as if the world around them is foggy, dreamlike, or visually distorted. Individuals with the disorder commonly describe a feeling as though time is passing them by and they are not in the notion of the present. In some cases, individuals may be unable to accept their reflection as their own, or they may have out-of-body experiences. One-third to one-half of patients with DPDR also experience hearing internal voices. This is to differentiate from external voices which are more commonly found in psychosis. Additionally some individuals experience difficulty concentrating and problems with memory retrieval. These individuals sometimes lack the "feeling" of a memory where they are able to recall a memory but feel as if they did not personally experience it. These experiences which strike at the core of a person's identity and consciousness may cause a person to feel uneasy or anxious. The inner turmoil created by the disorder can also result in depression. First experiences with depersonalization may be frightening, with patients fearing loss of control, dissociation from the rest of society and functional impairment. The majority of people with depersonalization-derealization disorder misinterpret the symptoms, thinking that they are signs of serious psychosis or brain dysfunction. This commonly leads to an increase of anxiety and obsession, which contributes to the worsening of symptoms. Factors that tend to diminish symptoms are comforting personal interactions, intense physical or emotional stimulation, and relaxation. Distracting oneself (by engaging in conversation or watching a movie, for example) may also provide temporary relief. Some other factors that are identified as relieving symptom severity are diet or exercise, while alcohol and fatigue are listed by some as worsening their symptoms. Occasional, brief moments of mild depersonalization can be experienced by many members of the general population; however, depersonalization-derealization disorder occurs when these feelings are strong, severe, persistent, or recurrent and when these feelings interfere with daily functioning. DPDR episodes tend to be transient but duration is highly variable with some lasting as long as several weeks. A growing number of users participating in virtual reality (VR) are facing the hazard of DPDR with dissociative experiences after use. Higher levels of a lessened sense of reality and being easily immersed can occur. Causes The exact cause of depersonalization is unknown, although biopsychosocial correlations and triggers have been identified. It has been thought that depersonalization can be caused by a biological response to dangerous or life-threatening situations