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Q: What is Derealization disease?

Q: What is depersonalization? 

Krishna: Derealization is a mental state where you feel detached from your surroundings. People and objects around you may seem unreal. But you will realize this altered state is not normal. It is an alteration in the perception of the external world.

Psychiatrists define depersonalization/derealization disorder as “persistent or recurrent … experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions". 

The most common thing that can trigger derealization is emotional abuse or neglect at a young age. The experience prompts the child to detach from its surroundings as a way to manage the trauma. Derealization sometimes can be a symptom of a medical condition. Other times, it can happen on its own, often in reaction to severe trauma or stress.

More than half of all people may have this disconnection from reality once in their lifetime. But about 2% of people experience it often enough for it to become a type of dissociative disorder.

Derealization usually happens in episodes, which means symptoms come and go. When this happens  

you might feel as if you are in a dream or fog, a see-through wall or veil is separating you from your surroundings, the world appears lifeless, muted, or fake, objects or people look “wrong” -- blurry, unnaturally sharp, too big, or too small, sounds are distorted, too loud, or too soft, and time seems to speed up, slow down, or stand still. Surroundings  appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings might also be experienced.

 In some cases, derealization results from serious mental illness, such as schizophrenia, or hallucinogens such as LSD. Extreme cases, usually associated with brain damage, may manifest as Cotard delusion, also called walking corpse syndrome, the belief that you are dead; and Capgras delusion, the conviction that people around you have been replaced by imposters.

This can end in a few minutes or stretch for months at a time. But even as you feel like you’re going “crazy,” you always recognize that something is going on and it is not normal. This is a key difference from psychotic disorders, where you can’t distinguish what’s real and what’s imaginary.

Depersonalization involves a feeling of detachment not from your environment, but from your own body, thoughts, or feelings. It’s as if you’re watching what’s happening to yourself as an outsider.

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