This video describes depersonalization-derealization disorder. With depersonalization-derealization disorder, we see criteria that has a dissociative property as well as some other criteria. The classification for depersonalization-derealization disorder is in the Diagnostic and Statistical Manual (DSM). We see with the symptom criteria that somebody would have a depersonalization experience or a derealization experience or both. With depersonalization, this would be experiencing detachment, unreality, or feeling like you’re an outside observer to your own body, thoughts, actions, and feelings. This would be a distorted sense of self, perceptual distortions, or emotional or physical numbing. Derealization is similar but it’s an experience of detachment or unreality related to surroundings. This would be experiencing other people or objects in a dreamlike, foggy, or visually-distorted or unreal way. There are other criteria for this disorder including that reality testing is intact during the experiences. The first thing we might think of we hear about depersonalization and derealization is psychosis, but it’s not the same thing as psychosis. An individual with depersonalization and derealization can separate reality from fantasy throughout the entire experience. With psychosis, of course, that would not be the case. Other criteria include there is clinically significant distress and this would be in areas of social occupational or other functioning, and the experiences are not attributable to substances a medical condition or better explained by another mental health disorder like schizophrenia, major depressive disorder, panic disorder, or post-traumatic stress disorder (PTSD), for example. The dissociative experiences that we see in depersonalization-derealization disorder can last hours, days, weeks, months, and sometimes even years, so it’s highly variable in terms of how long the symptoms can be present. Some common descriptions we hear with this disorder on the depersonalization side would be an out-of-body experience, feeling robotic, lacking control over movement or thought or feeling, and also knowing that feelings should be present but being unable to feel. With derealization some of the common descriptions are looking at the environment and it feels artificial, lifeless, or colorless. Also, visual distortions and auditory distortions are common with derealization, in particular, visual distortions. These experiences of depersonalization and derealization are actually quite common. Most people will experience this type of dissociative event at some point in their life but only about 2% of individuals will meet the full criteria for this disorder. Depersonalization-derealization disorder affects males and females at the same rate and typically has an early onset. We think of this disorder as having an early onset compared to a number of other disorders. The mean age onset is 16 and an onset of depersonalization-derealization disorder after the age of 20 would only occur about 20% of the time, and after age 25 only about 5% at a time. There are a number of mental health disorders that co-occur with depersonalization-derealization disorder. We see major depressive disorder and all of the anxiety disorders are comorbid with depersonalization-derealization disorder. Avoidant personality disorder, obsessive-compulsive personality disorder, and borderline personality disorder are fairly common comorbid mental health disorders with depersonalization-derealization disorder. Posttraumatic stress disorder (PTSD) is actually not highly comorbid with this disorder.