Today, my subjects are derealization and depersonalization (dpdr). Hi, I'm Paige Pradko. Welcome to Therapy for a Better Life. This topic is something that I get a lot of questions about from my subscribers and also from my clients.

I wanted to take the time to dive a little deeper into derealization and depersonalization and try to help you with these symptoms. First, it's fairly common. NAMI, the National Alliance of Mental Illness, suggests that there are about 50% of us will experience derealization and depersonalization at some point in our lifetime. It is one of four different dissociative disorders. Derealization is when people feel like they are detached from their surroundings, they're detached from their environment. When they talk to me, they describe it as that they are in a brain fog or kind of a dream state. They're going through the motions, but they're just questioning their reality. They know they don't feel normal.

Depersonalization is a little bit different. It's when people are feeling detached from their bodies and so they feel this disconnect and they describe it as kind of robotic. Again, they're going through the motions, but they feel numb to their sensations, and it's this disconnect between their thoughts and their feelings and their body and their mind, very uncomfortable condition. Now, these conditions can come and go. They can come and go in hours, days, weeks, months, but the really good news, and I want to reassure you that for most everybody, these conditions do not stay forever. They go away on their own. What causes derealization and depersonalization? As in so many things in the mental health field, we don't know the exact cause. It's a gray area. But we do know what the precipitating factors are or the risks. I'm going to talk about three different areas. The first is what we call neurochemical or drugs and substances. Substance use can cause this condition, and withdrawal from substance use. So, withdrawal from alcohol, benzodiazepines, opiates, can cause derealization and depersonalization symptoms. The second precipitating factor are certain physiological or physical conditions such as some types of seizure disorder, more severe sleeping disorders, or even migraines. And finally, what I see most often are psychological reasons, people who have experienced recent panic, very high levels of stress, high levels of anxiety, trauma or even depression or schizophrenia. Now there is a belief that our brain is in its own way trying to protect us, that our brain recognizes that we're under distress, some kind of distress. Something's not right. And so our brain is trying to numb our sensations or our experience of that distress. That kind of makes sense to me. Most often when I see people, they've already been to a medical professional. They've already been to see a doctor and they have ruled out all other physical kind of causes and they're coming to me for psychological help. I encourage you to do the same thing. The first is because our brain is already very aware that we're under distress, we want to give our brain very calming messages, calming messages that we are all right. Even if we're having these symptoms, we are okay. These symptoms will go away. Number two is we want to bring our brain to the present moment. Some of the best techniques to do this are called grounding techniques. I've made two videos on grounding techniques and I'm going to share those video links in the description so that you can review how to do grounding techniques. We're going to especially use a lot of temperature and touch, and so doing very simple things like putting your hands under a stream of water, cold water and then warm water, splashing cold water on your face, then warm water. Get into the shower, put the temperature difference between first cold, then warm, go back and forth. This helps your brain connect to the present moment. Next, exercise your auditory nerve. Listen to some music, listen to some podcasts. These are actually great grounding activities. Reading out loud is a great exercise for derealization and depersonalization because it uses many different areas of the brain, gets the brain functioning. Also try your best to keep a healthy sleep, wake cycle. We know that a poor sleep cycle can make these symptoms worse. And also do your very best to engage in your life as normal, as if everything were normal. We want to give the brain the message that we can work. We can socialize, we can work on our hobbies, we can exercise. We want to give normal messages to our brain and all of these activities are going to help us. People that begin to avoid everything because of these symptoms, it takes longer for their brain to heal. Their brain is still getting the message that something is very wrong. Now, there is a technique called interoceptive exposure therapy. For some of my clients that these a little bit lighter techniques are not working on, I'm going to teach them how to do interoceptive exposure therapy. I'm going to leave a link in the description as well for a video I did on how to do interceptive exposure. And finally, psychotherapy. If there are underlying stress conditions, anxiety, depression, panic, conditions that you really need extra help for, psychotherapy can help resolve some of these underlying conditions, and in doing that, help this derealization and depersonalization symptoms to die down.