🌫️ Depersonalization–Derealization Disorder (DPDR)


Overview:

Depersonalization–Derealization Disorder (DPDR) is a dissociative disorder where a young person feels detached from themselves (depersonalization) or from the world around them (derealization).

They often describe it as feeling like they’re “in a dream,” “watching themselves in a movie,” or that “nothing feels real.” These episodes can last minutes to hours — sometimes longer — and can be very frightening.


Although it may sound unusual, DPDR is the third most common psychiatric symptomafter anxiety and depression. It’s not psychosis — kids know what’s real, but feel emotionally disconnected from it.


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💭 Depersonalization vs. Derealization

• Depersonalization: Feeling detached from one’s body, thoughts, or emotions (“I don’t feel like me,” “My voice sounds strange”).

• Derealization: Feeling that surroundings are unreal or distorted (“Things look foggy,” “The world feels fake or dreamlike”).


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📊 How Common Is It?

• Temporary episodes of DPDR occur in about 50% of people at least once in their lifetime, often during high stress (Hunter et al., 2004).

• The chronic disorder form affects around 1–2% of the general population, and can start in adolescence (Sierra & David, 2011).

• It often co-occurs with trauma, panic disorder, or severe anxiety.


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🧠 Why It Happens


DPDR often develops as a protective response to trauma or extreme stress — the brain’s way of “checking out” when emotions feel too overwhelming.

Other possible causes include:

• Panic attacks or severe anxiety

• Childhood trauma or neglect

• Sleep deprivation or exhaustion

• Substance use (especially marijuana, LSD, or MDMA)

• Neurological conditions or migraines


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🌻 How Families Can Recognize It

• The child describes feeling “numb,” “robotic,” or “not real”

• Sudden zoning out or blank expression during stress

• Describing surroundings as foggy, dreamlike, or “off”

• Fear of “going crazy” or losing control

• Difficulty concentrating or feeling emotionally flat


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🌈 How Families Can Help

• Stay calm and validate the experience (“That sounds scary, but I believe you.”).

• Encourage grounding techniques — have them name 5 things they see, 4 they can touch, 3 they can hear, 2 they can smell, and 1 they can taste.

• Reduce anxiety triggers like caffeine, lack of sleep, or overstimulation.

• Seek evaluation with a child psychiatrist or trauma-informed therapist.

• CBT and trauma-focused therapy are very effective treatments.

• Encourage physical grounding: deep breathing, holding ice, or walking barefoot on grass.


💬 Kids often recover fully once they learn coping skills and feel emotionally safe again.


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References:

• Hunter, E. C., Sierra, M., & David, A. S. (2004). The epidemiology of depersonalization and derealization: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 39(1), 9–18.

• Sierra, M., & David, A. S. (2011). Depersonalization: A selective impairment of self-awareness. Consciousness and Cognition, 20(1), 99–108.

• National Institute of Mental Health. (2023). Dissociative Disorders Overview.Retrieved from https://www.nimh.nih.gov