How is depersonalization/derealization disorder treated?

Most people who seek treatment for depersonalization/derealization disorder are more concerned about their associated symptoms such as depression or anxiety rather than the dissociative disorder itself. In many cases the symptoms will go away on their own. Treatment is usually only needed (or only sought) when the disorder is lasting or recurrent, or if the symptoms are particularly debilitating or distressing.

The goal of treatment is to address all stressors associated with the onset of the disorder. The best treatment approach depends on the individual, the nature of any identifiable triggers, and the severity of the symptoms. Most likely treatment will include some combination of the following methods:

  • Psychotherapy: Psychotherapy, sometimes called “talk therapy,” is the main treatment for dissociative disorders. This is a broad term that includes several forms of therapy.
  • Cognitive-behavioral therapy: This form of psychotherapy focuses on changing dysfunctional thinking patterns, feelings, and behaviors.
  • Eye movement desensitization and reprocessing (EMDR): This technique was designed to treat people with persistent nightmares, flashbacks, and other symptoms of post-traumatic stress disorder (PTSD).
  • Dialectic-behavior therapy (DBT): This form of psychotherapy was designed for people with severe personality disturbances, which can include dissociative symptoms and often occur after the person has experienced abuse or trauma.
  • Family therapy: This helps to teach the family about the disorder as well as to help family members recognize symptoms of a recurrence.
  • Creative therapies (for example art therapy, music therapy): These therapies allow patients to explore and express their thoughts, feelings, and experiences in a safe and creative environment.
  • Meditation and relaxation techniques: These help people to better tolerate their dissociative symptoms and become more aware of their internal states.
  • Clinical hypnosis: This is a treatment method that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness, allowing people to explore thoughts, feelings, and memories they may have hidden from their conscious minds.
  • Medication: There is no medication to treat dissociative disorders themselves. However, people with dissociative disorders, especially those with associated depression and/or anxiety, may benefit from treatment with antidepressant or anti-anxiety medications.

Last reviewed by a Cleveland Clinic medical professional on 04/20/2016.

References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing, 2013.
  • Carlson, E. B. & Putnam, F. W. DES: Dissociative Experiences Scale II Accessed 4/20/2016.
  • Mental Health America. Dissociation and Dissociative Disorders Accessed 4/20/2016.
  • Steinberg, M. Interviewers’ Guide to the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). Arlington, VA: American Psychiatric Publishing, 1994.

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