People with depersonalization-derealization disorder experience repeat episodes of detachment from reality. Find out who it affects and how it is treated.
Depersonalization-derealization disorder, sometimes also called depersonalization disorder, is a highly distressing mental illness. The American Psychiatric Association classifies it as a dissociative disorder, a class of mental health conditions that disrupt memory, awareness, identity or perception. People who have depersonalization-derealization disorder feel disconnected from their mind or body (depersonalization) or their surroundings (derealization).
While statistics show that depersonalization-derealization is a relatively rare condition, there are a few risk factors that can increase its likelihood of developing. Learning more about these risk factors as well as available treatment options is crucial if you or a loved one live with this condition.
Prevalence of Depersonalization-Derealization
Much like a panic attack, moments of depersonalization or derealization can come on suddenly and seemingly without cause. Depersonalization episodes are relatively common. About half of all Americans are thought to experience at least one or two depersonalization episodes during their lifetime. Roughly 200,000 people in the United States each day experience a depersonalization event.
Depersonalization-derealization disorder is much rarer. People with this disorder experience repeated dissociative episodes on a spectrum of severity. These episodes can make it difficult to function normally at work, in school or in social situations. Prevalence of the disorder is estimated at 2% of the population, but this disease is likely underdiagnosed. The causes of depersonalization-derealization disorder are currently not well understood. However, there are a few factors associated with a higher risk of the disorder.
Depersonalization-derealization disorder statistics show that the condition affects:
- Up to 66% of people who have experienced a traumatic event
- 30% of war veterans
- 11% of people who suffer a major head injury
- As many as 79% of people who struggle with acute stress
Age of Onset
Symptoms of depersonalization-derealization disorder usually begin showing in early childhood. The average age of onset of the disorder is 16 years old. Most diagnoses happen during adolescence. Only 5% of cases develop after the age of 25, and cases that start after the age of 40 are extremely rare. Those who have earlier ages of onset tend to have more severe cases of the disorder. While individual episodes of depersonalization may occur at any time during acute stress or trauma, the disorder is more often linked to childhood trauma.
It can be challenging to treat depersonalization-derealization disorder because it is often associated with other mental illnesses. The earlier a person receives treatment, the better the prognosis is. Those who seek help following their first depersonalization episode are much more likely to stop experiencing episodes than those who wait. That being said, recovery and effective management are still possible even if the disorder has been happening for a while. In some cases, the disorder goes away on its own.
Depersonalization and Co-Occurring Disorders
In many cases, depersonalization-derealization disorder does not occur on its own. Often, other medical conditions, especially mental health disorders, occur at the same time. Common conditions that coexist with depersonalization-derealization disorder include:
- Post-traumatic stress disorder
- Substance use disorders
- Bipolar disorder
- Traumatic brain injury
- Chronic vertigo (dizziness)
Depersonalization Treatment and Recovery
Every case of depersonalization-derealization disorder is unique. The best treatment must include appropriate therapies for both depersonalization and any other comorbid conditions at the same time. Some types of psychotherapy, such as cognitive behavioral therapy and psychodynamic therapy, can help manage both depersonalization-derealization disorder and other co-occurring mental health problems.
Ongoing Research and Studies
Because it is a rare condition, depersonalization-derealization can be difficult to study. With access to greater technology and resources, however, doctors and researchers can collect data from across the country and the world to better understand this disorder. Some scientists are mapping brain activity in people with the condition to learn if neural pathways are part of its cause. So far, MRI scans show that white matter networks in the brain may be altered in patients with depersonalization-derealization disorder.
Other research is focusing on developing better depersonalization disorder treatment strategies. Currently, progress is being made in developing tailored therapies for people with depersonalization-derealization disorder as well as other conditions that can occur alongside it. For example, a case series published in 2016 showed promise for the use of transcranial magnetic stimulation for managing depersonalization episodes. Patients who underwent 20 sessions of this non-invasive, painless procedure reduced their symptoms of depersonalization by an average of 44%.
Depersonalization-derealization disorder often affects people who use drugs, and people with the condition may turn to drugs to improve their symptoms. If you or someone you love is living with co-occurring depersonalization-derealization disorder and substance abuse, specialized help is available. Contact The Recovery Village today to learn what your options are.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” May 2013. Accessed April 20, 2019.
Health Research Funding. “21 Interesting Depersonalization Disorder Statistics.” Accessed May 11, 2019.
Dadi G, Dervaux A, Krebs MO, Gaillard R, Laqueille X, Plaze M. “Persistent Depersonalization/Derealization Disorder Induced by Synthetic Cannabinoids.” The American Journal of Psychiatry, August 1, 2016. Accessed May 11, 2019.
Toupet M, Van Nechel C, Hautefort C, Heuschen S, Duquesne U, Cassoulet A, Grayeli AB. “Influence of Visual and Vestibular Hypersensitivity on Derealization and Depersonalization in Chronic Dizziness.” Frontiers in Neurology, February 13, 2019. Accessed May 11, 2019.
Sierk A, Daneils JK, Manthey A, Kok JG, Leemans A, Gaebler M, Lamke JP, Kruschwitz J, Walter H. “White matter network alterations in patients with depersonalization/derealization disorder.” Journal of Psychiatry & Neuroscience, June 6, 2018. Accessed May 11, 2019.
Jay EL, Nestler S, Sierra M, McClelland J, Kekic M, David AS. “Ventrolateral prefrontal cortex repetitive transcranial magnetic stimulation in the treatment of depersonalization disorder: A consecutive case series.” Psychiatry Research, June 30, 2016. Accessed May 11, 2019.
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