Depersonalization-derealization disorder

Diagnosis

Your doctor may determine or rule out a diagnosis of depersonalization-derealization disorder based on:

• Physical exam. In some cases, symptoms of depersonalization or derealization may be linked to another physical health problem, medicines, recreational drugs or alcohol.
• Lab tests. Some lab tests may help find out whether your symptoms are related to medical or other issues.
• Mental health evaluation. Talking about your symptoms, thoughts, feelings and behavior patterns can help determine if you have depersonalization-derealization disorder or another mental health condition.

Treatment

Depersonalization-derealization disorder is mainly treated using talk therapy. But medicines may be added to your treatment plan sometimes.

Talk therapy

Talk therapy is the main treatment for depersonalization-derealization disorder. The goal is to control the symptoms to make them better or make them go away. Two types of talk therapy are cognitive behavioral therapy and psychodynamic therapy.

Talk therapy can help you:

• Learn why depersonalization and derealization occur.
• Learn techniques that take your mind off your symptoms and connect you to your world and feelings.
• Learn coping strategies to deal with stressful situations and times of extreme stress.
• Talk about the emotions related to past trauma that you've experienced.
• Learn about other mental health conditions you may have, such as anxiety or depression.

Medicines

No medicine has been proven to effectively treat depersonalization-derealization disorder. But medicines may be used to treat specific symptoms or treat depression and anxiety that often are related to the condition.

Coping and support

While depersonalization-derealization disorder can feel scary, knowing that it can be treated may make you feel better. To help you cope with depersonalization-derealization disorder:

• Follow your treatment plan. Talk therapy may involve practicing certain techniques daily to help reduce or stop the feelings of depersonalization and derealization. Seeking treatment early can make it more likely that you'll use these techniques successfully.
• Learn about the condition. Books and internet resources are available that talk about why depersonalization and derealization occur and how to cope. Ask your mental health professional to suggest educational materials and resources.
• Connect with others. Stay connected with supportive and caring people, such as family, friends or faith leaders.

Preparing for your appointment

You're likely to start by first seeing your primary care doctor or another primary care professional. It may be suggested that you see a doctor who specializes in brain and nervous system conditions, also known as a neurologist. Or you may see a doctor who specializes in diagnosing and treating mental health conditions, also known as a psychiatrist.

You may want to take a family member or friend along, if possible. Someone who goes along with you may remember something that you missed or forgot.

Here's some information to help you get ready for your appointment and learn what to expect.

What you can do

Before your appointment, make a list of:

• Any symptoms you have, even if they're not related to the reason for your appointment.
• Key personal information, including any major stresses or recent life changes.
• All medicines, vitamins, herbs and other supplements that you're taking, including doses.
• Questions to ask your doctor.

Some basic questions to ask include:

• What's most likely causing my symptoms?
• Are there other possible causes?
• Do I need any tests to confirm the diagnosis?
• What treatments are available? Which do you recommend?
• Are there other options to the main approach that you're suggesting?
• Do I need to see a specialist?
• Is there a generic alternative to the medicine you're prescribing?
• Are there any brochures or other printed material that I can have? What websites do you recommend?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you some questions, such as:

• When did you first begin feeling symptoms?
• Have your symptoms been constant, or do they only occur once in a while?
• How serious are your symptoms?
• What, if anything, seems to make your symptoms better?
• What appears to make your symptoms worse?
• Do you have any long-term health conditions?
• Do you have any mental health conditions, such as anxiety, depression or post-traumatic stress disorder (PTSD)?
• What medicines or herbal supplements do you take?
• Do you drink alcohol or use recreational drugs?

Be ready to answer questions so you'll have time to talk about what's most important to you.