Difference between Depersonalization and Derealization

Depersonalization and derealization are usually combined by professional psychiatrists into a single diagnosis called Depersonalization-Derealization Disorder. Similar conditions as they are, depersonalization and derealization differ in some respects. Let’s explore these differences.


Depersonalization vs Derealization
“Depersonalization disorder.” A collage by Boris D. Ogñenovich

Depersonalization is a condition in which one experiences “detachment” from one’s self. It is as if the individual is not a person with a set of feelings, emotions, thoughts, sensations and physical activity. The one who suffers from depersonalization knows that he possesses the set of the properties that are normal to any human being, but this set “doesn’t belong to him.” A depersonalized person’s confessions typically include phrases like “I know that my hand is moving, but this is not really my hand, it is someone else’s hand” or “I have these strange sensations, but it is not me who feels them.” Depersonalization in some form typically accompanies mental conditions such as anxiety disorder, schizophrenia or borderline personality disorder.

The painting of Adolf Wölfli which could be seen as a visual representation of derealization disorder.

The individual who experiences derealization feels that the world around him doesn’t exist or exists on its own. The individual feels detached from his surroundings. If it lasts long enough, this experience causes one to question the reality outside of one’s body and mind. Derealization is often accompanied by unusual visual and acoustic sensations. Typical visual distortions as perceived by the individual with derealization include widened or narrowed visual field, blurriness and two-dimensionality. The world around seems to be “hallucinatory,” “elusive,” “dreamlike,” “as if projected on a screen.” Short-term derealization is often a consequence of taking substances such as alcohol, drugs or various medications that cause dissociation. However, once the action of a substance seizes, the perception of the world becomes normal again. A derealization experience, when it is not induced by some substance is often a symptom of schizophrenia, bipolar disorder or dissociative identity disorder.

Comparison chart

Depersonalization Derealization
One feels detached from one’s own self One feels detached from the world around
An individual is not socially alienated An individual is socially alienated
Normally not the result of physical injury Can be a result of a head injury

Depersonalization vs Derealization

What is the difference between Depersonalization and Derealization? Let’s compare them by the type of detachment they cause, by their social application and by how the disorder is connected to physical injuries.

  • An individual becomes  “detached” in the case of both depersonalization and derealization. But, while in the state of depersonalization one is detached from one’s self, whereas in the case of derealization one is detached from the outside world.
  • Someone who experiences depersonalization is normally not entirely socially alienated. A person with symptoms of depersonalization is able to maintain some kind of social relationships and to continue their occupational routines, unless it is an extreme case of depersonalization. On the other hand, a person with derealization can hardly keep any social relationships for the reason that the social world is the part of the outside world which is either non-existent for them, or, exists in a much distorted form.
  • Depersonalization is a psychological condition. It often accompanies anxiety disorders and is combined with physical symptoms like cold sweating, but it does not originate in central nervous system-related injuries. Derealization, on the other hand, often occurs as a result of head injuries. In the human brain the occipital lobe and the visual pathways leading to it are responsible for the images one sees. When those are somehow impaired, the world is “seen” in a distorted way. Furthermore, in cases of mild head injury, migraines or some forms of epilepsy, there is a reduced emotional response to the observed objects. As a result, the perceived world is not emotionally “colored” and it becomes “detached.”