Persistent and recurrent episodes of depersonalization or derealization or both cause distress and problems functioning at work or school or in other important areas of your life. During these episodes, you are aware that your sense of detachment is only a feeling and not reality.

The experience and feelings of the disorder can be difficult to describe. Worry about "going crazy" can cause you to become preoccupied with checking that you exist and determining what's actually real.

Symptoms usually begin in the mid- to late teens or early adulthood. Depersonalization-derealization disorder is rare in children and older adults.

Depersonalization symptoms

Symptoms of depersonalization include:

• Feelings that you're an outside observer of your thoughts, feelings, your body or parts of your body — for example, as if you were floating in air above yourself
• Feeling like a robot or that you're not in control of your speech or movements
• The sense that your body, legs or arms appear distorted, enlarged or shrunken, or that your head is wrapped in cotton
• Emotional or physical numbness of your senses or responses to the world around you
• A sense that your memories lack emotion, and that they may or may not be your own memories

Derealization symptoms

Symptoms of derealization include:

• Feelings of being alienated from or unfamiliar with your surroundings — for example, like you're living in a movie or a dream
• Feeling emotionally disconnected from people you care about, as if you were separated by a glass wall
• Surroundings that appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings
• Distortions in perception of time, such as recent events feeling like distant past
• Distortions of distance and the size and shape of objects

Episodes of depersonalization-derealization disorder may last hours, days, weeks or even months at a time. In some people, these episodes turn into ongoing feelings of depersonalization or derealization that may periodically get better or worse.

The exact cause of depersonalization-derealization disorder isn't well-understood. Some people may be more vulnerable to experiencing depersonalization and derealization than others, possibly due to genetic and environmental factors. Heightened states of stress and fear may trigger episodes.

Symptoms of depersonalization-derealization disorder may be related to childhood trauma or other experiences or events that cause severe emotional stress or trauma.

Factors that may increase the risk of depersonalization-derealization disorder include:

• Certain personality traits that make you want to avoid or deny difficult situations or make it hard to adapt to difficult situations
• Severe trauma, during childhood or as an adult, such as experiencing or witnessing a traumatic event or abuse
• Severe stress, such as major relationship, financial or work-related issues
• Depression or anxiety, especially severe or prolonged depression, or anxiety with panic attacks
• Using recreational drugs, which can trigger episodes of depersonalization or derealization

Episodes of depersonalization or derealization can be frightening and disabling. They can cause:

• Difficulty focusing on tasks or remembering things
• Interference with work and other routine activities
• Problems in relationships with your family and friends
• Anxiety or depression
• A sense of hopelessness