Guest Post: On Depersonalisation and Derealisation Disorder (DPRD) by Unreal

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Unreal is a mental health charity that exists to support people with Depersonalisation and Derealisation Disorder. But what is it? And if you think you might be experiencing symptoms, what can you do?

Joe Perkins is a Trustee of Unreal and documents life with the disorder on the YouTube channel ‘DPD Diaries’. Here, he tells us about his experiences and offers some tips for anyone who is suffering.

I’ve lived with chronic, 24/7 Depersonalisation and Derealisation Disorder for 13 years now. Many people find the symptoms come on suddenly and intensely, but for me, it’s been a slow decline over time. The condition can negatively impact every area of your life – from your ability to do ‘normal’ daily tasks, to being able to hold down a job or romantic relationship. People experience Depersonalisation and Derealisation Disorder differently but for me, it leaves me feeling emotionally numb, unable to feel any of life’s ‘peaks and troughs’. This makes everything – even important things – feeling completely meaningless.

One of the biggest difficulties with Depersonalisation and Derealisation Disorder is that awareness of the condition is so low, especially within medical communities. It’s thought the disorder affects 1-2% of the general population – making it as common as OCD and schizophrenia – but despite this, it remains largely unheard of. Misdiagnosis is common – and the average diagnosis period from the first onset of symptoms is between 7-12 years. Early intervention is key in tackling the condition, so Unreal’s primary aim is to lower this this through raising awareness.

What is Depersonalisation and Derealisation Disorder?

Depersonalisation can be a completely normal sensation that we will likely all experience during difficult times in our lives. It’s believed by experts to be ‘a protective reflex of the mind’ stemming from our evolutionary fight/flight response. By temporarily numbing our sense of reality in difficult situations, we’re better able to deal with surges of stress and anxiety; or if we’re in a threatening situation, we have a better chance of being able to escape if we can act instinctually – using available brain power to plan our escape rather than becoming overwhelmed by worry or panic. If you’ve ever been in a car accident, you might have found yourself feeling unexpectedly calm in the aftermath; but then broken down with shock upon getting home. That’s Depersonalisation doing its ‘job’ – we’ve calmly escaped the threat, then dealt with the emotions only once we were safe.

However, this defence mechanism can also begin to be triggered during other periods of overwhelm in our lives. If the mind finds itself feeling like it can’t cope with what’s being demanded of it, it might need to protect us and help us cope by temporarily numbing our sense of reality and emotions. We can navigate the tasks at hand as if ‘on autopilot’, until a point we feel less overwhelmed, and our mind releases the dissociation. We would refer to this as experiencing transient depersonalisation – it’s episodic, and ‘triggering’ events can usually be identified. Episodes typically last anywhere from a few minutes to a couple of weeks.

Depersonalisation and Derealisation Disorder is where these episodes of dissociation last for much longer periods of time – it’s common to find people who have experienced it for a decade or more. It might ultimately be triggered by a particularly intense event, but the underlying causes are usually more ingrained in who we are as a person stemming from the effects of negative past experiences.

What causes Depersonalisation and Derealisation Disorder?

‘Overwhelm’ is one of the most common terms we hear surrounding the onset of the condition – but of course, this can encompass a huge range of different stressors depending on what sort of person we are. The likes of stress, anxiety, fatigue, panic attacks and depression can all contribute, especially to transient episodes of depersonalisation. Reducing our overall level of overwhelm and learning to recognise what might be causing the ‘spikes’ that result in the episodes of depersonalisation is key to reducing their frequency and severity going forwards.

The causes of chronic Depersonalisation and Derealisation Disorder though are often slightly different. Whilst the likes of a panic attack or a period of high stress might ultimately trigger the onset, the root causes are usually much more ingrained in who we are as a person. Many people with the disorder identify as having experienced emotional difficulties (usually in childhood), hold negative self-beliefs, have PTSD, panic disorders, obsessive thought patterns or experience gender dysphoria. The disorder is also often triggered by drug usage – cannabis especially – though it’s thought it’s our psychological response to the drug trip that ultimately acts as the trigger; not a chemical response in the brain. Occasionally, symptoms can be caused by the likes of epilepsy and migraines also – so assessment by a medical professional is always recommended.

Essentially, depersonalisation is a psychological defence mechanism – and both transient and chronic instances are fundamentally reactionary; they’re our mind trying to protect us from something. It can be difficult to figure out what might be causing the symptoms, especially when they’re rooted deep in our personality, so seeking professional psychological help is key. The symptoms can be very distressing, so learning about the condition and understanding it has been known to reduce severity in itself – reducing fear of the unknown is never a bad thing.

Symptoms of the Disorder

Depersonalisation and Derealisation Disorder can be described in many different ways but essentially, it is a persistent feeling of being disconnected from your own body (Depersonalisation) and feeling disconnected from the world around you (Derealisation). Most people experience both of those sensations together – though they are subtly different.

Depersonalisation and Derealisation symptoms can be hard to describe – most people with the disorder are very reliant on metaphors to describe the sensations. Below are some of the most common:

  • Feeling as if you are living in a dream or a movie
  • Feeling as though you are ‘in a bubble’ or ‘behind glass’
  • Emotional or physical ‘numbness’
  • Feeling as if you’re permanently drunk
  • Feelings of being alienated from or unfamiliar with your surroundings
  • Your surroundings appear distorted, blurry, two-dimensional or artificial, or alternatively, a heightened awareness and clarity of your surroundings
  • Distortions in your perception of time
  • Feeling that you’re not in control of your speech or movements
  • Feeling like you are an outside observer of your own mental processes
  • Feeling like you are ‘outside’ of your body or parts of your body
  • Distortions of distance and of the size and shape of objects around you
  • Feeling like a ‘robot’

It is important to remember though that symptoms can be different for each person, so if your experience isn’t wholly reflected above, that doesn’t necessarily mean that you aren’t experiencing Depersonalisation and Derealisation.

I think I may have Depersonalisation and Derealisation Disorder. What should I do?

The symptoms of Depersonalisation and Derealisation Disorder can be very frightening and isolating but you can learn to manage your symptoms and many people recover completely. Here are a few things that you can do if you think you may be experiencing Depersonalisation and Derealisation Disorder:

1. Seek professional advice

The first thing to do is to seek professional advice. Many people find that their GP has not heard of the condition. This BMJ guidance is a useful tool that you can give to your GP to help them to assess you. Clinical psychologists and psychiatrists are often more knowledgeable of the condition, so it might be appropriate to ask your doctor if you can be referred to one.

2. Get some sleep

Some people find that tiredness can make their Depersonalisation and Derealisation symptoms worse. Try to make sure that you are getting enough sleep and avoid stimulants such as coffee before bedtime. It can also be useful to limit ‘screen time’ before bed, as studies have shown devices can hamper our abilities to sleep.

3. Give yourself a break

Try to schedule in time for yourself. Reducing our levels of overwhelm during difficult periods is rarely a bad thing – but this can have a direct effect on symptoms of depersonalisation. Putting aside time to take care of ourselves, indulge our hobbies, find ways to relax, etc can really help us to ‘switch off’. Especially when working a difficult job or studying at university, time out is important to help us unwind.

4. Grounding exercises

Some people find that Grounding Exercises can help them to feel more connected to themselves and the world. Try the 5,4,3,2,1 technique: Describe 5 things you can see, 4 things you can feel (“my feet on the floor” or “the texture of my jumper”), 3 things you can hear (“the wind blowing outside”), 2 things you can smell (“my aftershave”) and 1 thing you can taste (“toothpaste”).

5. Talk to someone you trust

The symptoms of depersonalisation can be very difficult to explain but confiding in somebody we’re close to can help us feel less alone in the struggles, and that we have someone we can turn to when we’re feeling especially bad. The condition can feel so isolating, so having a family member or friend look out for you and ask how you’re doing can be very important.

6. Join our Peer Support Group

From 2021, Unreal will be hosting an online Peer Support Group. These groups are an opportunity for you to meet others with Depersonalisation and Derealisation Disorder, share experiences, coping techniques and more. Subscribe to our mailing list and we’ll let you know when the groups are up and running.

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