I've had DP/DR for 37 years. I asked Claude, Gemini and ChatGPT for help. Here's the full conversation.
Hello,
I am in my 50s and have had symptoms of DP/DR since the age of 20. My start into adult life was severely impaired by this, and it took me a long time to manage reasonably well. From the age of 30, things tended to improve, though I still have some symptoms (see below).
I first heard about the diagnosis of DP/DR and the fact that other people experience it too about 4 years ago! Before that, I thought it was simply my own personal brand of madness. That realization alone helped me enormously.
I then asked three AIs — Claude, Google Gemini, and ChatGPT — for advice, simply to make use of that possibility. I found all the responses genuinely valuable, and I'll need to take my time working through them properly.
I thought my story and this dialogue might also be helpful to others who are affected, which is why I'm posting the complete conversation with the AIs here. In some places, the AI asked questions; I've marked my own responses accordingly.
At the end I've also linked a few videos.
This was my question / my prompt:
Please take on the role of a psychologist with therapeutic experience and deep expertise in DP/DR. I am male, 57 years old, and have had continuous symptoms of DP/DR since the age of twenty. It began essentially on the day I moved out of my parents' home.
I was overwhelmed by the situation — my long-term girlfriend had left me, I was deeply unhappy in my vocational training, and on top of that I was living in a shared flat that was very chaotic, whose housemates, like me, weren't coping well with their lives. I had occasionally used marijuana. My symptoms manifested as a sense of unreality, the feeling of no longer being centered in myself, of having to "act out" my own life according to the expectations of others in order to meet those expectations. I was in this state permanently. I also developed a kind of visual disturbance. I had — and still have — the permanent impression that my visual perception is different from how it was in my youth and childhood; I am less "in the moment" and constantly surrounded by a cloud of thoughts — a kind of intense inwardness that makes me experience situations in an alienated way.
Throughout the entire decade of my twenties I had very severe problems with this. The diagnosis of DP/DR didn't exist at the time, and no therapist or doctor could really address it. I underwent inpatient therapy at 23, which did not help me. From the age of 30, I began to cope somewhat better. I had learned that I could have a life and manage reasonably well even with the symptoms. I simply got used to them. And that's essentially how it has remained to this day — with the effect of habituation having become almost second nature. I have experienced my entire adult life this way. Today I still have the impaired visual perception and the feeling that my experience is less "in the moment," less real and authentic than it was in my childhood and youth.
I have learned that through meditation I can have brief moments in which this strange feeling disappears and I can also, usually for just a few seconds, see normally again. I have come to realize that I have habituated myself to being permanently immersed in a cloud of thoughts and streams of thought, sometimes also intense daydreaming. For brief moments I can bring these streams of thought to a standstill — for example, when I mentally say to myself: "What is my next thought?" (This is inspired by Eckhart Tolle.) This brings me into a mental stillness for a short time. What also works is when I mentally say a sentence to myself and deliberately pause in the middle of it — for example: "I am now going — pause — to the kitchen."
Here is some additional information: Regarding my symptoms: The visual impairment is difficult to describe. I am visually less "in the moment" than before. One might describe it as a sense of unreality. The symptoms are essentially always present, except when I actively seek to switch them off in deep meditative stillness — and even then only for seconds. I also experience them when waking up or falling asleep.
My emotional availability is very good and unimpaired. I am in fact very empathic and sensitive. I have not had any further therapy. I have not received a formal diagnosis — I discovered the term myself via the internet and recognized myself in it.
I have meditated formally, sitting for a few minutes every morning, for many years. Otherwise, I occasionally seek mental stillness consciously during the day.
I no longer suffer extremely from the symptoms today, yet they continue to affect me. I have these questions for you:
1. Can you recommend techniques/practices that can concretely help me?
2. Would you recommend that I continue seeking these moments of mental stillness, or simply come to terms with the situation?
3. Do you have any other therapeutic advice for me? If you still have questions in order to be able to answer my concerns in a qualified way, please ask me those questions first.
Claude:
My clinical assessment of your situation
What you describe fits very well with the picture of a chronic depersonalization/derealization disorder that has solidified from an acute trigger (overwhelm, loss, cannabis) into a persistent form. Three things stand out particularly:
First: Your emotional availability is preserved and even pronounced. This is clinically significant. In many affected individuals, emotionality is also blunted ("emotional numbing"). That is not the case with you — which suggests that your DP/DR sits primarily on the cognitive-perceptual level, not the emotional one. This is actually a favorable prognostic sign, but also explains why you were able to function with it for so long.
Second: Your observation that the streams of thought — the permanent inner noise — are the central mechanism is, in my view, clinically very precise and probably correct. DP/DR is experienced by many sufferers primarily as an external perceptual problem, but the actual driver is often a hyperactive self-referential mode of thinking. The brain is so preoccupied with itself that direct, uncommented perception of the outside world recedes into the background. What you describe as a "cloud of thoughts" is neuropsychologically likely an overactive Default Mode Network (DMN) — the network that is active when we are not focused outward.
Third: You have led a functional life for 37 years, developed deep empathy, and through self-observation worked out a tool (the mental stillness) that genuinely points in the right direction. That is no small thing.
Regarding your three questions
1. Concrete techniques and practices
Building on what you already do, I would recommend the following approaches — in an order that builds on your existing practice:
a) Extending formal meditation — but with an important nuance
Your morning sitting meditation is a good anchor. I would recommend gradually extending it to 15–20 minutes, but with a specific focus: not primarily striving for mental stillness, but sensory grounding. This means: consciously keeping attention with what you are currently perceiving — sounds, bodily sensations, the breath — without commenting on it. This trains the brain to interrupt the DMN and activate the so-called Task-Positive Network, which is responsible for direct, present perception.
b) "Sense and Label" — an adapted mindfulness technique
In daily life: when you notice the cloud of thoughts becoming dense, briefly direct your attention to a concrete sensory impression and name it inwardly, simply: "warmth," "street noise," "weight of my feet on the ground." Don't analyze — just name. This is not distraction, but an active switching of the direction of perception — from inward to outward.
c) Visual grounding exercises
Since your visual system is particularly affected: take two to three minutes each day to truly look at an object in your surroundings — not naming or categorizing it, but simply noticing: color, light, form, how it changes when you slightly shift your angle of view. This sounds simple but is a direct exercise against the visual "looking through glass." Children do this instinctively. We unlearn it.
d) Supplementing with body-based practices
DP/DR often resides in a disconnection from physical presence. I would recommend introducing a physical practice that connects attention and bodily awareness. Particularly suitable: Tai Chi, Qigong, or slow, mindful yoga. Not as sport, but as an exercise in embodied presence. Slow walks with conscious attention to the contact of your feet with the ground can also serve this purpose.
e) Developing your Tolle technique further
The "What is my next thought?" technique is good, and you discovered it yourself — which speaks to your intuition. An extension of it that you could try: after the moment of stillness, instead of waiting for the next thought, immediately direct your attention to what you see or hear. Use the stillness as a bridge to move into the sensory impression.
2. Should I keep seeking stillness, or come to terms with things?
This is the most important question you're asking — and I want to give you an honest answer, not a comfortable one.
Both are right, but in different contexts.
"Coming to terms" was a survival necessity and not a failure. You functioned with it, maintained relationships, lived a life. That deserves respect, not pathologizing.
But: you are 57, the symptoms are still there, and you are asking. That tells me that a part of you is not yet finished with this question. And I consider that legitimate and healthy.
My recommendation is: continue seeking the stillness — but change the inner attitude in doing so. The decisive difference is this:
- If you seek stillness in order to get rid of the DP/DR, you create tension and expectation. This is counterproductive, because DP/DR is sustained by hypervigilance and inner tension.
- If you seek stillness because the moment of stillness is valuable in itself, regardless of the outcome, then this is a healthy practice without pressure to suffer.
The Buddhist term for this is "non-striving mindfulness" — you don't practice to achieve something; the practice itself is the goal. This sounds paradoxical but is neuropsychologically well-founded: the state of relaxation and openness that enables presence only arises when there is no pressure to succeed.
3. Overall therapeutic advice
I would like to offer you three overarching thoughts:
First: You don't need to be healed in order to move forward.
37 years is a long time. It would be dishonest of me to say that you are likely to achieve complete freedom from symptoms at 57 — no one knows that, and promises in that direction would be irresponsible. But: symptom reduction, more moments of genuine presence, and a deeper familiarity with the state without suffering — that is absolutely realistic and achievable.
Second: Consider seeking grounded therapeutic support.
You have not had therapy for 37 years. The therapy at 23 was not helpful — but knowledge about DP/DR has changed fundamentally since then. There are today specialized approaches, particularly MBSR (Mindfulness-Based Stress Reduction) and ACT (Acceptance and Commitment Therapy), which are well evidence-based for chronic DP/DR. Neither of these therapies promises "healing," but they give structured form to what you are already intuitively doing. I would recommend looking for a therapist with experience in dissociation and mindfulness-based approaches. In Germany this is not easy to find, but not impossible.
Third: Your empathy and sensitivity are not coincidental.
I say this not as flattery, but as a clinical observation: many people with chronic DP/DR who are not emotionally numbed develop an unusually fine perception of inner processes — in themselves and in others. What you report about your streams of thought and the effect of stillness is qualitatively at a level that many don't reach after years of therapy. This self-awareness is your greatest resource. Keep using it.
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Gemini:
It is impressive how differentiated and reflective your description of your condition is. The fact that you have found a way to live with this "cloud" over 37 years speaks to a remarkable resilience. In the psychological field today, we often understand depersonalization and derealization disorder (DP/DR) as a "biological protective mechanism" that was activated in you during a phase of extreme overwhelm (moving out, separation, professional stress) and has since become stuck in "standby mode."
[I had to cut the text short here! You can read the complete dialogue including my responses in the PDFs linked below. I'd be curious to hear your feedback.]
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Relevant videos:
https://youtu.be/rmAJCcoHbEQ?si=4ru8oxhNc9D8cKaR
https://youtu.be/haWd-1Ia3d0?si=RFtyxbC-Lh3Cg6NC
I've made the complete text available as a PDF in both languages — English and German.