Treatment & Care
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For most people with symptoms of DPDR, the experience can feel extremely frightening. Many worry that:
they’ve damaged their brain
they’re experiencing a sudden neurological problem
they’re ‘going crazy’
That’s why it’s so important to quickly reassure people that these symptoms are part of a recognised condition — Depersonalisation and/or Derealisation Disorder (DPDR). Clear, accurate information and reassurance can make a huge difference.
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Clinicians play a vital role in helping people feel seen and understood. A calm explanation of what DPDR is, and how common it is, can help someone move from fear to hope.
We have resources you can share with patients, including:
Simple explanations of DPDR and its symptoms
Information on possible triggers
Links to peer support services
Stories from others with similar experiences
Reassurance that recovery is possible
You can also direct people to the Unreal website and our Peer Support service for ongoing support.
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Although there’s currently no NICE guidance for DPDR, a BMJ infographic and BMJ article offer a helpful, evidence-based overview of stepped care for DPDR.
These suggest four main care pathways:
Watchful waiting and monitoring
For people with recent symptoms, especially if they might improve naturally with reassurance and information.Treating associated conditions
If anxiety or depression is present, begin with treatment for these. DPDR symptoms may improve as a result.Treating secondary mental health conditions
If there’s a diagnosis of PTSD or a personality disorder, focus treatment there first, then reassess DPDR symptoms.Specialist treatment for DPDR
For people whose DPDR is the main or only issue, or whose symptoms persist despite other treatment. This might include referral to a specialist if no local expertise is available. More information on the NHS specialist service can be found at the bottom of this page.
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There is growing evidence that psychological treatments can help:
Cognitive Behavioural Therapy (including treatment adapted for DPDR) has been shown to reduce symptoms in some people
Medications can help alleviate symptoms, usually by treating a person’s anxiety or depression that may be causing or contributing to their DPDR
Repetitive Transcranial Magnetic Stimulation (rTMS) and Mindfulness-Based Cognitive Therapy have shown promise, but need further research
The academic papers at the bottom of this page provide information and results on the current findings about these approaches.
Cambridge Depersonalisation Scale
Learn more
For information about symptoms and lived experience, visit our ‘What is DPDR’ page. For clinical definitions, you can also refer to the DSM-5 or ICD-11.
In the below video Dr Emma Černis and Dr Elaine Hunter, Clinical Psychologists, discuss how to identify symptoms, support those with the condition, and provide details of further training.
“If you’re not sure what exactly people are experiencing, it might be a clue that it’s depersonalisation but it might also mean it’s time to ask a few more questions and really try and understand what it’s like for the person.”
— Dr Emma Černis, Clinical Psychologist
Publications
Specialist Service
In the UK, there is one specialist tertiary NHS service for the assessment and treatment of DPDR. The Centre for Anxiety Disorders and Trauma (CADAT) is an outpatient psychological therapy service. CADAT provides assessment and cognitive behaviour therapy (CBT) locally and nationally for specific anxiety disorders and depersonalisation disorder.
People frequently contact us regarding referrals, funding, assessment, treatment, medications, whether the service is accessible from outside the UK, and whether or not you have to travel to South London once you have been accepted. Joe visited by the hospital to these questions to Dr Claudia Hallett, a Clinical Psychologist working within the service.
Academic Papers