Depersonalization disorder (DPD) is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one’s mental processes or body. The symptoms include a sense of automation, going through the motions of life but not experiencing it, feeling as though one is in a movie, loss of conviction with one’s identity, feeling as though one is in a dream, feeling a disconnection from one’s body; out-of-body experience, a detachment from one’s body, environment and difficulty relating oneself to reality.
Occasional moments of mild depersonalization are normal; strong, severe, persistent, or recurrent feelings are not. A diagnosis of a disorder is made when the dissociation is persistent and interferes with the social and occupational functions necessary for everyday living. Depersonalization disorder is thought to be largely caused by severe traumatic lifetime events including childhood sexual, physical, and emotional abuse; accidents, war, torture, panic attacks and bad drug experiences. It is unclear whether genetics play a role; however, there is evidence of physiological factors with respect to DPD.
As the core symptoms of the disorder are thought to protect the victim from negative stimuli, depersonalization disorder can be conceptualized as a defense mechanism. Depersonalization disorder is often comorbid with anxiety disorders, panic disorders, clinical depression and bipolar disorder.
Although depersonalization disorder is an alteration in the subjective experience of reality, it is not related to psychosis, as sufferers maintain the ability to distinguish between their own internal experiences and the objective reality of the outside world. During episodic and continuous depersonalization, sufferers are able to distinguish between reality and fantasy, and their grasp on reality remains stable at all times.