Depersonalization vs. Derealization: What’s the Difference?

Depersonalization and derealization are both symptoms of mental health problems. These symptoms are commonly associated with a condition called a depersonalization-derealization disorder.

Depersonalization-derealization disorder (DPDR) is a mental health issue characterized by these two major symptoms that affect your perception of reality. However, unlike psychosis and other dissociative disorders, people with DPDR can test reality and remain aware of it. In other words, DPDR may affect your perception of reality without you detaching from it.

Depersonalization and derealization commonly occur together and may share some similarities, but they are two distinct mental health problems. What are the symptoms associated with these two psychological phenomena, and how are they different? Learn more about depersonalization and derealization and their distinction.

What Is Depersonalization?

Depersonalization (DP) is a psychological phenomenon that occurs naturally as a response to trauma or stress. When depersonalization lasts for a long time or occurs frequently, it may indicate a depersonalization disorder. DP disorder is in a category of mental health issues called dissociative disorders, which involves a disconnect from reality. Depersonalization isn’t just one symptom. It’s a mental phenomenon that can describe several symptoms that are associated with one another. When they occur, it can be frightening, especially if multiple symptoms happen at the same time. However, they may have some specific causes, and DP can be effectively treated.

Depersonalization is thought to be a natural response connected to fight or flight. In traumatic situations that you can’t run away from or fight, your brain may disconnect you from the moment by making you a passenger in your own body or distorting the experience to soften the psychological blow. Depersonalization is often referred to as a psychological airbag. It can be unpleasant and even painful, but it protects you from potentially damaging trauma.

The Symptoms of Depersonalization

The symptoms of depersonalization are often bizarre and frightening. It’s important to keep in mind that a person who experiences these strange symptoms still knows they aren’t real. Depersonalization differs from derealization, though they are often connected and experienced simultaneously. Depersonalization has to do with your perception of yourself. You feel like you’re not real. You feel like your memories aren’t yours. You feel that you’re cut off from reality. Here are some of the common symptoms.

Cut Off from Reality

One of the most common symptoms is feeling cut off from reality. This may be described as feeling like there’s an extra barrier between you and the real world, like a pane of glass that you’re looking through. This may also seem like an out-of-body experience. People often report feeling like they are floating over their body, looking down at themselves. This is the classic out of body experience that people report during moments of immense trauma. But it can also feel like you’re in your body, but you’re a distant observer who’s disconnected from your surroundings.

Feeling Unreal

While the out-of-body experience makes people feel like they’re a disconnected observer, another symptom involves feeling synthetic. People describe this as feeling like a robot that’s along for the ride in their body. They may also feel like they aren’t in control of themselves. This isn’t to say they can’t control their actions. Instead, it seems like actions and movements that you make aren’t yours. You may feel that your limbs or your voice belong to someone else. Though this may cause fears that you may lose control and do something you don’t want to do, that won’t happen. Realizing that you’re in control, despite feeling like your body is not your own, may help ease anxieties and DP symptoms.

Body Distortion

This may feel like your body or limbs are distorted, not your own, or too big or too small. You may also feel like your head is in a fog or wrapped in cotton, which can contribute to the foggy, dreamlike symptoms of derealization.

Numb Senses and Emotions

Emotional numbness is a common symptom of both depersonalization and derealization. General emotional numbness can contribute to a psychological fog that makes your environment seem less real. You may also feel no emotion toward your memories, causing you to feel they may not be yours.

What Is Derealization?

While depersonalization involves your perception of yourself and your relationship to your body and surroundings, derealization has to do with your perception of the world around you. You may feel the world is distorted, your vision is blurred, and that you’re in a dream or simulation.

A Dream-Like State

A common DPDR symptom is feeling like you’re in a mental fog or a dream-like state. You may feel like you’re in a dream and that the people and environment around you aren’t real. You may feel like you’re in a simulation and that everything around you is only a part of that simulation.

Visual Distortions

Visual distortions can include tunnel vision, floaters, visual snow, altered distance, and altered object sizes. These distortions can feel so real that people with the disorder will visit eye doctors to check their vision. Many of these symptoms are caused by hyper-awareness. Floaters, snow, and tunnel vision can occur as a normal part of your vision that you don’t usually notice. This symptom can also cause you to feel like everything is two-dimensional.

Time Distortion

You may feel like there are time gaps, time is moving faster than normal, or that you’re in a time-lapse. In reality, that may be a product of anxiety of being hyper-focused on fears. This can cause you to lose track of time, or you may have trouble remembering what happened while you were focused on anxiety.

Will DPDR Make You Go Insane?

A smooth face with no personality

This is a fear many people experience when they have DPDR, and it’s really just another symptom of the disorder. Despite your strange feelings, DPDR won’t make you go insane. In order to be qualified as DPDR, it means your symptoms don’t cause you to lose your grip on reality.

DPDR causes symptoms of unreality, despite your ability to reason through what is and isn’t real. Part of the frightening nature of DPDR is that your feelings don’t line up with what you know to be true and real. But even in severe cases, DPDR doesn’t cause you to go insane, or to completely lose your sense of reality.

The lost sense of reality is referred to as psychosis, and it’s a mental health issue that’s associated with other diagnoses like schizophrenia. DPDR may be mistaken for psychosis, but someone with DPDR is always aware that their dissociative feelings aren’t real.

How Is DPDR Diagnosed?

DPDR is an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). A doctor or clinician can evaluate your experiences with dissociative symptoms to determine if you have the disorder. For your symptoms to qualify as DPDR:

  • You have to have persistent or recurring DP or DR symptoms.
  • You have to maintain the ability to test and reason through perceptions to determine reality.
  • Your symptoms must cause distress that interferes with your life.
  • Your symptoms can’t be explained by drug use.
  • Your symptoms can’t be explained by another mental health condition.

If you do have DPDR, treatment options are available. In many cases, addressing underlying anxiety or trauma can help alleviate dissociative symptoms. Medication and therapy options can help you to effectively manage anxiety.

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