The Causes Are Less Specific

Depersonalization is a common anxiety-based condition. But let’s take another common anxiety-based condition like, say, claustrophobia.

So -- if somebody with claustrophobia is in, say, a crowded subway carriage, they might start to feel very uncomfortable and panicky. They might feel like the walls are closing in, they might need to get out as soon as possible.

And the same might apply when they’re in an elevator, a plane, even a toilet cubicle. But what’s important is that the symptoms and triggers are very clear and even specific.

With Depersonalization, the symptoms can be a lot more vague, but just as frightening. You might feel a sense of unease with literally everything around you.

But there’s nothing specific that’s triggering them. Nothing that you can point to and say, "THAT'S causing the feelings".

This simple fact can make DPDR more difficult to diagnose than other anxiety-based conditions.

The Symptoms Are Harder To Describe

Continuing with the example of claustrophobia, when you experience it for the first time, it will feel really inexplicable and scary. You have no idea why this is happening!

But when you explain the feelings to a doctor or psychologist -- and say that you feel scared and panicky in enclosed spaces -- those are pretty clear symptoms of claustrophobia, and the likelihood is that you will get diagnosed and start treatment very quickly. 

But with DPDR, the symptoms themselves are different. Feelings of Deja Vu, problems with vision etc are very common.

And in particular, one of the main symptoms is a feeling of being cut off from the world around you.

Now -- this is a perfectly natural and common response to stress and panic.

But if you’re experiencing a sudden and overwhelming sense of disconnection from yourself and your surroundings, for the first time, with no frame of reference for what it is -- well, that can be a very tough thing to describe!

So you often have people struggling to describe it, saying things like: 

"I feel like I’m not here"

"I feel like I’m stuck in a dream"

"I feel like I’m behind a pane of glass"

etc, etc... Which brings us to our next point!

The Symptoms Are Frightening To Describe

There’s also the fact that just saying things like ‘I feel like I’m not here’ can seem very frightening!

I remember walking into my doctor’s office back in 2005 and trying to describe what I was experiencing. Saying things like ‘I feel like I’m not real’.

And part of me was absolutely convinced that that was not something a sane person would say.

I was genuinely scared that I would be put away in a mental hospital for the rest of my life. 

Of course, I wasn’t. But even just the fear of describing your symptoms honestly can prevent people from even seeing a doctor in the first place.

DPDR Is Often Diagnosed As 'Just Anxiety'

Because the symptoms can often have a lot of crossover with more well-known symptoms of anxiety (racing thoughts, catastrophizing etc), and because the patient will typically be in a visibly anxious state, they tend to often just be diagnosed as having anxiety.

Now, the thing is that this isn’t incorrect -- DPDR IS an anxiety-based condition! But the problem is that that really doesn’t FEEL like it covers what you’re going through.

I remember thinking to myself:

“Hang on -- I’ve felt anxiety before -- and this is a LOT worse than that!”

Now, anxiety-based conditions are at very different levels from day-to-day anxiety, like having an exam coming up or giving a presentation at work.

But it is important to remember that even if a diagnosis of anxiety seems simplistic, it’s still technically correct!

Fewer Diagnoses

Because of all the reasons I’ve just outlined, there tends to be a lot fewer diagnoses of DPDR compared to say, agoraphobia, social anxiety disorder etc.

Fewer diagnoses means that it’s more difficult to research, because the numbers aren’t as great as those other conditions. 

Less research means less awareness of the condition, which means less diagnoses -- and so the circle continues. Or at least, it has done for decades!

It can be frustrating, but please do bear in mind that this has more to do with the nature of the condition (and just how difficult it can be to describe) than any sort of lack of interest or negligence in the medical community.

Also, it’s important to remember that this IS changing.

When I developed DPDR back in 2005, there was almost no information about the condition available online, aside from one or two small chat forums. Now there is a wealth of different resources.

And that’s being reflected in the medical community -- these days I’m speaking to more and more people whose doctors HAVE recognized the symptoms and diagnosed the condition.

It’s also worth noting that the legalization of cannabis is inevitably leading to more and more cases of weed-induced DP, which in and of itself is leading to more awareness of the condition. 

And with more awareness of the condition, the quicker that a diagnosis is likely to happen, the sooner you realise that this isn’t some sort of mysterious, bizarre disease.

It’s a common harmless, temporary anxiety-based condition. Sure, it may have some symptoms that aren’t as clear-cut as say, the fear of being an enclosed space.

And in fact, one of the scariest things about it is just that initial phase of not knowing what it is or what you can do to recover.