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How to Distinguish Irreality OCD from Depersonalization / Derealization Disorder

Irreality OCD, also known as Depersonalization/Derealization Disorder (DP/DR), is a subtype of Obsessive-Compulsive Disorder (OCD) characterized by intrusive and distressing obsessions related to feelings of unreality or detachment from oneself or the surrounding environment.

Individuals with Irreality OCD experience a persistent and intense sense of being disconnected or detached from their thoughts, emotions, sensations, or even their own body, leading to feelings of "unreality."

There are two main components of Irreality OCD:

  1. Depersonalization: This is a sense of detachment or disconnection from oneself. Individuals may feel like they are observing themselves from outside their body, as if they are in a dream or in a movie.

  2. Derealization: This is a feeling of detachment or disconnection from the external world. Individuals may perceive the world as unreal, foggy, dream-like, or lacking in significance. Colors may appear dull, sounds may seem distant, and the environment may feel distorted.

People with Irreality OCD often find these experiences distressing and intrusive, leading to high levels of anxiety. 

They may constantly question their own sense of reality and feel like they are losing touch with themselves and the world around them. These intrusive thoughts and feelings can become obsessive and create a cycle of anxiety and avoidance.

It's important to note that Irreality OCD is a specific subtype of OCD and should not be confused with Depersonalization/Derealization Disorder, which is a separate and distinct clinical diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). 

The key difference is that Irreality OCD is characterized by the presence of obsessions and compulsions, while Depersonalization/Derealization Disorder is a chronic condition involving persistent experiences of depersonalization and derealization without the presence of obsessions and compulsions.

Treatment for Irreality OCD typically involves a combination of therapies, such as Cognitive-Behavioral Therapy (CBT) with exposure and response prevention (ERP) and medications (e.g., selective serotonin reuptake inhibitors or SSRIs). 

CBT helps individuals challenge and modify their obsessive thought patterns, while ERP involves gradual exposure to situations that trigger feelings of unreality and preventing the usual compulsive responses. 

Additionally, supportive counseling and psychoeducation about the nature of the condition can be beneficial in helping individuals manage their symptoms effectively. As with any OCD subtype, it is essential to seek help from a qualified mental health professional for accurate diagnosis and appropriate treatment.


Please contact Kairos Wellness Collective today to learn more.