In A Better You, Syndromes & Disorders

Derealization – Depersonalization–Here is what is What

What is “Derealization”? Derealization has been described as if someone were looking at their world from the outside in, sort of like observing themselves from above. Although as authors we do not use blogger’s post as examples, research into the subject of derealization described by one blogger was put into perspective and is equivalent to the definition provided by research into this disease.

This blogger inserted a video from YouTube as an example of how derealization appears to them titled “The City of Samba” (Loutit, 2012). If this assist in helping someone explain to their physician exactly what it is they see or how they feel, it is well worth inserting it into this article.

By using this video link and the information from this blog, we are not promoting this video by any means, however the video and the blog are both informative and matched the definition of derealization and depersonalization, as well as, how the disease affects this person and many more.

Many researchers have suggested that derealization and depersonalization go hand in hand. “Derealization is a subjective experience of unreality of the outside world, while depersonalization is unreality in one’s sense of self. Although most authors currently regard derealization (surroundings) and depersonalization (self) as independent constructs, many do not want to separate derealization from depersonalization” (Radovic F., Radovic S. (2002)). The main reason for this is nosological, because these symptoms often co-occur, but there is another, more philosophical reason: the idea that the phenomenological experience of self, others, and world is one continuous whole. Thus, feelings of unreality may blend in and the person may puzzle over deciding whether it is the self or the world that feels unreal to them.

Chronic derealization may be caused by occipitaltemporal dysfunction (Sierra M, Lopera F, Lambert MV, Phillips ML, David AS (2002)). These symptoms are common in the population, with a lifetime prevalence of up to 5% and 31–66% at the time of a traumatic event” (Hunter EC, Sierra M, David AS (2004)).

The blogger (devoidzer0) describes derealization as this: “It’s probably different for everyone, but for me the derealization takes the form of reality having a fake, insubstantial feeling. I see the world perfectly clearly (not through a haze or wool cloth), but all of the depth and emotion feels sucked out of everything. My perspective of everything feels small, almost like I am looking at a model of the world instead of the real thing, and there is no emotional atmosphere to anything. The world feels dead to me. It’s been so long, I don’t remember what normal feels like” (devoidzer0, 2012).

As a person not afflicted with derealization, after viewing the video, there was an understanding of how this could affect others. We may find beauty in the video, however, from another’s perspective viewing their “real” world as this video on a persistent day to day basis is very disturbing and unsettling.

The medical definition of derealization is also associated with depersonalization and is defined as: “Depersonalization/derealization disorder (DP/DR-D) involves persistent episodes of depersonalization (DP) and/or derealization (DR), states that represent a changed overall experience in self-awareness. DP includes an altered, estranged, or detached subjective experience of one’s self, one’s mental processes, and one’s body during which people feel that they are robots or that they are in a dream. DR often accompanies DP in which the external world also appears strange or unreal (American Psychiatric Association [APA], 1994; World Health Organization [WHO], 1992). People with DP/DR-D typically report feeling as if they were spectators observing a play of the self or as if they were observing themselves from a distance. They may fear a loss of control over their thoughts and actions or that they are going crazy. Their capacity for reality testing, however, remains intact (e.g., knowing that one is not literally a robot). As well as these core diagnostic criteria, sufferers often report marked distress or impairment in social, occupational, or other functioning. Studies reveal the prevalence of DP/DR-D is within the range of 1–2% (Hunter, Sierra, & David, 2004).” (Sacco, 2010).

Researchers from the (Staff, 1998-2014) of the Mayo Clinic describe derealization symptoms as the following:

  • Feelings of being alienated from or unfamiliar with your surroundings, perhaps like you’re living in a movie
  • Feeling emotionally disconnected from people you care about, as if you were separated by a glass wall
  • Surroundings that appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings
  • Distortions in perception of time, such as recent events feeling like distant past
  • Distortions of distance and the size and shape of objects

© 1998-2014 Mayo Foundation for Medical Education and Research. All rights reserved

Derealization Causes may pertain to (Staff, 1998-2014):

  • Growing up with a significantly impaired mentally ill parent
  • Suicide or unexpected death of a close friend or family member
  • Severe stress, such as relationship, financial or work-related problems
  • Severe trauma, such as a car accident

© 1998-2014 Mayo Foundation for Medical Education and Research. All rights reserved

Basically, traumatic events could be the trigger for derealization/depersonalization.

Are there treatments and/or cures for depersonalization and derealization? Yes…

  • Psychological counseling. This helps you understand why depersonalization and derealization occur, and helps you gain control over the symptoms so that they go away. Two such techniques include cognitive behavioral therapy and psychodynamic therapy. Depersonalization-derealization disorder may also improve when counseling helps with other mental health conditions, such as depression.
  • Medications. While there are no medications specifically approved to treat depersonalization-derealization disorder, certain medications that are used to treat depression and anxiety may help. Examples that have been shown to relieve symptoms include fluoxetine (Prozac), clomipramine (Anafranil) and clonazepam (Klonopin).

Depression is a major side effect of derealization/depersonalization. Understandably so. A lot of people do not understand nor can they comprehend that derealization symptoms ARE real. They do exist. You are not crazy, you are not losing your mind, your perception of the world may be skewed, however; there is help.

If you or you suspect a loved one may be experiencing these types of symptoms, don’t dismiss it, seek professional help. There are medications to assist with the anxiety (another trigger of derealization), as well as, counseling. Talk with your physician or a mental health professional.

Derealization and Depersonalization may sometimes be temporary, however, if not dealt with could last for years. Finding the source of the problem is extremely important. As noted earlier traumatic events may trigger derealization, even if you have never experienced this before. Know it is NOT who you are, derealization is real, it has symptoms, affects your life, but also, has cures or is at least manageable.


American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.

American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association. ISBN 0-89042-024-6.

devoidzer0. (2012, March 9). This is what derealization looks like to me (video) – WOW! Retrieved November 24, 2014, from DPSELFHELP – Deperonalization Community:

Hunter, E. C., Phillips, M. L., Chalder, T., Sierra, M., & David, A. S. (2003). Depersonalisation disorder: A cognitive-behavioural conceptualisation. Behaviour Research and Therapy, 41(12), 1451–1467.doi:10.1016/S0005-7967(03)00066-4

Hunter EC, Sierra M, David AS (2004). “The epidemiology of depersonalization and derealisation. A systematic review”. Social psychiatry and psychiatric epidemiology 39 (1): 9–18.doi:10.1007/s00127-004-0701-4. PMID 15022041

Loutit, K. (2012, February 24). The City of Samba. Retrieved November 24, 2014, from YouTube:

Radovic F., Radovic S. (2002). “Feelings of Unreality: A Conceptual and Phenomenological Analysis of the Language of Depersonalization”. Philosophy, Psychiatry, & Psychology 9: 271–9.doi:10.1353/ppp.2003.0048

Sacco, R. G. (2010, December). The Circumplex Structure of Depersonalization/Derealization, Vol. 2, No 2. Retrieved November 24, 2014, from International Journal of Psychological Studies:

Sierra M, Lopera F, Lambert MV, Phillips ML, David AS (2002). “Separating depersonalisation and derealisation: the relevance of the “lesion method””. J. Neurol. Neurosurg. Psychiatr.72 (4): 530–2. PMC 1737835. PMID 11909918

Staff, M. C. (1998-2014). Depersonalization-derealization disorder. Retrieved November 23, 2014, from Mayo Foundation for Medical Education and Research:

World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva, Switzerland: World Health Organization.

Sacco, R. G. (2010, December). The Circumplex Structure of Depersonalization/Derealization, Vol. 2, No 2. Retrieved November 24, 2014, from International Journal of Psychological Studies:

Staff, M. C. (1998-2014). Depersonalization-derealization disorder. Retrieved November 23, 2014, from Mayo Foundation for Medical Education and Research:

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