DPDR
Depersonalization/
Derealization Disorder
Depersonalization/Derealization Disorder (DPDR) is a dissociative disorder characterized by persistent or recurrent experiences of feeling detached from oneself (depersonalization) or perceiving the external world as unreal or distorted (derealization). These experiences are often described as feeling like an outside observer of one’s thoughts, body, or actions, or as though the world around them is foggy, dreamlike, or artificial.
Unlike occasional moments of zoning out or daydreaming, DPDR episodes can last for hours, days, or even longer, creating a constant sense of detachment that makes it difficult to feel present. People with this disorder often say it feels like “living in a movie” or being “trapped behind glass,” watching life happen rather than experiencing it. They may feel emotionally numb or disconnected from their physical sensations, struggling to recognize their reflection or feel ownership of their body.
DPDR is different from ordinary distraction or fatigue; it causes significant distress and disruption to daily life. For example, a person might be in a conversation with friends and suddenly feel as though they’re watching the interaction from outside their body, unable to fully engage or feel emotion, even though they know the situation is real. This can lead to confusion, anxiety, and frustration about why they can’t “snap back” into reality.
While the disorder is often linked to trauma, severe stress, or anxiety, the causes are complex and can involve biological, psychological, and environmental factors. Episodes can be triggered by overwhelming emotional experiences, panic attacks, or periods of chronic stress. Over time, DPDR can erode a person’s sense of identity and confidence in their perception of reality, making professional support essential for recovery and stability.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), DPDR is classified under Dissociative Disorders. It is defined by persistent or recurrent experiences of depersonalization, derealization, or both, with intact reality testing. This means the individual recognizes that their experiences are not actually real, distinguishing DPDR from psychotic disorders.
Symptoms
Symptoms of DPDR can vary in intensity and duration, but common experiences include:
Persistent feelings of being detached from one’s body or thoughts (depersonalization).
Feeling like an outside observer of one’s own actions, emotions, or experiences.
A sense that the external environment is unreal, dreamlike, or distorted (derealization).
Emotional or physical numbness, difficulty connecting with others, or a sense of alienation.
Anxiety, depression, or panic attacks often accompanying dissociative episodes.
Difficulty concentrating, memory lapses, or feeling “foggy” or disconnected.
Episodes can last for minutes, hours, or even longer and may be triggered or worsened by stress, trauma, sleep deprivation, or anxiety. While not inherently psychotic, DPDR can be distressing and confusing for those experiencing it.
Treatment
Treatment for Depersonalization/Derealization Disorder focuses on reducing symptoms, managing triggers, and improving functioning and quality of life.
Psychotherapy:
Cognitive Behavioral Therapy (CBT): Helps individuals recognize and challenge distorted perceptions and maladaptive thought patterns that exacerbate feelings of detachment.
Mindfulness and grounding techniques: Encourage reconnecting with the present moment and physical sensations to reduce dissociation.
Trauma-focused therapy: Addresses underlying traumatic experiences that may contribute to dissociative responses.
Medication:
No medications are specifically approved for DPDR, but selective serotonin reuptake inhibitors (SSRIs) or anti-anxiety medications may help manage co-occurring symptoms such as depression or anxiety.
Self-Management and Lifestyle Strategies:
Prioritizing regular sleep, balanced nutrition, and stress management.
Using grounding exercises such as deep breathing, sensory engagement, or journaling during episodes.
Avoiding drugs or alcohol, which can worsen dissociation.
With consistent therapy, self-care, and coping strategies, individuals with DPDR can reduce the frequency and intensity of dissociative episodes and regain a stronger sense of connection with themselves and their environment.
How to Support Someone with DPDR
Supporting someone with Depersonalization/Derealization Disorder (DPDR) requires empathy, patience, and a calm presence. Because this disorder affects how individuals perceive themselves and their surroundings, it can be frightening and confusing—both for the person experiencing it and for those around them. The goal of support is not to “snap them out of it,” but to help them feel safe, grounded, and understood.
The first and most important step is to believe and validate their experience. Even if what they describe sounds difficult to imagine—such as feeling detached from their body or like the world isn’t real—it’s crucial to acknowledge that these sensations are real and deeply distressing to them. Dismissing or minimizing their feelings can increase anxiety and isolation. A simple response like, “I believe you, that sounds really hard,” can go a long way in building trust and comfort.
Providing stability and reassurance is equally important. People with DPDR often feel disoriented, so creating a calm, predictable environment can help reduce anxiety. Consistent routines, gentle reassurance, and avoiding overwhelming stimuli can make a significant difference. It also helps to speak softly and clearly when they’re in an episode, reminding them that they are safe and that the experience will pass.
Encouraging professional help is essential. Therapy—especially trauma-focused or cognitive-behavioral approaches—can help individuals process underlying causes and learn grounding techniques. Offer to help them find a therapist or accompany them to appointments if they’re comfortable with it. Emphasize that seeking help is a sign of strength, not weakness.
You can also support them by offering grounding techniques to reconnect with the present moment. Encourage practices that engage the senses, like holding something textured, describing the surroundings out loud, or practicing slow, mindful breathing. Activities such as walking, listening to music, or stretching can also help them feel more anchored.
Finally, remember to be patient with emotional fluctuations. Dissociation is not something they can control or stop on command. Avoid expressing frustration or guilt-tripping them for appearing “distant” or “zoned out.” Instead, focus on being a steady, understanding presence.
Your role is not to fix what they’re going through, but to offer compassion, reassurance, and gentle consistency while encouraging professional care. With the right combination of empathy, grounding, and therapeutic support, people living with DPDR can learn to manage symptoms and regain a stronger sense of connection to themselves and the world around them.
Depersonalization/Derealization Disorder is a challenging dissociative condition that can cause significant distress and interfere with daily life. Although the experiences can feel isolating and confusing, effective treatment and coping strategies can help individuals reconnect with themselves and the world around them. With therapy, grounding techniques, and supportive relationships, those living with DPDR can regain a sense of stability, clarity, and control over their experiences, allowing them to lead fulfilling and meaningful lives.
If you or someone you know is experiencing suicidal thoughts, self-harm, or severe mental health distress, immediate help is available.
United States & Canada: Call or text 988 (Suicide & Crisis Lifeline)
International: You can find local hotlines worldwide here: https://findahelpline.com
If immediate danger is present, always contact your local emergency services.
