Feeling disconnected from my body
Mental Health: Depersonalization Disorder
Written by WebMD Editorial Contributors
In this Article
- What Are the Symptoms of Depersonalization Disorder?
- What Causes Depersonalization Disorder?
- How Common Is Depersonalization Disorder?
- How Is Depersonalization Disorder Diagnosed?
- How Is Depersonalization Disorder Treated?
- What Is the Outlook for People With Depersonalization Disorder?
- Can Depersonalization Disorder Be Prevented?
Depersonalization disorder is marked by periods of feeling disconnected or detached from one's body and thoughts (depersonalization). The disorder is sometimes described as feeling like you are observing yourself from outside your body or like being in a dream. However, people with this disorder do not lose contact with reality; they realize that things are not as they appear. An episode of depersonalization can last anywhere from a few minutes to (rarely) many years.
Depersonalization also might be a symptom of other disorders, including some forms of substance abuse, certain personality disorders, seizure disorders, and certain other brain diseases.
Depersonalization disorder is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, consciousness, awareness, identity, and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person's general functioning, including social and work activities and relationships.
What Are the Symptoms of Depersonalization Disorder?
The primary symptom of depersonalization disorder is a distorted perception of the body. The person might feel like they are a robot or in a dream. Some people might fear they are going crazy and might become depressed, anxious, or panicky. For some people, the symptoms are mild and last for just a short time.
For others, however, symptoms can be chronic (ongoing) and last or recur for many years, leading to problems with daily functioning or even to disability.
What Causes Depersonalization Disorder?
Little is known about the causes of depersonalization disorder, but biological, psychological, and environmental factors might play a role. Like other dissociative disorders, depersonalization disorder often is triggered by intense stress or a traumatic event -- such as war, abuse, accidents, disasters, or extreme violence -- that the person has experienced or witnessed.
How Common Is Depersonalization Disorder?
Depersonalization can be a rare symptom in several psychiatric disorders and sometimes occurs after experiencing a dangerous situation, such as an assault, accident, or serious illness. Depersonalization as a separate disorder is quite rare.
How Is Depersonalization Disorder Diagnosed?
If symptoms of depersonalization disorder are present, the doctor will begin an evaluation by performing a complete medical history and physical exam.
Although there are no lab tests to specifically diagnose dissociative disorders, the doctor might use various diagnostic tests, such as imaging studies and blood tests, to rule out physical illness or medication side effects as the cause of the symptoms.
If no physical illness is found, the person might be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interviews and assessment tools to evaluate a person for a dissociative disorder.
How Is Depersonalization Disorder Treated?
Most people with depersonalization disorder who seek treatment are concerned about symptoms such as depression or anxiety, rather than the disorder itself. In many cases, the symptoms will go away over time. Treatment usually is needed only when the disorder is lasting or recurrent, or if the symptoms are particularly distressing to the person.
The goal of treatment, when needed, is to address all stresses associated with the onset of the disorder.
The best treatment approach depends on the individual and the severity of their symptoms. Psychotherapy, or talk therapy, is usually the treatment of choice for depersonalization disorder. Treatment approaches for depersonalization disorder may include the following:
- Psychotherapy: This kind of therapy for mental and emotional disorders uses psychological techniques designed to help a person better recognize and communicate their thoughts and feelings about psychological conflicts that could lead to depersonalization experiences. Cognitive therapy is a specific type of psychotherapy that focuses on changing dysfunctional thinking patterns.
- Medication: Medications are generally not used to treat dissociative disorders. However, if a person with a dissociative disorder also suffers from depression or anxiety, they might benefit from an antidepressant or anti-anxiety drug. Antipsychotic medications are also sometimes used to help with disordered thinking and perception related to depersonalization.
- Family therapy: This kind of therapy helps to educate the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence.
- Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express their thoughts and feelings in a safe and creative way.
- Clinical hypnosis: This is a treatment technique that uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness or awareness, allowing people to explore thoughts, feelings, and memories they might have hidden from their conscious minds.
What Is the Outlook for People With Depersonalization Disorder?
Complete recovery from depersonalization disorder is possible for many patients. The symptoms associated with this disorder often go away on their own or after treatment that help the person deal with the stress or trauma that triggered the symptoms.
However, without treatment, additional episodes of depersonalization can occur.
Can Depersonalization Disorder Be Prevented?
Although it might not be possible to prevent depersonalization disorder, it might be helpful to begin treatment in people as soon as they begin to show symptoms. Furthermore, quick intervention following a traumatic event or emotionally distressing experience might help reduce the risk of developing dissociative disorders.
Symptoms of Depersonalization-Derealization Disorder I Psych Central
Many people have felt disconnected from themselves and their surroundings. But if these feelings arise regularly, you might have depersonalization-derealization disorder.
At one time or another, all of us have found ourselves lost in our daydreams, thinking pleasant thoughts about our lives and our futures.
Maybe you’ve gotten lost in a book or become hyper-focused on a fascinating project.
Occasionally, maybe you’ve even felt disconnected from yourself, having an out-of-body experience during a stressful time in your life.
If these feelings are happening more frequently, you may have depersonalization-derealization disorder. Feeling disconnected from reality or yourself are two of the main symptoms of this condition.
Depersonalization-derealization disorder is classified as a dissociative disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
In depersonalization-derealization disorder, people experience one or both of these states:
- Depersonalization: feeling detached from your own body, thoughts, or feelings
- Derealization: feeling detached from your surroundings
Unlike psychotic disorders, people with depersonalization-derealization disorder know that their experience isn’t reality. People with the condition realize that something is off, which usually causes them to feel distressed.
It’s estimated that depersonalization-derealization disorder affects 1-2% of the population.
According to the DSM-5, some people with depersonalization-derealization disorder have discrete episodes, while others have continuous symptoms.
Or, some individuals may start out experiencing episodes that eventually become continuous symptoms.
People with depersonalization-derealization disorder may have a tough time describing their symptoms. They might also think they’re odd or unusual or fear they have irreversible brain damage, according to the DSM-5.
Understandably, experiencing depersonalization-derealization symptoms can feel unnerving. Some common symptoms include:
Depersonalization symptoms
- feeling like you’re completely detached from yourself, even believing that you have no self
- feeling detached from parts of yourself such as your thoughts, as in, “My thoughts don’t feel like my own,” or “My head is filled with cotton”
- feeling like you’re outside of your body, watching yourself in a movie or from above
- having a distorted sense of time – time is either too fast or too slow
- feeling mentally, emotionally, or physically numb
- feeling like you have no control over your body, including your movements or speech
- feeling like you’re a robot
Derealization symptoms
- feeling detached from reality
- experiencing others or objects as foggy, artificial, cartoonish, or dreamlike
- experiencing sounds or voices as muted or heightened
- experiencing objects as flat or two-dimensional
- seeing objects as distorted in size or distance
- feeling like you’re trapped in a glass bell or like there’s a veil between you and the world
In some cases, depersonalization-derealization symptoms go away on their own.
But for others, symptoms are persistent and can develop into depersonalization-derealization disorder.
Treatment may include psychotherapy, medication, or a combination of both.
Psychotherapy
Research on treatment for depersonalization-derealization disorder is limited. Still, existing research stresses the importance of psychotherapy.
According to this older study, strengthening coping skills is helpful when individuals are experiencing intense or acute symptoms, such as frequent dissociation or severe anxiety or depression.
When symptoms are milder or relatively stable, therapy may help delve into – and over time resolving – why individuals become disconnected from reality or themselves.
Other helpful therapies include:
- cognitive behavior therapy (CBT) for changing negative thoughts and unhealthy behavior
- dialectical behavior therapy (DBT) for tolerating difficult emotions, reducing self-destructive urges, and improving relationships
- eye movement desensitization and reprocessing (EMDR) for reducing distress from traumatic experiences
Grounding techniques that can help you reconnect to reality and yourself may also be addressed in therapy.
These in-the-moment strategies may include practicing deep breathing exercises or holding an ice cube.
Overall, a range of approaches may be used, depending on your needs, specific symptoms, and if you have another mental health condition.
Medication
The Food and Drug Administration (FDA) hasn’t approved any medication to treat depersonalization-derealization disorder.
A 2019 review that looked at medication for dissociative disorders found that paroxetine (Paxil) and naloxone (Narcan) may be effective for depersonalization and dissociative symptoms that co-occur with post-traumatic stress disorder (PTSD) and borderline personality disorder.
However, researchers noted that these findings were modest and “should be interpreted with caution” because of limited data.
In some cases, doctors might prescribe medication to reduce accompanying symptoms of anxiety or depression.
If your doctor suggests taking medication, consider asking these questions at your next appointment:
- What specific symptoms should this medication reduce or relieve?
- When can I expect to experience these improvements? Weeks or months from now?
- What are common and less common side effects?
- How can I reduce or prevent possible side effects?
- When is my follow-up appointment?
- How long should I take this medication?
- Is it OK to stop abruptly, or will I need to slowly and gradually take a reduced dose to avoid withdrawal syndrome?
If your symptoms are stressing you out or interfering with an area of your life – like your work or relationships – consider talking with a mental health professional.
It’s common for depersonalization-derealization disorder to co-occur with depression and anxiety disorders. So, it’s important to let your doctor know if you’re also experiencing these symptoms.
Remember that you don’t have to wait until your symptoms worsen or experience a crisis before you consider reaching out to someone for help.
Therapy, if it’s available to you, can be helpful. A therapist can help you:
- address specific symptoms or situations that are bothering you
- learn to cope with stress
- build a healthier lifestyle
Experiencing symptoms of depersonalization or derealization can lead you to feel alone – even if intellectually you know that others also have similar experiences.
Connecting with others to share your story, asking questions about possible treatments, or reminding yourself that you’re not alone can be helpful.
These online communities may be helpful:
- Depersonalization community forum
- Depersonalization/derealization support group on Facebook
- Depersonalization group on Facebook
Understandably, dealing with symptoms of depersonalization or derealization can bring up a range of emotions – from fear and frustration to confusion.
If possible, consider working with a mental health professional and connecting with others. With treatment and support, you can reduce your symptoms of depersonalization or derealization and feel better.
Depersonalization: a syndrome that interferes with feeling - BBC News
Image caption,Sarah says that because of her illness, familiar places seem like decorations
People with depersonalization syndrome see the world as unreal, two-dimensional, as if in a fog. Every hundredth suffers from this disorder, but despite this, British doctors are not taught to work with such patients, experts say.
"The connections you think are valuable lose their original meaning. You know you love your family. But the thing is, you're more aware of it than you feel it," says Sarah on Victoria Derbyshire's BBC program. -bc.
Sarah is an actress, she constantly tries on different images and reproduces other people's emotions.
But in reality, for most of her conscious life, she is emotionally paralyzed and unable to experience any feelings.
The reason for this is a little-studied mental disorder called depersonalization.
Sarah had the syndrome three times. The first time it happened was when she was preparing for her final exams.
The main sign of depersonalization is the feeling that a person loses physical connection with the world around him and his own body.
It is believed that this is how a defense mechanism manifests when, during stress or a serious shock, consciousness is disconnected from reality. Some drugs, such as marijuana, can cause the same effect.
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For people with depersonalization syndrome, the world can change in a second.
"It was an unexpected switch. Everything around seemed alien and even intimidating. Suddenly, the apartment and other places where you used to be become a film set for you, and all your things become scenery," says Sarah.
Other patients report feeling that they are outside their body, that it does not belong to them, and that the world around them seems two-dimensional and flat.
This happened to Sarah during the second episode.
"I was reading, I had a book in my hands. And suddenly my hands began to look like a picture on which two hands were drawn.
There was a feeling that the real world and my perception of it did not coincide."
Sarah's disorder is not uncommon. Three independent studies have proven that it occurs in one person out of a hundred.
Experts say the disorder has long been recognized as a medical condition. It is as common as obsessive-compulsive disorder or schizophrenia.
Some untreated patients may suffer lifelong depersonalization symptoms. And yet, not all doctors know what it is.
A doctor who recently graduated and suffers from this disorder himself stated that depersonalization was not taught in medical school or in continuing education courses for therapists.
He admitted that he misdiagnosed his patients at least twice. According to him, he will be very surprised if it turns out that at least one of his colleagues has heard about this syndrome.
Sarah says that in her life she encountered at least 20 professionals who had no idea what she was talking about.
Among them are consultants, therapists, district psychiatrists and doctors.
The Royal College of General Practitioners (RCGP) in London said that mental health was a key element of an expanded curriculum for physicians.
The institute added that the study of more complex psychological problems is still in development.
The Royal College of Psychiatry stressed the need to ensure that these disorders are properly understood.
Image caption,Dr Elaine Hunter runs the only referral center in the UK that treats patients with depersonalization
Poor diagnosis is only part of the problem, access to treatment is another complication.
There is only one specialist clinic in the UK. Its resources are limited, it can only accept 80 patients a year. Despite the fact that 650 thousand people can potentially suffer from this disease.
To access this health center free of charge, a referral from a local doctor is required.
And even if the patient is diagnosed with depersonalization, treatment will have to wait several months or longer.
After a year of waiting in line, Sarah decided that the only way out was to pay for the treatment herself.
"I used to have panic attacks all the time. It's really scary. I knew it was a crisis," she says.
A specialist center for patients with depersonalization syndrome operates at the Maudsley Hospital in south London. However, there are restrictions for patients under 18 years of age; the center only treats adults.
Often the disease occurs in adolescence. Dr. Elaine Hunter, who heads the center, is concerned that she has to withhold care for children and adolescents.
"Sometimes 15-year-old patients come to us deeply depressed and frightened, but we have nothing to offer them," she says.
One of the adult patients of the center developed the syndrome at the age of 13.
For two years she could not leave the house, she experienced ten panic attacks a day caused by the disorder.
At the beginning of the treatment, she did not even recognize her own parents.
Dr. Hunter hopes that over time, the right treatment will be available to underage patients.
She believes that treatment should be organized in every district. Physicians in local centers for psychological assistance should undergo special training, then disseminate information among other specialists.
Image caption,Sarah Ashley couldn't eat or sleep until she was treated by Dr. Hunter
Hunter developed Cognitive Behavioral Therapy (CBT) specifically for patients with depersonalization. She believes that she will be easily mastered by doctors who already have experience in talking therapy.
Sarah Ashley, a patient of Dr. Hunter, says she was initially skeptical about the technique, but after a while she felt a huge difference.
"[Before CBT] I looked at my own hands or other body parts and felt like they weren't mine. I looked at myself in the mirror and didn't realize it was me," explains Sarah.
"I couldn't eat or sleep, and due to stress I lost 42 kg. Now I still have some symptoms, but I can get over them quickly," she continues.
Treatment is available but difficult to obtain.
As Dr. Hunter says, we need to correct the situation in which patients are forced to look up information about their disorder on the Internet, and then explain to the doctor what it is about. Instead of, on the contrary, the doctor told the patient about his illness.
What is depersonalization and how to live with it
Impairment of the perception of one's own "I", a feeling of unreality of what is happening, anxiety attacks, panic attacks and loss of emotions - these are the symptoms of depersonalization disorder, which is often confused with schizophrenia.
Afisha Daily publishes three stories of people with this terrible diagnosis.
Tatyana, 28 years old: “For the first time I encountered a feeling of unreality of what was happening when I was 22 years old. One day, I just stopped feeling any emotions; my relatives suddenly became strangers, I didn’t want to communicate with anyone, go out anywhere. I didn’t feel like myself - the personality was erased, and I became a different person: the feeling that there was no more soul, only one shell. This was accompanied by constant anxiety, soul-searching, headaches, and a sense of hopelessness. This is a terrible state when suicide seems to be the only way to stop everything.
I was very frightened and urgently called my mother, because I myself could not even go to the doctor. The neurologist at the hospital said that I was depressed and prescribed a cocktail of antidepressants and neuroleptics. Surprisingly, almost from the first days of taking the pills, I returned to life: the symptoms disappeared, my mood improved, my ability to work increased, I became sociable and open.
A month later, I stopped taking these drugs and did not go to the doctor again (although I was warned not to give up the drugs). For four years, I forgot about the problems.
The symptoms returned when a relative offered me a new job. There were rather high requirements for employees - a mandatory driver's license, specialized education in the field of shipping and fluent English. I was given six months to prepare. The relative paid for all the courses, the university - and then the stress began. I felt that it was covering me, so I arbitrarily returned to the pills. It got a little easier for a while. I tried my last strength not to lose face, to get this job, not to let down the person who believed in me and also spent money. But I got worse and worse, and I failed the job interview. It was a very difficult period.
After that, I began to sit on forums, google articles about mental disorders with similar symptoms. There were thoughts that I had schizophrenia and I was finally going crazy.
I started running around psychiatrists, but all of them refuted my suspicions. Depression was re-diagnosed, antidepressants were prescribed - anxiety subsided a little, but emotions and feelings never returned.
Once on some website I saw a description of a diagnosis that exactly matched my symptoms. Then my acquaintance with depersonalization-derealization disorder began. I went to doctors, but they basically didn't know what it was and how to treat it. Sometimes they simply did not want to listen to me - they immediately prescribed medicines and sent me home. One professor said that I "read on the Internet." I found my salvation in online consultations with a doctor who dealt with dereal: according to his scheme, I started taking antidepressants and antiepileptic drugs.
The reason for my depersonalization is neurosis, which is accompanied by anxiety: under stress, the body defends itself and the brain seems to turn off, isolation from the outside world occurs. This happens to impressionable people who worry about anything, take everything to heart.
I am one of those.
My experience is 2.5 years. I know that there may be deterioration, but there is a way out. Now I have reached the stage when a new job is a joy, I feel like myself again, mental abilities, emotions and feelings are the same as before the illness. And, although I'm still on the pills, it's better than suffering again. I hope someday I can cancel them. It sounds strange, but this illness has changed me for the better. Thanks to her, I truly began to appreciate life and loved ones. Became more patient. I am glad that I can live a normal life again, feel, love, enjoy communication with people and from my favorite activities.
Our society is very contemptuous of those in need of psychological help. If they find out that a person has been to a psychiatrist, they immediately label him a psycho and avoid him. Nevertheless, you should not be afraid to seek qualified help, the main thing in this matter is to find a really good doctor. And there are very few of them.
"
Nikolai, 27 years old: “I have been neurotic since childhood: stuttering, obsessive-compulsive disorder (obsessive thoughts syndrome). In August 2014, I went to a psychiatrist with depression and impaired perception of reality, I was then 25 years old. It all started with rare panic attacks, which were replaced by bouts of severe derealization. The world turned upside down, and I had to lie down on the floor and close my eyes, this helped to come to my senses. After another such attack, I developed anxiety.
For exactly 6 months I have been thrashing around looking for and inventing physical illnesses to justify my condition. Admitting to yourself that you are a little "cuckoo" is difficult, and this is how hypochondria appears. The catalyst for hypochondria is still such an unpleasant reality as unskilled medicine. The inertia coming from the USSR still persists - doctors sculpt a diagnosis of VVD (which has long been absent from the world classification of diseases), say that everything is in order, prescribe vitamins and send them home.
Therefore, I had to engage in self-diagnosis and be terribly afraid of what was really happening to me. Unfortunately, I made the diagnosis of "depersonalization disorder" myself, once again surfing the Internet. Through acquaintances, I managed to go to a psycho-neurological dispensary. There I was pumped with the same Soviet drugs, put on droppers, there was even a massage and a circular shower. At discharge, there were no significant results: it became easier to sleep, but the condition remained the same painful.
Finally, miraculously, I managed to get to a good psychiatrist. Properly selected drugs have built a solid foundation for my recovery. Now pharmacology has reached such a level that drugs work reliably with a minimum of side effects and consequences for the body. Of course, they do not eliminate psychological problems, but they provide a runway for climbing to the height where these problems could be eliminated. The antidepressant began to noticeably act somewhere in 3-4 weeks after the start of the reception.
The mood improved, strength appeared, life began to bring pleasure. Then slowly: communication with friends began to recover, I began to go out, my libido and the desire to do something woke up. I recovered at work: when getting to the toilet is a huge test, work becomes something unbearable.
Depersonalization is, in the usual sense, the loss of oneself; when you can't understand what kind of person you are. Recovery after this leads to a rethinking of life attitudes. For example, in the past, I limited myself, tried to conform to the ideas dictated by society. He lived according to the principle “as it should be”, and not “as I want”. During this period, the understanding of one's person is lost: who are you? why are you? who are you supposed to be? You are depersonalizing. At the turning point of frustration, you understand that you need to live for yourself, and not for others, you stop constantly looking for flaws and correcting them in order to become someone. I accepted myself.
"
Anastasia, 20 years old: “At school, I was often bullied because of my excess weight, no one took me seriously at home, there were constant screams and scandals because of my father’s alcohol addiction. At the age of 15, I decided to try drugs and, not knowing the “correct dosages”, I took too much at one time. After that, my health deteriorated sharply: short-term panic attacks began, heart palpitations, unsteadiness of gait, dizziness appeared. At first I thought that I had something with my heart or blood vessels; over time, this developed into a fear of a heart attack, stroke, or sudden death. Then there was an examination of the whole body, but nothing concrete was found out: the doctors either did not find anything, or made a diagnosis of "vegetovascular dystonia". One doctor advised me to get tested for cancer.
Over time, the situation progressed. There was a terrible feeling inside, like anxiety: I couldn’t sleep normally, it seemed that I would die any minute.
One day I realized that I did not feel my body. There was a feeling of lightness and weightlessness at the same time, and then I began to catch myself thinking that it was as if I were not there. The sensations in my hands became not mine, the reflection in the mirror was not the same. Then I realized that I was in danger not of a heart attack, but of schizophrenia. I completely surrendered to this fear: the physical symptoms disappeared, there was an indescribable horror that now I would lose touch with reality and control over myself. I began to hide the handle from the balcony so that in a fit of unconsciousness the window would not suddenly jump out. The world as I knew it was shattered. Going out into the street, I understood that there was a big barrier between me and reality. The world behind the glass seemed flat, colorless, dead. I couldn't figure out if this was a dream or reality, or maybe I had died altogether. Time just stopped, it didn't exist, it didn't exist for me. And in the soul there is emptiness, silence and no emotions.
I found out that this is not schizophrenia on a site about dissociative disorder. Thus began a new phase. On VKontakte, I found a group about dereal, where there were hundreds of people like me. For about a week I sat in the community, reading information, personal stories and recommendations, until I fully understood that this was it - depersonalization-derealization disorder.
In the 11th grade, everything got to the point that I was taken from the USE in an ambulance. When I went to the doctor, he started asking something, and I was silent: I was so tired of this shit that I could not say a word. My parents found out that I have serious mental problems. It seemed to me that my mother did not understand me. I was again taken to the doctors, but we failed to find an intelligent specialist. In Soviet-era hospitals, doctors are not at all familiar with depersonalization: in one of these, I was prescribed 12 dubious pills a day, and glycine was also completely useless for my symptoms.
There were doctors who were more interested in my outlook on life than my health.
As a result, I found my psychiatrist, with whom we still keep in touch, through my mother's friend. If we talk about treatment, then you can’t do without antidepressants. They help to return to the previous mode and significantly improve the condition. Now I'm 20, and I'm still on pills: I decided that it's better to feel good with them than to think about suicide every day.
“The depersonalization-derealization syndrome is based on the attempt of the psyche to adapt to stress in conditions of its high intensity, for example, during fear or panic. This syndrome as a separate disorder is included in the international classification of diseases (ICD-10), but often occurs as a secondary syndrome with severe anxiety, depression and other acute conditions. Depersonalization and derealization, although combined into one term due to their similarity and general nature, represent two independent symptoms that can manifest themselves separately from each other.
During depersonalization, the patient's own face, figure, smile, speech seem unfamiliar, as if you are watching yourself as an outsider. Derealization, on the other hand, concerns the perception of the environment: place, time, circumstances, etc. Sometimes a feeling of “drunkenness”, “unreality” and “floating picture” is added.
The main cause of DP/DR lies in the activation of opiate receptors - there is an assumption that in this way the human body tries to reduce severe anxiety. Stress can become a reason if it was intense and caused a vegetative crisis (like a panic attack).
Feelings during depersonalization-derealization frighten with their unusualness. It seems to the patient that he has lost control of his own body, and this in itself provokes even more intense fear. It differs from schizophrenia primarily in the absence of symptoms of psychosis (hallucinations, delusions, catatonia, etc.). Also, the DP / DR syndrome can be observed in acute psychotic episodes, but then there must be appropriate mandatory symptoms of a severe mental illness.
