Dissociation and depersonalization: Causes, risk factors, and symptoms Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What are dissociation and depersonalization Medically reviewed by Nicole Washington, DO, MPH — By Joseph Nordqvist — Updated on August 23, 2022Depersonalization and dissociation refer to a dreamlike state when a person feels disconnected from their surroundings. Things may seem ‘less real’ than they should be. Sensations of depersonalization and dissociation vary in severity and can result from a range of conditions, including post-traumatic stress disorder and the use of recreational drugs. The person may feel as if they are watching themselves from a distance. Some take on a different identity. The person is able to do a “reality check” and is generally aware that their sensations are unusual. Depersonalization is one aspect of dissociation. The term is used to describe a feeling of detachment, especially from oneself and one’s identity. It may also be associated with derealization, which is characterized by an altered perception of or detachment from one’s surroundings. This article will take a closer look at the causes and symptoms of depersonalization and dissociation, as well as the ways that they may be diagnosed and treated. Causes Share on PinterestPTSD or past trauma can lead to depersonalization, when people feel detached from themselves. Image credit: Tomazl/Getty ImagesThe exact cause of dissociation is unclear, but it often affects people who have experienced a life-threatening or traumatic event, such as extreme violence, war, a kidnapping, or childhood abuse. In these cases, it is a natural reaction to feelings about experiences that the individual cannot control and is a way of detaching from past experiences that may be difficult to tolerate. According to the American Psychiatric Association, symptoms can begin in early childhood or adolescence. In fact, less than 20% of people with depersonalization-derealization disorder first experience symptoms after age 20. Risk factors A number of factors can make a person more likely to experience dissociation and depersonalization. Recreational drugs Some recreational drugs affect the chemicals in the brain, which could trigger feelings of depersonalization.Ketamine: People often use this dissociative anesthetic as a recreational drug. Some people may take it because they seek an “out-of-body” experience.Cannabis use: Though uncommon, some people may experience dissociation and depersonalization with cannabis use and withdrawal.Alcohol and hallucinogens: These could trigger depersonalization in some people. People have also reported perceptual disturbances such as depersonalization when withdrawing from benzodiazepines. Other conditions Many people who experience depersonalization also have another mental health condition. Some kinds of dissociation can occur with the following conditions:depressionschizophreniaepilepsyobsessive-compulsive disorder (OCD)phobic disorderpost-traumatic stress disorder (PTSD)migraine Dissociation and depersonalization disordersShare on PinterestSome people will have an out-of-body experience or feel as if they are watching themselves from a distance. Image credit: Volkankurt/Getty Images According to the National Alliance on Mental Illness (NAMI), dissociative disorders that feature dissociation or depersonalization are:Dissociative amnesia: People forget information about themselves or things that have happened to them.Depersonalization-derealization disorder: This can involve out-of-body experiences, a feeling of being unreal, and an inability to recognize one’s image in a mirror. There may also be changes in bodily sensations and a reduced ability to act on an emotional level.Dissociative identity disorder: A person becomes confused about who they are and feel like a stranger to themselves. They may behave differently at different times or write in different handwriting. This is sometimes known as multiple personality disorder. In some cultures, people seek to attain depersonalization through religious or meditative practices. This is not a disorder. Symptoms Dissociation can happen in different ways. A study published in Access Advances in Psychiatric Treatment notes that symptoms can include:changes in bodily sensesa reduced inability to react emotionally Here are some of the experiences a person may have:an out-of-body experience, in which they feel as if they are floating away or watching themselves from a distance or as if in a filma sense of disconnection from their own body or emotionsthe feeling that life is a dream, where everyone and everything seems unreala sense of not being in control of their actionsgaps in memory, especially of specific people, events, or periods in lifeobsessive behavior, for example, repeatedly looking in a mirror to check that they are real Some people may travel physically to another place and take on a different identity while there. The individual may not remember their own identity. Anxiety can be a cause or a result of dissociation. When to see a doctor Occasional feelings of dissociation or detachment are common and may not necessarily be cause for concern. However, if a person experiences ongoing or severe sensations of dissociation, they may want to consider talking to a doctor or mental health professional. A person should also consult with a doctor if these symptoms interfere with relationships or daily activities, including work or school. DiagnosisShare on PinterestDoctors use specific criteria to diagnose dissociation and depersonalization. Image credit: Maskot/Alamy Stock Photo A doctor will ask a person about their symptoms and their personal and medical history. The doctor may recommend neurological tests to rule out conditions such as epilepsy. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) lists the following as diagnostic criteria for depersonalization disorder:The person persistently or repeatedly has a sense of depersonalization or derealization.During these experiences, the person is aware that these changes are not reality.These symptoms result in distress and difficulty carrying out routine tasks.The symptoms do not happen because of another disorder or the use of a medication or other substance. Treatment There is no specific treatment for this condition, but medication and counseling may help. Medications Though therapy is typically recommended as the first line of treatment for depersonalization disorder, a doctor may prescribe medications to treat associated conditions or other symptoms that a person may be experiencing. For example, antidepressants may be recommended to treat conditions like anxiety, depression, or panic attacks. Some studies have found that other medications may also be beneficial, such as lamotrigine or naltrexone, but more research is needed. Cognitive behavior therapy CBT This type of talk therapy can help people understand and cope with the underlying cause of their disorder and practice techniques to manage symptoms of the condition. Additionally, CBT may help to reduce the anxiety, depression, and obsessive behavior that can occur alongside depersonalization and dissociation. Takeaway Depersonalization, dissociation, and related experiences can happen for a number of reasons, including PTSD, the use of some substances, and other mental health conditions. Though it can cause several adverse symptoms, medications and counseling may be beneficial. A doctor can also help determine the cause and best course of treatment to help manage other symptoms and conditions that might be associated with dissociation or depersonalization. Last medically reviewed on August 23, 2022Mental HealthNeurology / Neuroscience 11 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Ballard, E. D., et al. (2020). The role of dissociation in ketamine's antidepressant effects.https://www.nature.com/articles/s41467-020-20190-4Brett, J., et al. (2015). Management of benzodiazepine misuse and dependence.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/Dissociative disorders. (n.d.).https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-DisordersDissociative disorders. (2020).https://www.nhs.uk/mental-health/conditions/dissociative-disorders/Fattahzadeh-Ardalani, G., et al. (2017). Somatoform dissociation, fatigue severity and pain behavior compared in patients with migraine headache and in healthy individuals.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505118/Heydrich, L., et al. (2019). Depersonalization‐ and derealization‐like phenomena of epileptic origin.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764488/Madden, S. P., et al. (2019). Cannabis-induced depersonalization-derealization disorder.https://psychiatryonline.org/doi/10.1176/appi.ajp-rj.2018.130202Medford, N., et al. (2018). Understanding and treating depersonalisation disorder.https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/understanding-and-treating-depersonalisation-disorder/6216AE06994D1094873145C016CC1F57Michal, M., et al. (2016). A case series of 223 patients with depersonalization-derealization syndrome.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924239/Thal, S. B., et al. (2019). The link between childhood trauma and dissociation in frequent users of classic psychedelics and dissociatives.https://www.tandfonline.com/doi/full/10.1080/14659891.2019.1614234What are dissociative disorders? (2018).https://psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disordersFEEDBACK:Medically reviewed by Nicole Washington, DO, MPH — By Joseph Nordqvist — Updated on August 23, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is a circadian rhythm sleep disorder? A circadian rhythm sleep disorder is when a person's sleep-wake cycle is out of sync with their environment. Learn about types, treatments, and more.READ MOREDepression after COVID-19: What is the link?Medically reviewed by Nicole Washington, DO, MPH Depression after COVID-19 is common. It may occur due to physiological or psychological changes. Scientists are still exploring the link.READ MOREWhat to know about self-loathingMedically reviewed by Vara Saripalli, PsyD Self-loathing is a pattern of thoughts or feelings of self-hatred and extreme criticism of oneself. Read on to find examples of behaviors and ways to…READ MOREWhat are the stages of the grieving process?Medically reviewed by Karin Gepp, PsyD Grief is a process that helps people heal after experiencing loss. Read on to learn about the stages of grief, types of grief, how to offer support…READ MORELoneliness and unhappiness accelerate aging faster than smoking, study shows Researchers have found that certain psychological issues — such as hopelessness, unhappiness, and loneliness — could increase a person's biological…READ MORE