What is Derealization?
Derealization is a subjective experience where the external world feels strange, artificial, or distant, as if one were watching a movie or living in a dream. It can be temporary, but when it becomes persistent, it may indicate Depersonalization-Derealization Disorder (DDD).
What is Depersonalization-Derealization Disorder (DDD)?
DDD is a dissociative disorder that affects approximately 1% of the population and is characterized by:
- Depersonalization: A feeling of disconnection from one's body or identity.
- Derealization: A perception of the environment as unreal or artificial.
Unlike psychotic disorders, individuals with DDD retain their ability to distinguish reality from fantasy.
Why Does Derealization Occur? Neurobiological Mechanisms
1. Alterations in Emotional Processing
People with DDD exhibit hyperregulation of emotions. Studies have shown:
- Reduced subjective and physiological response to emotional stimuli.
- Hyperactivity in the prefrontal cortex, inhibiting the amygdala and other emotional areas.
2. Hypervigilance and Excessive Self-Observation
DDD is linked to excessive attention to internal experiences. Research indicates:
- Increased activity in the dorsolateral prefrontal cortex.
- Reduced insular activity, affecting the integration of bodily signals.
3. Alterations in Body Perception
Individuals with DDD can perceive bodily signals normally but struggle to integrate them into their conscious experience, leading to a sense of disconnection from their body.
4. Altered Physiological Responses
Studies have found inconsistent patterns in autonomic responses:
- Some research indicates a reduction in emotional response.
- Others suggest increased activation in stressful situations.
How Can Derealization Be Treated?
1. Cognitive-Behavioral Therapy (CBT)
CBT helps reduce symptoms by:
- Refocusing attention outward.
- Reframing symptom interpretation.
- Training in emotional regulation.
2. Body-Mind Therapies
Since DDD affects body perception, therapies like mindfulness, yoga, or dance therapy can help restore the connection with the body.
3. Pharmacological Treatment
No specific medication exists for DDD, but some studies suggest that lamotrigine and certain antidepressants may help in some cases.
Conclusion
Depersonalization-Derealization Disorder is a complex condition involving alterations in emotional regulation, body perception, and attention. While its origins are not fully understood, CBT, body therapy, and mindfulness have proven effective in managing symptoms.
If you experience persistent derealization symptoms, seeking professional support is key to regaining a sense of connection with reality.
Article based on the systematic review published in Neuroscience and Biobehavioral Reviews.
Author: Psicólogo José Álvarez