Depersonalisation, derealisation & dissociation

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 post traumatic stress. Studies have estimated that about half of people who experience trauma will develop some degree of depersonalisation, derealisation or both. Other mental health conditions such as 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.’ In short derealisation is a sense of feeling disconnected to reality or your life.

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 dissociative disorders such as 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.

We understand therapy can be daunting for some, which is why we offer online therapy so you can speak to our experts in the comfort of your own home. Our online therapy services also mean that no matter where you are in the world, we can help you.