Condition · Texas
Depersonalization-Derealization Disorder in Texas
Depersonalisation-derealisation disorder involves persistent or recurrent detachment from your own body, thoughts, or surroundings, with intact reality testing: you know things are not actually unreal, which is precisely what makes it so distressing.
Clinically reviewed by Dr. Akinwande Akintola, MD · Last reviewed July 2026 · Next review January 2027
Understanding depersonalization-derealization disorder
Intact reality testing is the defining feature and the reason this is not psychosis. You know you have not changed and the world has not changed; it simply does not feel that way, and that gap is what people describe as unbearable.
Brief episodes are common in the general population, particularly during panic, exhaustion, or after cannabis. The disorder is diagnosed when the experience is persistent or recurrent and causes significant distress or impairment.
It is frequently anxiety-linked and frequently missed. Many people are told it is 'just anxiety' or that they are describing psychosis, and go years without hearing that the experience has a name and a treatment approach.
Symptoms and when to seek an evaluation
- Feeling detached from your body, as if watching yourself
- Emotions feeling muted, absent, or not yours
- Surroundings appearing flat, foggy, or dreamlike
- Familiar people or places feeling unfamiliar
- Distorted sense of time or of physical size and distance
- Knowing all of it is not literally true, which increases the distress
Seek an evaluation when these symptoms have lasted for weeks, are getting worse, or are affecting your work, sleep, or relationships. If you are thinking about harming yourself, call or text 988 now.
What your first visit involves
- Onset and course, including any link with panic, cannabis, or acute stress
- Confirming intact reality testing, which separates this from psychosis
- Screening for panic disorder, depression, and trauma
- Excluding medical and substance causes with your medical provider
First appointments run longer than follow-ups so there is time to take a full history. You leave with a working diagnosis, a plan, and a follow-up date rather than a prescription and no explanation.
Therapy, psychiatry, and combined care
- Psychoeducation, which alone reduces distress substantially for many people
- CBT targeting symptom monitoring, catastrophic interpretation, and avoidance
- Grounding techniques used deliberately rather than as constant self-checking
- Treating the underlying anxiety, panic, or depression that maintains it
- Stopping cannabis and other substances that reliably worsen it
Therapy and psychiatry are delivered in-house by clinicians licensed in Texas and share one chart, so a prescriber and a therapist working with you are looking at the same notes. Many people do best with both.
What we do not treat here
- No medication is specifically approved for DPDR; prescribing targets co-occurring conditions
- Lyte does not provide neurological evaluation or investigations
- Specialist depersonalisation clinics do not exist in most of Texas, so care is delivered within general psychiatry
Care options at Lyte
Clinicians who provide this care
Insurance and cost
Lyte is in network with several Texas plans, and coverage depends on your specific plan and benefits. We verify your benefits before the first visit so you know your expected cost in advance. See which plans we accept.
Frequently asked questions
Am I going crazy?
No. Knowing that things are not really unreal is exactly what distinguishes DPDR from psychosis. It is a recognised condition, it is frightening, and it is treatable.
Why did this start after smoking cannabis?
Cannabis is one of the most common precipitants, particularly high-THC products. Episodes can persist long after use stops, and continuing to use reliably makes the condition worse.
Will it ever go away?
Many people improve substantially, particularly when the underlying anxiety, panic, or depression is treated and substance use stops. Recovery is often gradual rather than sudden.
Is there a medication for it?
No medication is specifically approved for DPDR. Prescribing targets co-occurring anxiety, panic, or depression, which frequently reduces the detachment indirectly.
Sources
Related conditions
- Dissociative Disorders: the wider dissociative groupDPDR sits within the dissociative disorders and shares the underlying mechanism.
- Panic Disorder: unreality during panic attacksDepersonalisation is a common panic symptom, and panic frequently triggers the disorder.
- Anxiety: chronic anxiety underneathPersistent anxiety maintains the symptom, and treating it usually reduces the detachment.
- Substance Use Disorder: cannabis-triggered episodesCannabis is one of the most common precipitants and reliably worsens the condition.
This page is for general education and is not medical advice or a substitute for care from your own clinician. If you are in crisis, call or text 988 (the Suicide & Crisis Lifeline), and for a medical emergency call 911.
Book an assessment for persistent feelings of unreality
Lyte Psychiatry sees patients by secure telehealth across Texas and in person at our Pantego clinic in the Dallas–Fort Worth area.
Book an appointment