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  • Aisha Marie Sho

Depersonalization/derealization disorder

Updated: Jun 4

Often when people are experiencing trauma their minds become so overwhelmed with the gravity of the traumatic event that they dissociate from that event. This can result in the fragmentation of one’s personality, where memories are often difficult to integrate and a person cannot make sense of his or her own past or reality. There are a number of dissociative disorders, one of the most widely known being Dissociative Identity disorder (DID) which was formerly known as multiple personality disorder. In DID the individual becomes so fragmented that he or she fails to adjoin the different aspects of past experiences and consciousness into one integrated whole.


On the lower end of the dissociative spectrum is Depersonalization/derealization disorder. In this disorder the person can feel as if he or she is outside of his or her own body and merely observing life from the outside instead of consciously living and making decisions for oneself. Although this separation from reality may vaguely mimic psychosis the difference is that someone with Depersonalization/derealization disorder is aware that the sensation of not being in one’s own body is not real. They are aware that this feeling is only an illusion, which can lead them to feel as if they are going crazy when they are perfectly sane. Their brains simply dissociated due to a traumatic event or a series of events. This is the brain’s way of protecting itself when faced with danger, in an effort to not feel any pain.


Some people who are diagnosed with Depersonalization/derealization disorder only experience one aspect of the disorder. One who depersonalizes his or her experiences feels as though he or she is observing his or her own life as a third party. As one would when watching a TV show or movie. They may feel no connection to their own emotions and can even lack the ability to put what they’re feeling into words. Memories of the traumatic event can be forgotten and a sense of numbness to pain and pleasure may be all encompassing.


In derealization one feels a sense of detachment from his or her environment as a whole. Not only do they feel detached from themselves, but also from the people and objects in their environment. Derealization can also result in physical symptoms, such as impaired vision or the distortion of objects and images in one’s environment. It is not uncommon for a person experiencing derealization to witness floaters, defined as, “Spots in your vision. They may look to you like black or gray specks, strings, or cobwebs that drift about when you move your eyes and appear to dart away when you try to look at them directly,” (Mayo Clinic Staff, 2019). The reason for this being that the mind is in a state of fight or flight and is constantly scanning its environment for impending danger. Since there is no physical danger present one’s range of vision becomes conscious of minor details which it would have otherwise not noticed, had it not been in a state of hypervigilance.


The treatment for Depersonalization/derealization disorder include cognitive behavioral therapy, psychodynamic therapy, and dialectical behavioral therapy. Practices such as mindful meditation can be helpful as well, as the practitioner should seek to integrate all aspects of one’s conscious awareness in the present moment. No medications specifically treat Depersonalization/derealization disorder, although a patient may be prescribed anti-anxiety antidepressant medication. The most important factor to overcoming this disorder is to effectively identify and address the source of the trauma and the triggers which accompany it.


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