In the discussion about mental health, many of us may first think of: depression, anxiety, insomnia, PTSD, etc. – buzzwords nowadays – followed by schizophrenia, bipolar disorder, and eating disorders like anorexia and bulimia – and other, more hushed disorders.

There’s a ton of these classified illnesses, so many that the 10 disorders I just listed may have sounded like a lot. But hidden under the most common of these are more than 100 mental illnesses.  And according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these illnesses affect an estimated 450 million people worldwide – that’s 58% of the global population.

Because and in spite of this great impact, I wanted to speak to you today about the category of dissociative disorders, specifically about Depersonalization/Derealization Disorder as a sparsely documented illness with little public awareness.

For almost four years now, I’ve been diagnosed with Depersonalization/Derealization Disorder. And for each of those four years, I’ve had friends, family, strangers, and on occasion, health professionals tell me that what I’m experiencing as a result of this disorder is unfounded or beyond their understanding and expertise.

So in the hopes of bridging that gap in understanding, I want to provide you with 3 things you need to know about Depersonalization/Derealization Disorder:

  1. What it is and what it isn’t
  2. What it feels like
  3. What its function is

So what is this disorder?

First, it is a dissociative disorder – meaning that there’s an inherent separation or disconnection from one’s normal mental processes. What’s interesting though, is that people can identify with this characteristic of the disorder.

In fact, the Merck Manual of Diagnosis and Therapy states that about 50% of the general population will have at least one of these transient experiences in their lifetime. However, only 2% will exhibit the more specific characteristics of the disorder.

This fact complicates the level of understanding and ultimately support those struggling receive.

Additionally, Depersonalization and Derealization are not the same thing.

Depersonalization is characterized by a detachment from one’s thoughts, feelings, body, and general sense of self. Whereas Derealization is characterized by a disconnection from one’s surroundings, feeling like an outside observer of the world, rather than a part of it.

“Decalcomania” by Rene Magritte (1966)

While for some the two may overlap, there is often an imbalance, where one may have a greater impact than the other. Because of this, it’s important for people exhibiting more frequent dissociative symptoms to seek psychological counsel.

This brings me to my second point. Whether someone with a dissociative disorder is seeking help from a friend, family member, professional, or stranger, it’s important for all parties to know how to talk about the symptoms and general experience of Depersonalization/Derealization.

Mental health activist, Hannah Daisy, explains feelings of depersonalization through her artwork, specifically on Instagram to spark the conversation. Daisy describes the surreal experience through illustrated feelings of fear, uncertainty, helplessness, and solitude.

And while these feelings listed here are mainly negative ones, many people also report feeling excited, freed, calmed, and inspired by it at times.

This kind of duality to the experience further confuses of our understanding. But those positive feelings sometimes associated with it point to interesting functionality of the disorder.

So, for my final point, I want to talk about the function of Depersonalization /Derealization disorder. As with a lot of mental illnesses, it can be the result of a traumatic experience, genetic trend, or develop as a side effect of another disorder such as depression or anxiety.

In many cases, the function of dissociation can be to protect oneself. To detach from something traumatic or harmful, thus inducing numbness or unfamiliarity with its cause or environment. Dissociative episodes can also disrupt, focus, or change someone’s experience in ways some psychologists believe it has a purpose.

Because of certain causes or triggers, dissociative symptoms may decrease with age and circumstance (for example when you no longer need that dissociative protection). However, for others, symptoms may worsen or change, increasing the need for treatment and understanding.

Whatever the effect, it’s important to be able to talk about it. Talk therapy is extremely valuable for understanding and dealing with dissociative symptoms that, if not already experienced, may lead to those feelings of liberation and excitement.

To conclude, I wanted to remind you of the complexity of Depersonalization/Derealization disorder.

If you, or someone you know, struggles with a dissociative disorder, know that there are ways to start the conversation, to understand its experience and to help.

Now that you know a bit about what it is, what it can feel like, and what some of its hypothesized functions are, I hope that you feel more inclined to to speak up about it. And encourage others to explore the experience, function and treatment of Depersonalization/Derealization disorder.

And if you forget everything from this talk today, support and listening is always a great place to start.