Derealization in teenagers: Everything to know

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Depersonalization-derealization disorder (DPDR) is a type of dissociative disorder. It involves feelings of detachment — or dissociation — from a person’s mental processes or body. It can also involve feelings of detachment from a person’s surroundings, which is also known as derealization. DPDR can activate due to severe stress.

Around 50% of people will experience at least one episode of depersonalization or derealization in their lifetime. However, only 2% of them will meet the criteria for DPDR.

People with DPDR will typically experience either depersonalization, derealization, or both. Health experts can define these conditions in the following ways:

• Depersonalization: Experiencing unreality or detachment from one’s self, body, or mind. An individual experiencing depersonalization may feel as though they are outside of their body watching events take place.
• Derealization: Experiencing unreality or detachment from one’s surroundings. A person may feel as though the world around them is not real.

Derealization and depersonalization can occur with physical conditions, such as seizure disorders. It is also common for symptoms of DPDR to co-occur with mental health conditions, including:

• psychotic disorders, such as schizophrenia or bipolar disorder
• post-traumatic stress disorder
• panic disorder
• borderline personality disorder
• acute stress disorder
• generalized anxiety disorder
• obsessive-compulsive disorder

People experiencing derealization experience a detachment from their surroundings. People, objects, and other items around them seem unreal.

They may feel as though they are in a fog or a dream. Some people describe it as feeling as though there is a glass wall separating them from their surroundings. Objects may appear unusually clear or blurry. They may seem bigger or smaller than they typically would. Sounds may appear louder or quieter than usual, and time may feel as though it is moving slower or quicker than usual.

However, generally, people experiencing derealization understand that what they are experiencing is not real but simply how they feel. This separates derealization from psychosis.

Dissociative disorders, such as DPDR, typically develop as a way for a person to deal with trauma.

People may experience derealization due to severe stress, including:

• emotional abuse or neglect during childhood
• physical abuse
• witnessing domestic violence
• having a mentally ill or severely impaired parent
• when a close friend or family member dies unexpectedly

Other triggers of derealization may include:

• interpersonal or occupational stress
• depression
• anxiety
• using illegal drugs, such as cannabis, ketamine, or hallucinogens

Treatment for derealization largely involves psychotherapy. Some common psychotherapies mental health professionals may recommend include:

• cognitive behavioral therapy
• dialectal behavioral therapy
• eye movement desensitization and reprocessing

There is no specific medication that researchers have proven to be effective in treating DPDR. However, healthcare or mental health professionals may recommend medications to treat co-occurring conditions, such as anxiety or depression.

People who experience derealization may find that it goes away on its own over time. This may occur following the removal of the triggering stressor from their life. However, for some, derealization can become chronic. This may require treatment from a mental health professional.

There are ways to support a loved one experiencing derealization. These include the following measures:

• Try to be patient and understanding.
• Ask them what they believe may help.
• Listen with acceptance and without judgment if they choose to talk about their experiences.
• Discuss touching with them before doing so. Some may find touch from others uncomfortable.
• Try to understand the triggers of their derealization. This can help them avoid them and be better prepared to handle them if they do happen.
• Encourage and help them find support.

Derealization occurs when a person experiences unreality or detachment from their surroundings. This generally includes feeling as though objects, people, and other pieces of the world around them are not real.

A person experiencing derealization is typically aware that what they are experiencing is not real and simply the way they feel.

Common causes for derealization are usually trauma or severe stressors. Following the removal of these triggers, people find that derealization goes away on its own.

However, for some, this may become chronic. Treatment for derealization generally includes psychotherapy.

If a teenager is experiencing derealization, a person can contact a mental health professional for information and support.