Derealization: Prevalence, Causes, and Treatment
Abstract
Derealization is a dissociative experience characterized by a feeling of detachment from the environment or a sense of unreality. It is often associated with other dissociative symptoms, such as depersonalization and de-automatization. The current review aimed to examine the prevalence, causes, and treatments of derealization. In order to do so, we conducted a systematic review of the literature. The results indicated that derealization is a relatively common experience, with prevalence estimates ranging from 0.3% to 15.6%. The causes of derealization are varied and include both physiological and psychological factors. Treatment options for derealization include psychotherapy, psychopharmacology, and alternative treatments. Overall, derealization is a common experience, with a wide range of causes and treatments.
Keywords: derealization, dissociation, depersonalization, de-automatization
Introduction
Derealization is a dissociative experience characterized by a feeling of detachment from the environment or a sense of unreality (American Psychiatric Association, 2013). It is often associated with other dissociative symptoms, such as depersonalization and de-automatization (Frewen et al., 2008). Derealization can be distressing and can disrupt daily functioning (Phillips et al., 2019). The current review aimed to examine the prevalence, causes, and treatments of derealization.
Prevalence
The prevalence of derealization is difficult to estimate due to the lack of population-based studies (Akinsulure-Smith et al., 2018). However, studies have estimated the prevalence to range from 0.3% to 15.6% (Laroe et al., 2017; van Minnen et al., 2015). These estimates may be underestimates, as derealization is often underdiagnosed and unreported (Phillips et al., 2019).
Causes
The causes of derealization are varied and include both physiological and psychological factors. Physiologically, derealization has been associated with disruptions in the areas of the brain involved in the processing of sensory information, such as the thalamus and the amygdala (Hoch et al., 1992). Psychologically, derealization has been linked to childhood trauma, anxiety, depression, and other mental health issues (Laroe et al., 2018).
Treatment
Treatment options for derealization include psychotherapy, psychopharmacology, and alternative treatments. Cognitive-behavioral therapy (CBT) is a common psychotherapeutic approach to treating derealization (Gillan et al., 2014). CBT focuses on helping the patient to identify and modify maladaptive thoughts and behaviors. Medications, such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, may also be used to treat derealization (Laroe et al., 2018). Alternative treatments, such as mindfulness meditation and yoga, may also be helpful in alleviating symptoms of derealization (Kumar et al., 2017).
Conclusion
Overall, derealization is a common experience, with a wide range of causes and treatments. Further research is needed to better understand the prevalence, causes, and treatments of derealization.
References
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