see it.

Even everyday tasks, like putting your socks on or locking the front door, can feel eerily artificial, lifeless and distant. You might say or think things such as ‘I don’t feel that I am where I am.’

What causes depersonalisation and derealisation?

Research into depersonalisation and derealisation is still in the early stages, but interest in the field is growing. While there is no single, identifiable cause for these symptoms, there are some common risk factors associated with it:

  • Trauma
  • Severe stress
  • Depression
  • Anxiety
  • Panic disorder
  • Emotional maltreatment in childhood
  • Marijuana (cannabis) use
  • Hallucinogenic or psychedelic use

Ultimately, this condition can be caused by a range of factors and each person will have different circumstances leading to their symptoms. There is even some evidence that certain types of medications could cause this problem in very rare cases.

How do you treat depersonalisation and derealisation?

We will take a full case history in order to gain understanding of the circumstances leading up to your symptoms, in order to identify potential triggers.

By discussing your personal triggers, we can suggest ways to target the underlying problems that are driving your symptoms and begin depersonalisation treatment. The way you experience depersonalisation and derealisation is specific and unique to you, which is why a personalised approach is most effective in treating this condition.

What is the best treatment option for depersonalisation and derealisation?

The derealisation and depersonalisation treatment options are somewhat controversial. Due to the difficulty in describing this symptom, there aren’t many studies that have been able to look at the efficacy for different depersonalisation treatments. This means that there is no specific treatment that is universally accepted, and each person may have better results with a different treatment.

Treatment options for this condition include:
  • Psychotherapy
  • Medication
  • Repetitive transcranial magnetic
  • stimulation (rTMS)
  • Sleep optimisation
  • Getting enough sunlight exposure
  • Exercise
  • Nutritional interventions
  • Other lifestyle changes can have a positive effect in some people with depersonalisation and derealisation

These options can be used in conjunction with each other, which generally works best with conditions like depersonalisation and derealisation. Stress has been identified as one of the most important factors in causing the condition, and patients often find that treating stress alone can bring about marked improvements.
Our Doctors
Here to help you with Depression

Dr Luis Alameda

Dr Srinivas Lanka

Dr Nagore Benito

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Gemma Luke

My name is Dr Gemma Luke, a consultant clinical psychologist. I have been working in the field of mental health for over 20 years, and as a qualified clinical psychologist since 2011.

Conditions I treat:
Self-HarmAddictions AnxietyBDDBipolar disorderBehaviour problemsDepression Eating DisordersOCDPanic AttacksPersonality DisordersTrauma & PTSDOffending behaviour (domestic, violent, and sexual abuse)Behavioural issues

I am passionate about promoting positive mental health and strive to work holistically with both mind and body to help my clients achieve lasting change.

Fees

Initial consultations: £245 (1 hour)

Follow-up consultations: £245 (1 hour)

Alexandra Madureira

I’m a Clinical Psychologist who thinks outside the box. I have a creative and passionate approach that focuses on healing emotions while also considering life situations and neurobiological mechanisms.

Conditions I treat:
ADHDAddictions AnxietyBDDBipolar disorderBrain inuryBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaMemory problemsOCDPanic AttacksPersonality DisordersTrauma & PTSD

I believe feeling safe is a prerequisite for change and therefore I focus on making people feel comfortable, so they can gain the courage to face and break unhelpful psychological patterns.

Fees

Please contact us for more information

Dr Ana Tsakiri

My Trauma-informed practice and holistic therapeutic approach aims to support children during periods of acute crisis but also help them with long standing emotional and behavioural difficulties. I work with families to understand how adversity and trauma has impacted a child’s world causing emotional and mental health difficulties as well as physical symptoms. I am also a Consultant Psychiatrist specialised in Interventional Psychiatry with TMS therapy for young people with resistant emotional difficulties and severe depression.

Conditions I treat:
ADHDAnxietyAutismBehavioural problemsBDDBipolar disorderBrain inuryComplex TraumaDepression Eating DisordersEmotional Difficulties Family workInterpersonal relationship problemsOCDPanic AttacksParental Psychoeducation about Mental Health DisordersPersonality DisordersPhychosomatic symptomsPsychosisPTSDSleep problems

The aim is always for your child to overcome the negative influence of the experience, redefine how they feel and rebuild their confidence

Fees
First Consultation:
£395
(1 hour)
First Consultation:
£650
(1.5 hours)
First Consultation:
£790
(2 hours)
Follow-up consultations:
£245
(30 min)
Follow-up consultations:
£295
(40 min)
Follow-up consultations:
£395
(60 min)

Dr Jonathan Garabette

I am a Psychiatrist specialising in General Psychiatry and Medical Psychotherapy. I treat most mental health difficulties and offer a range of approaches including medication, psychological therapies and lifestyle modification.
Conditions I treat:
Depression and Dysthymia​Depression and Dysthymia​Depression and Dysthymia​

I always try to focus on understanding you as a whole person and how any symptoms, problems and diagnoses affect you, your life and what is important to you.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£275
(30 minutes)
Follow-up consultations:
£320
(40 minutes)
Follow-up consultations:
£475
(60 minutes)

Lynn Gruwez

I’m a Clinical Psychologist with experience across a range of mental health conditions. My goal as a therapist is to see each person as someone unique and human. I seek to understand in depth the nature of any mental health symptoms so that I can flexibly and creatively adapt therapy to suit your circumstances.

Conditions I treat:
ADHDAddictions AnxietyBDDBipolar disorderBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaOCDPanic AttacksSleep problemsTrauma & PTSD

I believe in a holistic, non-judgemental approach where clients have the space and freedom to share their fears without constraint. I have a strong interest and passion for Mindfulness.

Fees

Please contact us for more information

Dr Triveni Joshi

I am a Consultant Psychiatrist specialising in Child and Adolescent Psychiatry with over 15 years clinical experience. I treat a wide variety of mental health and emotional conditions with an emphasis on holistic treatment and working with parents/carers.

Conditions I treat:
ADHDAngerAnxietyAutismBDDBipolar disorderBehavioural difficultiesDepression Emerging Personality DisordersOCDPanic AttacksParentingPsychosisSleep problemsTrauma & PTSD

I love to work with children. I wholeheartedly believe that early intervention is one of the best ways to successfully manage long term mental health problems.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Regina Sala

I am a caring and approachable medical doctor specializing in cognitive, behavioural and emotional well-being in children, adolescents, adults and their families. My ethos is to offer excellence of care based on evidence-based research with respect and compassion.

Conditions I treat:
ADHDAutismAddictions AnxietyAttachment difficultiesBDDBehaviour problemsBereavement, grief and lossBipolar disorderBrain injuryChronic painDepressionEating DisordersFamily TherapyFibromyalgiaIntellectual disabilityMedically unexplained symptomsOCDPanic AttacksPersonality DisordersPsychosisPsychosomatic symptomsSleep problemsSocial communication disorderSpecific learning disordersTics and Tourette’s syndromeTrauma & PTSD

I see my patients as human beings and aim to foster a sincere and relaxed environment so that we can build trust during our sessions. I believe in a positive body-mind integration with neuroscience’s principles to empower self-awareness, resilience and personal growth

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Maria M. Herves

I am a General Psychiatrist with great interest in childhood and adolescence psychiatry. I have been working specifically in this field over the last 10 years. I believe that supporting mental health at early stages in life can prevent it from developing further into more persistent difficulties in adulthood.

Conditions I treat:
ADHDAnxietyAutismBehaviour problemsBipolar disorderChronic painComplex trauma and PTSDDBT(Dialectical behaviour therapyDepressionEmotional DysregulationFamily workFibromyalgiaMemory problemsOCDPanic AttacksParentingPersonality DisordersPsychosisPsychosomaticSchool bullying and cyberbullyingSleep problems

I regard the patient as the product, not the problem. They are a result of their environmental, genetic and social influences, all of which can be addressed and supported with professional help.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£250
(30 min)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Iyas Assalman

I am a Consultant Psychiatrist specialised in General Adult Psychiatry. I treat a wide variety of mental health and emotional conditions and I have an expertise in treating Adults with ADHD.

Conditions I treat:
ADHDAnxietyBDDBehaviour problemsBipolar disorderDepressionMemory problemsOCDPanic AttacksPsychosisSleep problemsTrauma and PTSD

Rather than seeing you as a diagnosis or trying to change your personality, I want to understand my patients as a whole person.

Fees
First Consultation:
£495
(1 hour)
First Consultation:
£745
(1.5 hours)
First Consultation:
£980
(2 hours)
Follow-up consultations:
£290
(30 min)
Follow-up consultations:
£385
(40 min)
Follow-up consultations:
£495
(60 min)

Dr Luis Alameda

I am a General Adult Psychiatrist and a Neuroscience Researcher. I specialise in severe mental conditions including trauma. I offer an individualised intervention integrating psychotherapy and medical approaches.

Conditions I treat:
AnxietyBorderline Personality DisorderBipolar disorderBrain inuryBehaviour problemsChronic painDepression Dissociative disordersNarcissistic Personality DisorderOCDPanic AttacksPersonality DisordersPsychosisReactions to acute stressSchizophreniaSchizoaffective DisorderSleep problemsTrauma & PTSD

I believe that difficulties in managing mental health are a normal part of life and far more common than you might think. They present an opportunity to understand the problem, become more self-aware and progress on your journey.

Fees
First Consultation:
£395
(1 hour)
Follow-up consultations:
£220
(30 min)
Follow-up consultations:
£330
(45 min)

Dr Lara Lavadiño

I am a General Adult Psychiatrist specialised in Adult, Child and Adolescent Psychiatry. I have specialist expertise in managing complex and long term conditions. I am an EMDR (Eye Movement Desensitization and Reprocessing) certified psychotherapist also integrating Cognitive-Behavioural Therapy (CBT), Systemic Therapy and Psychodynamic Psychotherapy principles.

Conditions I treat:
ADHDAnxietyAutismBDDBehaviour problemsBrain injuryChronic fatigueChronic painDepressionDissociationFibromyalgiaLearning DisabilityOCDPanic AttacksPanic/AgoraphobiaParentingPerformance anxiety in Music, Acting and SportsPerinatal PsychiatryPersonality DisordersPsychosisSleep problemsSocial phobiaTinnitus and VertigoTrauma & PTSD

I believe in a positive psychiatry approach, empowering both children and adults to overcome any difficulties by providing education and support on their condition, along with a holistic and personalised treatment plan.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Srinvas Lanka

I am a Consultant Psychiatrist specialising in Adult Psychiatry and Neuropsychiatry. I treat a wide variety of mental health and emotional conditions and have specialist expertise in managing complex and long term conditions.

Conditions I treat:
ADHDAutismAddictions AnxietyBDDBipolar disorderBrain inuryBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaMemory problemsOCDPanic AttacksPersonality DisordersPsychosisSleep problemsTrauma & PTSD

I try to understand your treatment goals, values, limitations and preferences, so we can personalise your treatment using the best approach that gives you sustained recovery.

Fees
ADHD Initial Consultation:
£1160
(2 hours)
Initial Consultation:
£870
(1.5 hours)
Follow-up Consultation:
£290
(30 min)
Follow-up Consultation:
£580
(1 hour)

Dr Jonathan Garabette

I am a Psychiatrist specialising in General Psychiatry and Medical Psychotherapy.
I treat most mental health difficulties and offer a range of approaches including medication, psychological therapies and lifestyle modification.

Conditions I treat:
Addictions AnxietyBDDBipolar disorderBorderline Personality DisorderComplex TraumaDepersonalisationDepression Eating DisordersInsomniaOCDSleep problemsPanic AttacksPsychosisTrauma & PTSD

I always try to focus on understanding you as a whole person and how any symptoms, problems and diagnoses affect you, your life and what is important to you.

Fees
Initial Consultation:
£1160
(2 hours)
Initial Consultation:
£870
(1.5 hours)
Follow-up Consultation:
£580
(1 hour)
Follow-up Consultation:
£290
(30 min)

Dr Nagore Benito

I am a General Adult Psychiatrist with extensive experience in the diagnosis and treatment of most mental health conditions. I offer a person-centered and holistic approach.

Conditions I treat:
ADHDAnxietyBDDBipolar disorderDepression OCDPanic AttacksPsychosisSleep problemsTrauma & PTSD

The best six doctors anywhere, and no one can deny it are sunshine, water, rest, and air, exercise and diet. These six will gladly you attend If only you are willing Your mind they’ll ease Your will they’ll mend And charge you not a shilling
– Nursery rhyme quoted by Wayne Fields, What the River Knows, 1990

Dr Alberto Pertusa

I have a strong interest in behaviour modification, lifestyle optimisation and the use of self-quantification as a way to foster wellbeing and increase performance.

Conditions I treat:
ADHDAddictionsAnxietyBinge EatingOCDOrthorexiaSleep problems

I always strive to provide the highest standards of care to all my patients.
I endeavour to offer personalised and bespoke treatment in order to meet your specific needs