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Many of us have found ourselves going through the motions and lacking a sense of presence at times. But if you experience these feelings of confusion about what you're doing, where you are, and maybe even who you are frequently, it might mean you have a dissociative disorder. According to the Mayo Clinic, dissociative disorders are "mental health disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity."
A common but not often-talked about dissociative disorder is depersonalization, which New York-based neuropsychologist Dr. Sanam Hafeez says is when you feel detached from your thoughts and body. "The disorder is feeling as if you are observing yourself in a dream or from outside your body," she explains.
Depersonalization disorder often gets confused with derealization disorder, yet while the two are similar, there are key differences. Ahead, learn what those differences are, including more about the symptoms of depersonalization, what causes it, and how to treat it.
What is depersonalization disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders, depersonalization is a dissociative disorder described as a persistent or recurrent feeling of being detached or estranged from one's self. As Board-certified psychiatrist Dr. Rashmi Parmar explains, "a person might feel like they are an outside observer of their thoughts, feelings, actions, or body."
Depersonalization disorder can cause significant distress and impairment because a person is living in an altered perception of their own life. However, it isn't a psychotic illness or delusion because they are aware of these disconnected feelings. "Patients often describe it to me as an incredibly scary and uncomfortable experience," says Dr. Parmar.
What causes depersonalization?
There can be many causes of depersonalization disorder. Dr. Hafeez says a traumatic event or prolonged stress, such as a sudden death or witnessing or experiencing extreme violence, can often trigger the disorder. It's also frequently associated with other mental health disorders, such as depression, anxiety, PTSD, or schizophrenia.
Dr. Parmar adds that depersonalization disorder can also be caused by physical changes or disruptions in your body, like neurological illnesses such as epilepsy or complicated migraines, drug or alcohol withdrawal, or side effects from certain sedative medications.
What are the symptoms of depersonalization disorder?
"The main symptoms include, but are not limited to feeling robotic and not in control of your movements or speech, inability to describe or recognize emotions, and feeling disconnected to your mind, sensations, or body," Dr. Hafeez.
The Mayo Clinic notes that it's also common to feel a sense of emotional and physical numbness, detachment from your memories as though they aren't your own, and a distorted perception of your body, like your limbs are enlarged or shrunken.
What's the difference between depersonalization and derealization?
Both derealization and depersonalization involve feelings of disconnect, but depersonalization is how you view yourself, while derealization involves how you view the outside world. "So in essence, the former condition (depersonalization) directs the unreal perception towards the inner self whereas the other involves projecting this feeling on the environment," says Dr. Parmar.
"Derealization is when you feel as if you're observing the world through a veil and feel detached from your environment and the people and objects in it," adds Dr. Hafeez. Symptoms include feelings of being in a dream, like you're living in an unreal or artificial world, distorted perceptions of sound, and feelings of time passing too fast or too slow.
What is the treatment for depersonalization disorder?
According to Dr. Parmar, most people will experience depersonalization or derealization at some point in their lives. However, if it begins to interfere with your ability to function or seems like it doesn't go away, it's necessary to seek help. The most common way to treat depersonalization disorder is through psychotherapy.
"Psychotherapy can help individuals learn techniques or coping mechanisms that distract them from their symptoms and make them feel more connected to their feelings and the world around them," says Dr. Hafeez.
Dr. Parmar says reducing stress levels can also play a vital role in treating depersonalization disorder. "Use of stress reduction techniques like relaxation skills, mindfulness, and distraction can be quite effective," she notes. "Maintenance of a well-structured routine with adequate nutrition, hydration, sleep, and exercise may also help in reducing symptoms."
If you're having an episode of depersonalization, distracting yourself by throwing cold water on your face, doing sudden quick movements like jumping jacks, or engaging in deep breathing can help bring your awareness back to reality, says Dr. Parmar. And in addition to psychotherapy, both experts say prescribed medications, like antidepressants or anti-anxiety drugs, can be helpful.
Ultimately, don't be afraid to seek help from a professional to help you get your life back on track.