Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Derealization is a psychological state in which you feel disconnected from your environment.
  • Over half of all people will experience this sense of separation from reality at least once in their lives.
  • However, only approximately 2 percent of people have it frequently enough to qualify as a dissociative disorder.

Derealization is a psychological state in which you feel disconnected from your environment. People and things in your immediate surrounding don’t seem genuine. Even yet, you have an insight and you are aware that this isn’t normal.

Over half of all people will experience this sense of separation from reality at least once in their lives. However, only approximately 2 percent of people have it frequently enough to qualify as a dissociative disorder.

Derealization is comparable to depersonalization disorder, but they are not the same. The latter is characterized by a sense of separation from your surroundings, but from your individual body, ideas, or feelings. It’s as if you are an outside observer looking in on yourself.

Depersonalization disorder, also known as depersonalization-derealization (DPDR) disorder, is a mental health problem.

This new name highlights the two fundamental problems that people with DPDR face:

  • Depersonalization has an influence on how you interact with yourself. It can cause you to feel and think as if you aren’t who you believe you are.
  • Derealization has an effect on how you interact with other people and objects. It can give you the impression that your environment or other people are not genuine.

These concerns might make you feel distant or alienated from yourself and the environment around you when they occur together.

It’s not uncommon to have these feelings from time to time. However, if you have DPDR, these symptoms might last for a long time and interfere with your daily tasks. (source: APA, n.d.)

Continue reading to learn further about DPDR, particularly its symptoms and available treatment options.

A detailed treatment plan will lay out the measures required to complete treatment as well as the essential tools outside of treatment. A sympathetic team at a high-end depersonalization-derealization disorder treatment clinic will assist your loved one in achieving the following depersonalization/derealization disorder goals:

  • Developing coping skills and recognizing triggers
  • Dissociative states are being drastically reduced.
  • Relationship improvement

We recognize that deciding on the best treatment choice for someone you care about is one of the most difficult decisions you can make. We have been on this path several times with other families who came to us with similar concerns. There are various factors that contribute to the success of this one-of-a-kind deluxe treatment center.

The Admissions Process and Extensive Assessment. In order to get an accurate diagnosis and the most suitable level of treatment, we incorporate thorough in-depth exams into our admissions procedure.

The whole family is treated. We involve the entire family in treatment to help them navigate life with a loved one who is suffering from depersonalization/derealization disorder.

Levels of Care and an Inclusive Therapeutic Community As clients advance through therapy, we give appropriate structure, supervision, and support in a safe atmosphere that promotes accountability, responsibility, and social connectivity. (source: NIMH, n.d.)

Behavioral change that lasts. We provide clients with the resources, skills, and encouragement they need to achieve greater stability and independence, as well as the courage and confidence to live a long and healthy, joyful, and productive life.

Although there is no cure for derealization and depersonalization disorder, treatment can help to alleviate distressing symptoms and perhaps lead to complete recovery from the illness. People who are experiencing derealization or depersonalization should speak with a specialist about their concerns so that treatment may begin and they can start feeling like themselves again. Depersonalization symptoms may be treated with antidepressant and antipsychotic drugs.

Selective Serotonin Reuptake Inhibitors (SSRIs). Depression is among the most common co-occurring symptoms in people with dissociative disorders. Co-occurring depression is routinely treated with antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). SSRIs used to treat dissociative disorders include:

  • Citalopram
  • Sertraline
  • Fluoxetine

Antipsychotic Medications. Dissociative disorders, such as derealization, are distinguished by the fact that they are not psychotic conditions. People who have had them keep their sense of reality intact. Antipsychotic medications, on the other hand, can be an effective form of depersonalization treatment for these disorders.

Antipsychotics can help persons with depersonalization-derealization illness achieve a number of positive outcomes, such as mood stabilization, stress relief, and a wider spectrum of affect. They might even be able to target and diminish symptoms of derealization and depersonalization.

Therapy for Depersonalization-Derealization Disorder

While reflective thinking might lead to queries about what is genuine and real, the sensation that the self and the outside world aren’t real is frequently a dissociative response learned to dissociate from unpleasant or painful traumatic events. Any therapy treatment for the depersonalization-derealization condition should aim to help people reclaim their real emotional range, which often involves developing both safety and understanding. (source: NICE, 2018)

Psychotherapy can help you learn how to:

  • Keep oneself from worrying about fictitious events.
  • Use activities to keep yourself occupied.
  • Using your 5 senses, anchor yourself in reality (for instance, by holding something cold or warm or laying loud music).
  • Deal with your negative emotions and figure out what’s causing your symptoms.
  • Use specific words to express your sentiments.

Symptoms of derealization and depersonalization can make a certain individual seem unreal. The self, mind, emotions, body, and the external world may all feel as if they don’t exist, or as if they are distant or distorted at different moments. Any of these symptoms, to the extent that they are present, can indicate a depersonalization-derealization disorder.

A therapist can utilize a depersonalization-derealization disorder test to identify the condition. While a specific test for symptoms, such as the structured clinical interview, may be employed, the Steinberg Depersonalization Questionnaire is the most common depersonalization disorder test. The Steinberg Derealization Questionnaire is a comparable derealization test.

Teletherapy

Patients are met with a professional therapist via teletherapy. The therapist will develop a specific treatment plan with the patient, helping him or her down the road to long-term recovery. More information on how to get started with teletherapy may be found here.

Psychotherapy (source: Psychiatry.org, n.d.)

Psychotherapy is a broad term that refers to any type of talk therapy where a client expresses his or her feelings and thoughts to a therapist.

While pharmacologic treatment of mental health issues has progressed significantly, psychotherapy is still the primary and most important psychiatric intervention. This is particularly true in the management of the depersonalization-derealization disorder, which may or may not be fully curable with medicines. One of the earliest types of therapy is psychodynamic therapy.

Psychodynamic psychotherapy emphasizes going back in time to figure out what led an individual to feel and think the way they do. Someone with a depersonalization-derealization condition can begin to comprehend why they feel separated from reality and take measures to address this by making the underlying unconscious roots of emotional reactions more conscious and comprehendible.

Insight is perhaps the most effective treatment for the depersonalization-derealization disease, allowing previously suppressed emotions to surface. People can begin to experience thoughts and emotions that they previously considered unpleasant and that caused their dissociation symptoms by deconstructing previously unconscious patterns of interacting with the world.

Cognitive Behavioral Therapy

CBT is one of the most well-researched treatment interventions and is regarded as an evidence-based technique for the treatment of a wide range of psychiatric problems. It works by assisting individuals in recognizing cognitive distortions and unreasonable ideas. People can lessen or eliminate negative feelings and actions generated by these concepts by confronting and reframing them. (source: StatPearls, 2024)

CBT usually works successfully for people with the depersonalization-derealization disorder. Many of the symptoms include a cognitive component. Obsessive self- and world-reflection heighten emotions of disconnection. CBT can help individuals with depersonalization-derealization disorder evaluate and challenge thoughts that increase derealization, as well as develop breathing and grounding strategies to help them cope with disembodiment and other dissociative symptoms.

Dialectical Behavioral Therapy

One of the most common personality disorders, Borderline personality disorder (BPD), is a trauma-related illness that can be treated using dialectical behavioral therapy (DBT). DBT blends mindfulness techniques and philosophy of acceptance with cognitive-behavioral tools and procedures.

DBT assists people with backgrounds of abuse and trauma to explore emotional issues without shame or guilt, and to feel much more comfortable discussing what they feel and think, by moving away from the CBT method of classifying particular ideas or feelings as bad. DBT therapies aid in the development of distress tolerance and emotional regulation.

For the management of depersonalization disorder, this type of behavioral therapy provides important insights and benefits. People who suffer from this dissociative condition have a tendency to distrust their own ideas and feelings, labeling them as negative. This skepticism is what makes people believe that their inner states, and even themselves, aren’t genuine.

DBT can help individuals reconnect with themselves by teaching them to embrace their inner states. Individuals with depersonalization-derealization disorder can benefit from DBT’s mindfulness, self-soothing, and breathing strategies which can help them reconcile with their body and the feelings of being in the moment. (source: WHO, 2019)

Eye Movement Desensitization and Reprocessing

Another technique designed expressly for patients with trauma-related problems is eye movement desensitization and reprocessing (EMDR). Its purpose is to assist people in gently and safely processing unpleasant memories, ideas, and feelings that they have been denying or avoiding.

Clients engage in EMDR by talking or thinking about painful memories while following back-and-forth audio or visual cue designed to assist their brains in reprocessing these events. While experts disagree on why this strategy works, research demonstrates that it is an effective treatment for persons who have experienced trauma, especially those who suffer from the depersonalization-derealization disorder.

EMDR, like CBT, may help individuals change their mental processes, and it can do so in a manner that is supportive and founded on physical experience, just like DBT. Because this type of therapy focuses solely on trauma, it can assist those who have suppressed or avoided terrible memories in addressing them in a secure setting.

Many persons who have derealization and depersonalization have had traumatic or non-traumatic events that prompted them to reject their emotions and conceal thoughts and memories. EMDR can help patients break past those defenses and reconnect with their emotions.

While each person diagnosed with depersonalization/derealization disease should have a unique treatment plan, there are several common therapy procedures to follow at a depersonalization treatment center, including: (source: Cochrane, 2013)

Treatment in a residential facility. The greatest location for your loved one to heal is in a treatment and rehabilitation facility. Inpatient treatment centers provide a thorough diagnosis, a personalized treatment plan, medications for any co-occurring disorders, nutrition and exercise, and holistic healing approaches.

Therapy. Individuals can learn to overcome their dysfunctional thinking and behavior patterns via psychodynamic therapy and cognitive-behavioral therapy (CBT). Family therapy, in addition to personal therapy, might be effective.

Medications. While antidepressant or antianxiety medications are not indicated for depersonalization/derealization conditions on their own, most people who suffer from it also have a co-occurring disorder for which antidepressant or antianxiety medications may be prescribed.

Holistic. Individuals suffering from depersonalization/derealization disorder have found holistic therapeutic methods to be effective. Meditation, tai chi, yoga, music, acupuncture, and art therapy all serve to create a grounded state of consciousness, which is beneficial in treatment.

The majority of patients with dissociative disorders have co-occurring disorders, the most prevalent of which are depression and anxiety. Because the symptoms of these conditions are so closely linked, it’s better to treat them all at the same time.

Depressive symptoms, such as muted emotions, emerge naturally as a result of depersonalization and derealization. When emotional abuse and trauma create derealization and depersonalization, these symptoms serve as defenses. When suppressed content becomes conscious, anxiety can occur. (source: SAMHSA, n.d.)

Medication can be an extremely beneficial tool in the treatment process when persons with depersonalization-derealization conditions and co-occurring depression or anxiety. However, based on the individual being treated and the presence of any other comorbid medical or mental health disorders, using drugs is not always necessary or the best option.

You can also discover more about other mental health issues from our web resources that are open to anybody who wants to lower anxiety, increase self-esteem, work through depression, and receive post-treatment support.

Substance Abuse and Depersonalization-Derealization Disorder

Individuals with dissociative disorders are more likely to use drugs and alcohol. Substance misuse can be triggered by the depersonalization-derealization condition in one of two ways. Substances may be used to increase the severity of depersonalization and derealization symptoms, as well as to strengthen the protective role. They may use drugs or alcohol to break down dissociative shields and feel feelings they are unable to feel natural. These interactions have the potential to quickly escalate to substance abuse.

An integrated strategy is a finest and most effective technique to treat co-occurring substance use disorders and depersonalization-derealization. This implies that many treatments should be delivered in a coordinated manner, preferably by the same treatment team or organization.

Several treatment clinics across the country employ an interdisciplinary approach to treating alcohol and drug addiction as well as co-occurring illnesses, such as depersonalization derealization disorder.

FAQs

What Are The Risk Factors For DPDR Disorder?
Depersonalization/derealization disorder has a number of established risk factors, including:
Children who have been subjected to severe abuse and neglect. When children are neglected or subjected to emotional, physical, or sexual abuse, they may learn to cope with stress and emotional anguish by developing the ability to dissociate.
Family history and genetics. Inherited features, as well as the general family environment, play a part in the development of mental illness.
Prior substance misuse and/or mental illness history.
Lifestyles that are stressful. Nearly 80 percent of individuals in one study who indicated regular stress exposure had suffered derealization and/or at some point in their lives.
Being raised by parents who are emotionally unstable.
What Are The Causes Of Depersonalization/Derealization Disorder?
Derealization is a symptom of a number of psychiatric illnesses. Derealization can occur as a result of severe anxiety or despair. Derealization can occur in those who are experiencing panic attacks as a result of anxiety disorders or memories as a result of posttraumatic stress. Derealization is a typical symptom of dissociative disorders and may be present in some forms of schizophrenia.
An individual may also feel the symptom during or shortly after a distressing event. Depersonalization and derealization can also be caused by brain injury to the temporal or occipital lobes. Derealization can be aided by drugs like marijuana, hallucinogens, pain relievers, and even heavy doses of coffee.

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