Depersonalization-derealization disorder, sometimes just called derealization disorder, is a mental illness that affects an individual’s perception of reality, causing them to question what’s real. A person with this condition may feel disconnected from their own body, mind, and feelings (depersonalization) or their surroundings (derealization).
As a relatively uncommon and misunderstood condition, there are many misconceptions about depersonalization-derealization disorder. Myths about the condition can be harmful and prevent people from receiving the help that they need. Knowing the facts about depersonalization-derealization disorder can help debunk these myths and better support those who are dealing with the condition.
1. Myth: There are different types of depersonalization.
Fact: There is only one type of depersonalization-derealization disorder.
No two cases of depersonalization-derealization disorder are identical. Everybody experiences the condition and its symptoms differently. However, there are enough similarities between cases that experts have not identified any subtypes of the disease.
Depersonalization and derealization used to be considered two different disorders. However, psychologists found that the two had the same characteristics. In 2013, the American Psychiatric Association merged both into a single disorder. They state in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), “There is no evidence of any distinction between individuals with predominantly depersonalization versus derealization symptoms. Therefore individuals with this disorder can have depersonalization, derealization or both.”
2. Myth: Depersonalization can turn into schizophrenia.
Fact: Depersonalization-derealization disorder and schizophrenia are two distinct illnesses, and one does not turn into the other.
Not everyone who experiences a depersonalization or derealization episode has depersonalization-derealization disorder. In fact, about half of all Americans will experience such an episode during their lifetime, though only about 2% actually have the disorder.
People with schizophrenia often experience depersonalization episodes, especially earlier in their disease, which fades as the disease progresses. These episodes, however, are not part of depersonalization-derealization disorder. By definition, the symptoms of depersonalization-derealization are “not better accounted for by another disorder,” such as substance use or schizophrenia. Further, schizophrenia is caused by an organic condition in the brain, while depersonalization-derealization can develop from life experiences like trauma. Therefore, depersonalization-derealization disorder cannot turn into schizophrenia.
3. Myth: Depersonalization is a permanent condition.
Fact: Many people recover from depersonalization-derealization disorder, often without treatment.
Some mental illnesses are considered lifelong conditions, but this is not the case with depersonalization-derealization. Often, it is only a transient or temporary condition related to stressful periods of life that lasts for different amounts of time for different people. For many, episodes of depersonalization become less severe and less frequent over time. Treatment can be very successful and lead to a complete discontinuation of symptoms.
4. Myth: Depersonalization-derealization can be treated with medication.
Fact: Psychotherapy is currently the only approved method for treating depersonalization-derealization disorder.
There are currently no medications that are effective in addressing depersonalization-derealization disorder. A few have been tried but did not show improvements in patients. However, some pharmaceutical drugs, like antidepressants, can treat co-occurring disorders, which can help with depersonalization symptoms. Many patients have other mental illnesses along with depersonalization-derealization, such as depression or anxiety, which can improve with medication.
Psychotherapy is the main course of treatment for depersonalization-derealization disorder. In particular, psychodynamic therapy can be very helpful. This type of therapy can help patients learn to function normally when having episodes and manage the stressors that may trigger episodes.
5. Myth: Recovery is impossible.
Fact: It is possible to recover from depersonalization-derealization disorder.
Most people eventually fully recover from depersonalization-derealization disorder. While some recover on their own, others require years of therapy. Most eventually experience a decrease or total end to symptoms.
Episodes of depersonalization or derealization can be triggered by drug or alcohol abuse. If you or a loved one is struggling with a substance use disorder and depersonalization-derealization, specialized help is available. Contact The Recovery Village today to learn what resources are available.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” May 2013. Accessed April 20, 2019. Speigel, D. “Depersonalization/Derealization Disorder.” Merck Manual, March 2019. Accessed May 24, 2019. Luque-Luque R, Chauca-Chauca GM, Alonso-Lobato P, Jaen-Moreno MJ. “Depersonalization and schizophrenia: Comparative study of initial and multiple episodes of schizophrenia.” Revista de Psichiatria y Salud Mental, July-September 2016. Accessed May 24, 2019. Gentile JP, Snyder M, Gillig PM. “STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization-Derealization Disorder.” Innovations in Clinical Neuroscience, July-August 2014. Accessed May 24, 2019.
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” May 2013. Accessed April 20, 2019.
Speigel, D. “Depersonalization/Derealization Disorder.” Merck Manual, March 2019. Accessed May 24, 2019.
Luque-Luque R, Chauca-Chauca GM, Alonso-Lobato P, Jaen-Moreno MJ. “Depersonalization and schizophrenia: Comparative study of initial and multiple episodes of schizophrenia.” Revista de Psichiatria y Salud Mental, July-September 2016. Accessed May 24, 2019.
Gentile JP, Snyder M, Gillig PM. “STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization-Derealization Disorder.” Innovations in Clinical Neuroscience, July-August 2014. Accessed May 24, 2019.