Am I Experiencing Depersonalization And Derealization?

Depersonalization-derealization disorder is a condition characterized by feelings of unreality and detachment from your self (your emotions, thoughts, memories, or body sensations), or feelings of unreality and detachment from the world around you. It is experienced by between 1 and 2 people out of every 100 (Stein, 2016; Kessler et al, 2005) but like many anxiety disorders, it is under-diagnosed and often goes unrecognized (Hunter et al, 2017; Kasper, 2006).

Depersonalization describes experiencing the self as strange or unreal, or feeling detached from one’s thoughts, feelings, sensations, body, or actions, as if one were an external observer. It may take the form of emotional or physical numbing, or a sense of watching oneself from a distance or ‘being in a play’. It can also cause perceptual alterations, such as a distorted sense of time.

Derealization consists of experiencing other persons, objects, or the world as strange or unreal (it might seem dreamlike, distant, foggy, lifeless, colorless, or visually distorted) or feeling detached from one’s surroundings.

The DSM-5 diagnostic criteria for depersonalization-derealization disorder include:

• The presence of persistent or recurrent experiences of depersonalization, derealization, or both.
• Intact reality testing during depersonalization or derealization experiences.
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The ICD-11 diagnostic criteria for depersonalization-derealization disorder include: 

• Persistent or recurrent experiences of either depersonalization or derealization (or both).
• During experiences of depersonalization or derealization, reality testing remains intact. The experiences are not associated with delusions or beliefs that the individual is being controlled by external persons or forces.
• The symptoms are not better accounted for by another mental disorder (e.g., post-traumatic stress disorder, an anxiety or fear-related disorder, another dissociative disorder, personality disorder).
• The symptoms are not caused by a substance or medication on the central nervous system, including withdrawal effects, and are not due to a disease of the nervous system (e.g., temporal lobe epilepsy), head trauma, or another medical condition.
• The symptoms result in significant distress or impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort.

Am I Experiencing Depersonalization And Derealization? is an indicative screening tool, designed to help clients self-assess whether their experiences might warrant further investigation. It is not intended to give a formal diagnosis or provide a measure of severity.

Some people who report similar experiences to yours have a condition called depersonalization-derealization disorder. Would you like to try a short quiz that could give us an idea of whether this problem troubles you?

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Kasper, S. (2006). Anxiety disorders: under-diagnosed and insufficiently treated. International Journal of Psychiatry in Clinical Practice, 10(sup1), 3-9.
• Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. 
• Hunter, E. C., Charlton, J., & David, A. S. (2017). Depersonalisation and derealisation: assessment and management. BMJ, 356.
• Stansfeld, S., Clark, C., Bebbington, P., King, M., Jenkins, R., & Hinchliffe, S. (2016). Chapter 2: Common mental disorders. In S. McManus, P. Bebbington, R. Jenkins, & T. Brugha (Eds.), Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014. Leeds: NHS Digital. 
• Stein, D. J., Lim, C. C., Roest, A. M., De Jonge, P., Aguilar-Gaxiola, S., Al-Hamzawi, A., ... & De Girolamo, G. (2017). The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC medicine, 15(1), 143. 
• World Health Organization. (2019). ICD-11: International classification of diseases (11th revision). Retrieved from https://icd.who.int/