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Depersonalization, Derealization and Panic Disorder

What Are Depersonalization and Derealization

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Updated May 18, 2009

According to the DSM-IV- TR, depersonalization and derealization can be symptoms of a panic attack. If you have panic disorder and experience episodes of depersonalization and/or derealization, you’re likely to wonder:

  • “Am I going crazy?”
  • “Do I have some grave illness?”
  • “Am I dying?”

The answers to these questions are no, no and absolutely not. Though quite disturbing, the symptoms of anxiety-related depersonalization and derealization are actually not thought to be dangerous.

The symptoms of depersonalization and derealization can be similar, but they are distinct enough to warrant a separate discussion of each.

Depersonalization

What can be more frightening than feeling as though you are detached from yourself? This is the central feature of depersonalization. It is a feeling of being outside of yourself without any sense of control. Some sufferers often describe the sensation as observing themselves from outside of the body.

Other sensations of depersonalization may include:

  • feeling unhuman or robot-like
  • feeling foreign or unrecognizable to oneself
  • feeling invisible or unreal

Derealization

Where depersonalization focuses on one’s sense of self, derealization focuses on one’s sense of his or her surroundings. Sufferers often describe the sensation of derealization as being in a dream-like state where the environment seems unreal, foggy or hazy.

Other sensations of derealization may include:

  • feeling cut off from one’s surroundings
  • feeling like being trapped in a glass bubble
  • feeling like surrounding objects are unreal or cartoon-like

What You Need to Know

If you have anxiety- or panic-related symptoms of depersonalization or derealization, it is important to understand what these symptoms are and what they are not. First, they are fairly common occurrences for those suffering from panic disorder or other types of anxiety disorders. Second, they are not dangerous. And third, they are not an indication of psychosis. Although the symptoms seem bizarre, one does not lose touch with reality. Sufferers continue to be able to discern and perceive the symptoms as “feelings” and not as events that are actually happening.

It is important to note that symptoms of depersonalization or derealization may indicate a more serious medical or psychological disorder. And, a condition called depersonalization disorder can exist on its own. Therefore, self-diagnosis is not advised. If you are experiencing any of the symptoms outlined above, see your doctor or other healthcare provider. He or she will be able to tell you whether or not your symptoms are anxiety-related or part of another illness.

Getting Help

Panic disorder and its associated symptoms are very treatable. The sooner treatment begins after the onset of panic disorder, the less likely one is to develop agoraphobia, which greatly complicates recovery. Treatment options are likely to include therapies to lessen anxiety and may include:

Sources:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.

Kaplan MD, Harold I. and Sadock MD, Benjamin J. Synopsis of Psychiatry, Eighth Edition 1998 Baltimore: Williams & Wilkins.

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