Materiały źródłowe

• #1 Depersonalization-Derealization Disorder: Etiological Mechanism, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11910194/

  This comprehensive review delves into the complexities surrounding Depersonalization-Derealization disorder (DPDR), a dissociative disorder characterized by enduring feelings of detachment from one’s self and surroundings. […] Despite many trials and studies conducted the exact cause of this condition is still unknown. The best way to understand its etiology is by taking into account its clinical presentations and linking it to different structural and functional alterations of the brain. Alteration in cortical activity and structure associated with white matter, gray matter, caudate nucleus, amygdala, and other areas like Broadmans areas of cortex are analyzed to be potential mechanisms for etiology. […] While the precise cause remains elusive, factors such as traumatic experiences, stress, and genetic predispositions have been implicated, with modern neuroimaging studies offering insight into potential structural and functional brain alterations.

• #2 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/

  Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from ones sense of self and the surrounding environment, respectively. […] Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. […] Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema. […] DPDR is not merely the disruption of various sensory integrations, but also of several large-scale brain networks. […] The current review will revisit the works of literature available on the neurobiology involved in DPDR. Discerning the diverse neural processes that underlie this prevalent, yet often-neglected, psychiatric disorder could aid in better diagnosis and treatment moving forward.

• #3 Depersonalization-Derealization Disorder: Etiological Mechanism, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11910194/

  Neuroimaging investigations have indicated a pathophysiological mechanism like a decrease in activity in the orbitofrontal cortex and an increase in activity of the caudate nucleus. These mechanisms result in a relatively common pathway leading to similar symptoms as DPDR thus acting as a potential mechanism for the progression and development of DPDR.

• #4 Depersonalization-derealization disorder – Wikipedia

  https://en.wikipedia.org/wiki/Depersonalization-derealization_disorder

  Compared to other types of childhood trauma, emotional abuse has been found to be the most significant predictor both of a diagnosis of depersonalization disorder and of depersonalization scores, but not of general dissociation scores. […] Studies are beginning to show that the temporoparietal junction has a role in multisensory integration, embodiment, and self-other distinction. […] Several studies analyzing brain MRI findings from DPDR patients found decreased cortical thickness in the right middle temporal gyrus, reduction in grey matter volume in the right caudate, thalamus, and occipital gyri, as well as lower white matter integrity in the left temporal and right temporoparietal regions. […] It is unclear whether genetics plays a role; however, there are many neurochemical and hormonal changes in individuals with depersonalization disorder. […] DPDR may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the „fight-or-flight” response. […] The vestibular system may also play a role in DPDR.

• #5 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/

  A hypoactive limbic system would therefore indicate difficulty recalling firmly etched past experiences. […] When a memory reaches a traumatic threshold, the hippocampus cannot store an explicit memory trace, as in dissociative amnesia, because it cannot contextualize the threat. […] Neuroimaging studies on DPDR have also revealed variations in cortical thickness. […] Certain structural MRI studies showed decreased cortical thickening in the right middle temporal region and increased size of the gyrus rectus, left dorsomedial PFC, and right somatosensory region in these patients. […] The first known study on aberrations of structural white matter connections in patients with DPDR showed that, compared to controls, patients with DPDR had disrupted connections between the left superior temporal gyrus and left temporal poles, as well as between the right middle temporal gyrus and right supramarginal gyrus. […] The degree of disconnection correlated with dissociative symptom severity in the DPDR group. […] Overall, there are positive correlations between DPDR and neurological impairment, which are likely mediated by trauma.

• #6 Depersonalization-Derealization Disorder – FindZebra

  https://www.findzebra.com/details/DKjQKWJ-depersonalization-derealization-disorder?q=

  It is unclear whether genetics plays a role; however, there are many neurochemical and hormonal changes in individuals with depersonalization disorder. DPDR may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the „fight-or-flight” response. […] The vestibular system may also play a role in DPDR. The vestibular system helps control balance, spatial orientation, motor coordination, but also plays a role in self-awareness. Disruption to this system can potentially cause a feeling of detachment from surroundings. […] Treatment of DPDR is often difficult and refractory. Some clinicians speculate that this could be due to a delay in diagnosis by which point symptoms tend to be constant and less responsive to treatment. […] Treatment is primarily non-pharmacological and can include paradoxical intention, record keeping, positive reward, flooding, psychotherapy, cognitive-behavioral therapy, psychoeducation, self-hypnosis, and meditation.

• #7 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/

  Another study concluded that depersonalization is a distinct result of frontal lobe, as opposed to temporal lobe, misfiring, when comparing depersonalization and derealization postictal sequalae in ES. […] The concept of corticolimbic disconnection is one model that explains the neurobiology of DPDR. […] This model presupposes that DPDR occurs because of excitatory amygdala circuits that modulate ascending arousal systems, leading to right prefrontal cortex (PFC) hyperactivation. […] A reciprocal inhibitory element mediated by PFC hyperactivation then impedes the limbic system, which is involved in experiencing emotions, and dampens sympathetic outputs. […] It is thought that activation of PFC functions inhibits the anterior cingulate cortex (ACC), an area that plays a key role in coordinating bottom-up and top-down processing within fear regulation circuitry.

• #8 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/

  The sum of these activities is a hyperattentive state and a subsequent overmodulation of emotionsfindings consistent with those in patients with PTSD+DS. […] Patients with PTSD+DS were also found to have enhanced top-down connectivity from the ventromedial PFC (vmPFC) to another key brain area, the periaqueductal gray (PAG). […] In a functional magnetic resonance imaging (fMRI) study, patients with DPDR who viewed images meant to elicit revulsion had less activation compared to controls in the occipitotemporal cortex, amygdala, and insula, all areas responsible for perceiving disgust. […] The insula of patients with DPDR was shown to be active when viewing neutral images. […] What accounts for the feelings of unfamiliarity or alienation from ones environment and sense of self in DPDR may also be explained by the frontolimbic inhibition model.

• #9 When experience becomes detached from sensation: Depersonalization/Derealization Disorder – Knowing Neurons

  https://knowingneurons.com/blog/2025/01/09/depersonalization-derealization-disorder/

  While the research supporting this model is still scarce, there has been some evidence from neuroimaging studies of PTSD patients with the dissociative subtype of the disorder (PTSD+DS). In clinical studies where patients conducted tasks involving processing of fear stimuli, PTSD+DS patients show increased activity in the PFC in conjunction with decreased activity of the amygdala, and a slowed heart rate (Lanius et al., 2010; van Huijstee et al., 2017). Increased activation of the PFC and decreased activation of the amygdala during tasks involving fear processing have also been observed in clinical studies of DPDR patients (Phillips et al., 2001). […] Other neuroimaging studies of DPDR patients have also shown evidence for decreased activation in brain regions like the insula, which processes emotionally salient stimuli such as disgust, and the hypothalamus which is implicated in the stress response, paired with increased activation of prefrontal cortical areas governing attention (Phillips et al., 2001). While much research into DPDR is still needed, researchers and clinicians have begun utilizing therapeutic tools to help alleviate the debilitating symptoms of those struggling with DPDR.

• #10 When experience becomes detached from sensation: Depersonalization/Derealization Disorder – Knowing Neurons

  https://knowingneurons.com/blog/2025/01/09/depersonalization-derealization-disorder/

  Most of our current understanding of the neural processes constituting DPDR has come from clues from clinical studies done on post-traumatic stress disorder (PTSD) patients. Dissociative symptoms (i.e., feeling disconnected from oneself or their surroundings) like those observed in DPDR and PTSD are thought to be the brain’s way of protecting individuals from memories of life events perceived as highly stressful (Bob, 2008). In this way, the brain uses dissociation as a coping strategy by changing the typical awareness of an individual’s sense of self and surroundings and blocking out the connection to the mental stress in the process (Costa, 2020). When this protective mechanism becomes dysregulated and persists maladaptively over time, disorders like PTSD and DPDR can result. […] A concept known as the frontolimbic inhibition model suggests that DPDR occurs when the amygdala become dysregulated, leading to increased activation of the prefrontal cortex (PFC) in response as the brain tries to compensate for these changes (Murphy, 2023; Geschwind, 1965; Sierra & Berrios, 1998). The amygdala is a brain region that processes emotions like fear and anxiety as well as the processing of memories with emotional and personal qualities (Murphy, 2023). The PFC is a brain region that governs things such as attention and planning. The current thought behind this model is as follows: excitatory circuits in the amygdala become dysregulated → activation of the PFC increases in response → amygdala becomes underactive due to increased inhibition by the PFC. Together, this system works as a loop, with the overall result being a dampening of emotional processing. The current belief is that these changes in neural circuit activity are the brain’s survival response, meant to reduce feelings of anxiety with the objective of increasing attention through executive brain regions like the PFC. However, in DPDR, this survival response becomes maladaptive, activating whenever the individual experiences feelings of discomfort induced by things like stress and fatigue (Hunter et al., 2003).

• #11 Depersonalization/Derealization Disorder | Concise Medical Knowledge

  https://www.lecturio.com/concepts/depersonalization-derealization-disorder/

  Trauma: […] Thought to occur as a response to severe stressors […] Survival mechanism to manage stressful situations without feeling overwhelmed. […] Organic causes: […] It is thought that there is a genetic predisposition to developing depersonalization/derealization disorder (DDD). […] Neurobiology: […] Several neurotransmitter systems (N-methyl-d-aspartate (NMDA), opioid, and serotonin) are associated with the disorder and involvement of the receptors leads to symptoms. […] NMDA receptors are important in associative processes. […] Ketamine, an NMDA antagonist, induces a dissociative state. […] Brain regions, like the inferior parietal lobule (right hemisphere) are noted to have abnormal activity during a depersonalization experience. […] Hypoactivation of the limbic system (notably in the insula) has been also linked to depersonalization/derealization disorder.

• #12 Depersonalization/Derealization Disorder – Neuropedia

  https://neuropedia.net/articles/psychiatry/dissociative/depersonalization-derealization-disorder/

  There are many neurotransmitters affiliated with the disorder. NMDA glutamatergic pathways, endogenous opioids, and serotonergic pathways all show a possible involvement. […] A novel study states that there is a strong inverse correlation between the amount of 24-hour urine noradrenaline and the degree of depersonalization, suggesting that the lack of noradrenaline could also aid a hand in its pathophysiology. […] Lastly, the hypothalamic-pituitary axis may have a role in its pathogenesis; however, studies show inconsistent and conflicting evidence.

• #13 Depersonalization-Derealization Disorder – FindZebra

  https://www.findzebra.com/details/DKjQKWJ-depersonalization-derealization-disorder?q=

  Neither antidepressants nor antipsychotics have been found to be useful, additionally, antipsychotics can worsen symptoms of depersonalisation. Tentative evidence supports naloxone and naltrexone, as well as gabapentin. […] Some studies have found repetitive transcranial magnetic stimulation (rTMS) to be helpful.

• #14 Depersonalization disorder – wikidoc

  https://www.wikidoc.org/index.php/Depersonalization_disorder

  Not much is known about the neurobiology of depersonalization disorder, however a few studies may explain the subjective sense of detachment that forms the core of this dissociative experience. A PET scan found functional abnormalities in the visual, auditory, and somatosensory cortex, as well as areas responsible for an integrated body schema. […] In an fMRI study of DPD patients, emotionally aversive scenes activated the right ventral prefrontal cortex. Participants demonstrated a reduced neural response in emotion-sensitive regions, as well as an increased response in regions associated with emotional regulation. […] Depersonalization disorder may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the „fight-or-flight” response. Patients demonstrate abnormal cortisol levels and basal activity. Studies found that patients with DPD could be distinguished from patients with clinical depression and posttraumatic stress disorder.

• #15 Depersonalization – Wikipedia

  https://en.wikipedia.org/wiki/Depersonalization

  Dysregulation of the HPA axis, which governs the body’s stress response system, is frequently observed in individuals who experience depersonalization. […] Depersonalization is a classic response to acute trauma, and may be highly prevalent in individuals involved in different traumatic situations including motor vehicle collision and imprisonment. […] Psychologically depersonalization can, just like dissociation in general, be considered a type of coping mechanism, used to decrease the intensity of unpleasant experience. […] Chronic symptoms may represent persistence of depersonalization beyond the situations under threat.

• #16 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review – Innovations in Clinical Neuroscience

  https://innovationscns.com/depersonalization-derealization-disorder-trauma-pathology/

  Depersonalization and derealization refer to an estranged state of mind that involves a profound feeling of detachment from ones sense of self and the surrounding environment, respectively. […] Lack of awareness of DPDR is partly due to a limited neurobiological framework, and there remains a significant risk of misdiagnosis in clinical practice. […] Earlier literature has focused on several brain regions involved in the experience of depersonalization and derealization, including adaptive responses to stress via defense cascades comprising autonomic functioning, the hypothalamic-pituitary-adrenal (HPA) axis, and various other neurocircuits. […] Recent evidence has also demonstrated the role of more complex mechanisms that are bolstered by dissociative features, such as emotional dysregulation and disintegration of the body schema.

• #17 Depersonalization-derealization disorder – Wikipedia

  https://en.wikipedia.org/wiki/Depersonalization-derealization_disorder

  Depersonalization-derealization disorder is thought to be caused largely by interpersonal trauma such as early childhood abuse. […] Adverse childhood experiences, specifically emotional abuse and neglect have been linked to the development of depersonalization symptoms. […] The exact cause of depersonalization is unknown, although biopsychosocial correlations and triggers have been identified. […] It has been thought that depersonalization can be caused by a biological response to dangerous or life-threatening situations which causes heightened senses and emotional numbing. […] There is growing evidence linking physical and sexual abuse in childhood with the development of dissociative disorders. […] Childhood interpersonal trauma emotional abuse in particular is a significant predictor of a diagnosis of DPDR.

• #18 Depersonalization-derealization disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911

  The cause of depersonalization-derealization disorder is not well understood. Some people may be more likely to experience depersonalization and derealization than others. This is possibly due to genetic and environmental factors. High levels of stress and fear may cause bouts. […] Symptoms of depersonalization-derealization disorder may be related to childhood trauma or other experiences or events that cause severe emotional stress or trauma.

• #19 Depersonalization-derealization disorder – Wikipedia

  https://en.wikipedia.org/wiki/Depersonalization-derealization_disorder

  Compared to other types of childhood trauma, emotional abuse has been found to be the most significant predictor both of a diagnosis of depersonalization disorder and of depersonalization scores, but not of general dissociation scores. […] Studies are beginning to show that the temporoparietal junction has a role in multisensory integration, embodiment, and self-other distinction. […] Several studies analyzing brain MRI findings from DPDR patients found decreased cortical thickness in the right middle temporal gyrus, reduction in grey matter volume in the right caudate, thalamus, and occipital gyri, as well as lower white matter integrity in the left temporal and right temporoparietal regions. […] It is unclear whether genetics plays a role; however, there are many neurochemical and hormonal changes in individuals with depersonalization disorder. […] DPDR may be associated with dysregulation of the hypothalamic-pituitary-adrenal axis, the area of the brain involved in the „fight-or-flight” response. […] The vestibular system may also play a role in DPDR.

• #20 Depersonalization/Derealization Disorder and Neural Correlates of Trauma-related Pathology: A Critical Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/

  Dissociative symptoms, including depersonalization/derealization, are thought to be the result of a vestigial reaction to events perceived as life-threatening. […] It has been shown that there exists an especially strong relationship between early interpersonal trauma and dissociative disorders. […] It has been suggested that these highly stressful encounters fail to fit into the subjects cognitive scheme regarding the self, others, and the world; therefore, they split off from consciousness. […] Recent research exploring disorders with a traumatogenic etiology, such as PTSD+DS, has shed light on the neural processes involved in DPDR. […] When traumatic memories surface, nondissociative patients with PTSD demonstrate activity associated with emotional hyperarousal, such as an accelerated heart rate, reduced activation of prefrontal regions, and increased activation of the amygdala.

• #21 Depersonalization disorder as a systematic downregulation of interoceptive signals | Scientific Reports

  https://www.nature.com/articles/s41598-022-22277-y

  Depersonalisation disorder (DPD) is a psychopathological condition characterised by a feeling of detachment from one’s own body and surrounding, and it is understood as emerging from the downregulation of interoceptive afferents. However, the precise mechanisms that drive this interoceptive silencing are yet to be clarified. […] We propose that depersonalisation is the result of an attempt to cope with a situation characterised by abnormally high physiological activation (as in the aforementioned conditions) and perceived as inescapable. We outline a candidate mechanism both at a computational and neurobiological level, arguing that prefrontal suppression of interoceptive prediction error units in the AI can result in preventing interoceptive signals from being processed at higher levels of the cortical hierarchy, ultimately leading to a blunted, disembodied perception of the self (interoceptive silencing).

• #22 Dissociative disorders – NHS

  https://www.nhs.uk/mental-health/conditions/dissociative-disorders/

  Depersonalisation is where you have the feeling of being outside yourself and observing your actions, feelings or thoughts from a distance. […] Derealisation is where you feel the world is unreal. People and things around you may seem „lifeless” or „foggy”. […] You can have depersonalisation or derealisation, or both together. It may last only a few moments or come and go over many years. […] There are many possible causes of dissociative disorders, including previous traumatic experience. […] Someone with a dissociative disorder may have experienced physical, sexual or emotional abuse during childhood. […] Some people dissociate after experiencing war, kidnapping or even an invasive medical procedure. […] Switching off from reality is a normal defence mechanism that helps the person cope during a traumatic time. […] It becomes a problem when the environment is no longer traumatic but the person still acts and lives as if it is, and has not dealt with or processed the event.

• #23

  https://link.springer.com/article/10.1007/BF02093366

  The study examines the relationship between experiencing depersonalization during traumatic events and subsequent psychiatric symptomatology. […] As predicted the participants who experienced depersonalization during traumatic events were found to be significantly lower than those who did not on 7 out of the 9 SCL-90-R subscales and the General Severity Index (GSI) scale. […] These findings suggest that, for this sample, depersonalization during traumatic events played a significant role in defending them from the full impact of these events.

• #24 Depersonalization – Wikipedia

  https://en.wikipedia.org/wiki/Depersonalization

  Depersonalization can arise from a variety of factors, of both a psychological and physiological nature. […] A case-control study conducted at a specialized depersonalization clinic included 164 individuals with chronic depersonalization symptoms, of which 40 linked their symptoms to illicit drug use. […] Studies have linked dysregulation of the immune system with depersonalisation. […] Depersonalization involves disruptions in the integration of interoceptive and exteroceptive signals, particularly in response to acute anxiety or trauma-related events. […] Furthermore, vestibular signal processing, crucial for balance and spatial orientation, is increasingly recognized as a factor contributing to feelings of disembodiment during depersonalization experiences. […] Research suggests that abnormal activity in the left hemisphere may play a role, although abnormalities in right hemisphere brain activity, responsible for self-awareness and emotion processing, may also contribute to depersonalization symptoms.

• #25 Frontiers | Past and Future Explanations for Depersonalization and Derealization Disorder: A Role for Predictive Coding

  https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2022.744487/full

  Overall, if the precision of interoceptive predictions is lower relative to that of predictions derived from other sensory modalities, then individuals may over-integrate sensory information from other modalities in attempts to reduce interoceptive prediction error, leading to experiences of DP/DR. […] If frequent, large and variable interoceptive prediction errors can be generated over short periods of time, interoceptive prediction precision may steadily decline. […] This may lead to a reliance on non-interoceptive sensory modalities (over-integration of sensory data) to reduce interoceptive prediction error, leading to the subsequent generation of DP/DR experiences.

• #26 Frontiers | Past and Future Explanations for Depersonalization and Derealization Disorder: A Role for Predictive Coding

  https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2022.744487/full

  Depersonalization (DP) and derealization (DR) refer to states of dissociation in which one feels a sense of alienation in relation to one’s self and environment, respectively. […] Chronic experiences of DP and DR may last for years, with common treatments lacking a strong evidence base for their efficacy. […] We propose a theoretical explanation of DP and DR based on interoceptive predictive coding. […] Our model will propose a multi-sensory, interoceptive predictive coding account of DP and DR in line with more recent theories. […] The convergence of interoceptive and emotional processing within the AIC and ACC suggests diminished activity in these brain regions may explain symptoms of DP and DR. […] It has been proposed that in cases of anxiety disorders, the precision of interoceptive predictions (of threat) may be so great that these predictions are maintained in the absence of actual threat, resulting in sustained, heightened physiological arousal.

• #27 Understanding and treating depersonalisation disorder | Advances in Psychiatric Treatment | Cambridge Core

  https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/understanding-and-treating-depersonalisation-disorder/6216AE06994D1094873145C016CC1F57

  Both psychological and biological models suggest that, in depersonalisation, normal emotional responses are shut down, leading to de-affectualisation with associated loss of emotional tone in the experience of oneself (depersonalisation, desomatisation) and one’s surroundings (derealisation). […] Recent functional neuroimaging and psychophysiological studies have found objective evidence of an abnormal response to emotional stimuli, consistent with patients reports of loss of emotional reactivity. […] The neural substrate for the shutting down of emotional responses is hypothesised to be a combination of prefrontal regions inhibiting limbic areas (particularly the amygdala) and reciprocal actions of the right dorsolateral prefrontal cortex and anterior cingulate cortex.

• #28 Depersonalization/ Derealization Disorder

  https://www.brightpathbh.com/mental-health/disorder/depersonalization/

  The exact causes of DDD are not fully understood, but it is linked to extreme stress, trauma, or adverse life experiences, based on a study by Columbia University Irving Medical Center in 2023 titled Depersonalization: Everything You Need to Know. Certain personality traits, such as high levels of neuroticism, also increase susceptibility. […] The risks of depersonalization and derealization disorder are mental health deterioration, increased anxiety, comorbid conditions, and functional impairment. […] The persistent nature of the symptoms and their association with other mental health issues underscore the seriousness of DDD. […] The causes of DDD are trauma, chronic stress, anxiety disorders, substance use, mental health conditions, neurobiological factors, and sleep deprivation. […] Trauma leads to depersonalization. Depersonalization is linked with stress or traumatic experiences such as physical abuse, exposure to domestic violence, or being involved in accidents and natural disasters, based on information published by Cleveland Clinic in 2023 titled Depersonalization-Derealization Disorder.

• #29 Kevin William Grant—Registered Psychotherapist – Fading Self, Elusive Reality: Navigating Through the Fog of Depersonalization/Derealization Disorder

  https://www.kevinwgrant.com/blog/item/the-fog-of-depersonalization-derealization-disorder

  Depersonalization/Derealization Disorder (DPDR) is a psychological conundrum where the self and reality become elusive fragments. […] The exact cause of DPDR is not well-understood, although it may be triggered by severe stress, trauma, or substance use. […] The exact causes of Depersonalization/Derealization Disorder (DPDR) are poorly understood, but several factors might contribute to its development. […] Severe stress or traumatic events, such as accidents, natural disasters, war, abuse, or the sudden loss of a loved one, can trigger DPDR. […] The use of substances, particularly hallucinogens like LSD or cannabis, can trigger episodes of depersonalization and derealization and might contribute to the development of DPDR. […] Some research suggests that differences in specific brain areas or neurotransmitter systems might contribute to DPDR, although the neurobiological underpinnings are not fully understood.

• #30 Depersonalization-Derealization Disorder Symptoms | BetterHelp

  https://www.betterhelp.com/advice/personality-disorders/depersonalization-derealization-disorder-what-to-expect-symptoms-and-treatment/

  Certain genetic and environmental factors may cause the symptoms of depersonalization-derealization disorder as well. Environmental factors that may trigger episodes can vary and may include different sights, smells, sounds, touches, or even events like natural disasters. For genetic factors, one study has linked the genes ADCY8 and DPP6 to the cognitive process that underlies dissociative phenomena. […] According to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), to be diagnosed with depersonalization-derealization disorder, an individual must experience ongoing or serious feelings of disconnectedness or dissociation, and they must interfere with or significantly affect the social or occupational functioning that’s necessary for daily living. […] The symptoms of depersonalization-derealization disorder can be similar to those associated with certain medical conditions or the side effects of medications, substance use, or substance withdrawal. That’s why a thorough physical examination including laboratory and diagnostic tests is usually performed to determine if other conditions are at play or if it’s likely depersonalization-derealization disorder. […] Although there is no known cure for derealization disorder, many people find that treatment from a mental health or primary care professional can be effective in reducing symptoms and may lead to the remission of the psychiatric disorder.

• #31 Depersonalization/Derealization Disorder – PsychDB

  https://www.psychdb.com/dissociative-disorders/depersonalization

  Common causes of the disorder are severe stress (interpersonal, financial, occupational), depression, anxiety (particularly panic attacks), and substance use. […] Cannabis in particular may precipitate new-onset panic attacks and depersonalization/derealization symptoms simultaneously.

• #32 Depersonalization/ Derealization Disorder

  https://www.brightpathbh.com/mental-health/disorder/depersonalization/

  Yes, anxiety can cause depersonalization and exacerbate symptoms of depersonalization disorder. […] Stress is a primary trigger for depersonalization. When individuals experience high levels of stress, the body activates its fight-or-flight response, which leads to dissociative symptoms as a coping mechanism. […] Yes, drugs and alcohol trigger depersonalization. Certain substances induce feelings of detachment or unreality, leading to or exacerbating existing symptoms of depersonalization. […] Yes, antidepressants and other medications cause depersonalization as a side effect, according to a 2021 research published in Risk titled Side Effects of AntiDepressants. […] Yes, caffeine and dehydration contribute to depersonalization. High doses of caffeine can lead to jitteriness and racing thoughts, with a positive correlation between caffeine use disorder and poor sleep quality. […] Yes, ADHD, OCD, and PTSD cause depersonalization. These comorbid conditions overlap and trigger symptoms of Depersonalization/Derealization Disorder (DDD) through mechanisms related to anxiety and emotional dysregulation.

• #33 Depersonalization: Everything You Need to Know | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/depersonalization-everything-you-need-know

  Many people can have an „out of body” experience, feel detached at certain times, or have a distorted perception of themselves and their surroundings. […] Although specific causes are not well understood, there may be some related factors that can contribute to the condition that include: […] Treatments for depersonalization-derealization disorders mainly involve psychotherapy or talk therapy and certain medications, including antidepressants and mood stabilizers. […] Depersonalization-derealization disorder can affect various aspects of a person’s life, including work, relationships, and overall quality of life. […] It is very common for individuals with DDD to have another mental health condition. Treating the comorbid conditions may also help with DDDs frequency and intensity of the core symptoms.

• #34 Depersonalization/Derealization Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/depersonalization-derealization-disorder

  Depersonalization/derealization disorder is a type of dissociative disorder that consists of persistent or recurrent feelings of being detached (dissociated) from ones body or mental processes, usually with a feeling of being an outside observer of ones life (depersonalization) or of being detached from one’s surroundings (derealization). The disorder is often triggered by severe stress. Diagnosis is based on symptoms after other possible causes are ruled out. Treatment consists of psychotherapy plus medications for any comorbid depression and/or anxiety. […] Depersonalization or derealization can also occur as a symptom in many other mental disorders as well as in physical disorders such as seizure disorders (ictal or postictal). When depersonalization or derealization occurs independently of other mental or physical disorders, is persistent or recurrent, and impairs functioning, depersonalization/derealization disorder is present.

• #35 Unraveling the brain dynamics of Depersonalization-Derealization Disorder: a dynamic functional network connectivity analysis | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06096-1

  Our study suggests the brain dynamics of DPD could be a potential biomarker for diagnosis and symptom analysis, which potentially leads to more personalized and effective treatment strategies for DPD patients. […] Our dFNC analysis revealed pronounced discrepancies in brain dynamics between the HC group and the DPD group. Notably, we identified distinct patterns in the dwell time of the global cohesive state, which may suggest that brain dynamics could be the potential biomarker for DPD diagnosis. […] The observed disparity in the dwell time of the State-1 between the DPD group and the HC group suggests that DPD individuals may experience a hyper-connected neural state, a phenomenon that aligns with the predictive coding framework. […] In responders, tDCS notably influenced the dwell time of State-2, the intra-network cohesive state. This alteration underscores the potential of tDCS in modifying the activity within the DMN and SMN.

• #36 Dysfunctional large-scale brain networks in drug-naïve depersonalization-derealization disorder patients | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06497-w

  Our findings predominantly revealed decreased FC in DPRD patients, specifically noting decreased FCs in 18 between-networks and four within-network. Notably, the between-network FCs of VN-LN and DAN-LN demonstrated a medium effect size. […] The notable decreased FC in the VN-LN provides new evidence to support the „visuolimbic disconnection” hypothesis of DPRD. […] The high accuracy of the SVM model indicated the significance of FC value as a diagnostic feature of DPRD. […] Moreover, we also observed a significant correlation between the 'Self’ factor and FC within SMN. This factor encompasses symptoms indicative of impaired self-consciousness in DPRD patients, including feelings of detachment, mechanical movements, and disconnection from one’s thoughts and voice. This discovery supports previous attempts to neurologically distinguish depersonalization from derealization. […] This study presents a novel approach to deciphering the potential mechanisms of DPRD through large-scale network analysis.

• #37 When experience becomes detached from sensation: Depersonalization/Derealization Disorder – Knowing Neurons

  https://knowingneurons.com/blog/2025/01/09/depersonalization-derealization-disorder/

  As technological advances in preclinical and clinical models continue to make progress in deepening our understanding of dissociative disorders, future targeted treatment options for those struggling with DPDR may be just at the horizon. […] DPDR is a dissociative disorder that can make daily life difficult for those afflicted with the condition. While our current understanding of this disorder is still limited in scope, recent findings from neuroimaging studies have enlightened researchers about the underlying etiology of DPDR – mainly, the working model of increased activation of the PFC and decreased activation of the amygdala.

• #38 Depersonalization/Derealization Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/depersonalization-derealization-disorder

  Patients with depersonalization/derealization disorder often have experienced severe stress, such as the following: Being emotionally abused or neglected during childhood (a particularly common cause), being physically abused, witnessing domestic violence, having a severely impaired or mentally ill parent, having a family member or close friend die unexpectedly. […] Diagnosis of depersonalization/derealization disorder is clinical, based on the presence of the following criteria in the DSM-5-TR: Patients have persistent or recurrent episodes of depersonalization, derealization, or both. Patients know that their dissociative experiences are not real (ie, they have an intact sense of reality). Symptoms cause significant distress or significantly impair social or occupational functioning. […] Treatment of depersonalization/derealization disorder must address all stresses associated with onset of the disorder as well as earlier stresses (eg, childhood abuse or neglect), which may have predisposed patients to late onset of depersonalization and/or derealization. Various psychotherapies are successful for some patients.

• #39 Depersonalization/Derealization Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/depersonalization-derealization-disorder

  Various medications have been used, but none have clearly demonstrable efficacy. Some patients may benefit from selective serotonin reuptake inhibitors (SSRIs), lamotrigine, opioid antagonists, anxiolytics, or stimulants. However, these medications may function largely by targeting other psychiatric disorders (eg, anxiety, depression) that are often associated with or precipitated by depersonalization and derealization. […] Patients with depersonalization/derealization disorder often improve without intervention. Complete recovery is possible for many patients, especially if symptoms result from treatable or transient stresses or have not been protracted. In others, depersonalization and derealization become more chronic and refractory.

• #40 Dissociation and depersonalization: Causes, risk factors, and symptoms

  https://www.medicalnewstoday.com/articles/262888

  Some studies have found that other medications may also be beneficial, such as lamotrigine or naltrexone, but more research is needed. […] Depersonalization, dissociation, and related experiences can happen for a number of reasons, including PTSD, the use of some substances, and other mental health conditions.

• #41 Understanding Depersonalization/Derealization Disorder

  https://lakecountyin.gov/departments/health/nursing-clinic/diseases-and-conditions/mental-health/understanding-depersonalization-derealization-disorder

  Depersonalization/Derealization Disorder (DPDR) is a dissociative disorder characterized by persistent or recurrent episodes of depersonalization and/or derealization. […] The development of Depersonalization/Derealization Disorder is thought to result from a combination of biological, psychological, and environmental factors: […] Neurobiological factors, such as abnormalities in brain function or neurotransmitter imbalances, may play a role in the development of DPDR. Research is ongoing to understand the neurobiological underpinnings of the disorder. […] Effective treatment for Depersonalization/Derealization Disorder involves a multifaceted approach, including psychotherapy, medication, and support services.

• #42 Depersonalization Derealization Disorder | Charlie Health

  https://www.charliehealth.com/post/why-do-i-feel-out-of-my-body

  If your episodes of depersonalization or derealization happen regularly or last for a long period of time; if you are fully aware of the fact that your symptoms represent something outside of your normal way of experiencing life and are able to identify them as such; and if your symptoms are causing distress and challenges in your ability to function on a day to day basis, a medical professional may explore the possibility that you have DDD. […] There are several types of psychotherapy that are used to help people take control of dissociative processes and cope with symptoms. […] Two approaches that are used in Charlie Health’s Intensive Outpatient Program that help individuals with depersonalization-derealization disorder are cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) skills.

• #43 Depersonalization-Derealization Disorder: Symptoms & Causes

  https://www.jagrutirehab.org/disorder/depersonalization-derealization-disorder.html

  To treat Depersonalization/ Derealization Disorder, there is a particular medication. Therefore, the primary course of treatment is psychotherapy which equips patients with better coping skills and a sense of identity. […] Eye Movement Desensitisation and Reprocessing (EMDR) therapy uses bilateral stimulation to process traumatic memories and live a normal life by gradually exposing them to the consequences. Patients reframe their distressing experiences and control their emotional reactions. This approach is particularly designed to address trauma-related Derealization.

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