I'm a therapist, age 65. Long history of anxiety dating back to early childhood. Derealization started in 2004 when I had many health scares. I think derealization is secondary to being such an inward individual........too much in my own head. So that very familiar surroundings become 'not real', because I've made my inner world the whole reality in a sense. I don't generally experience DR when I have a lot to focus on outside of myself. I'm a musician, and practice a lot, which helps. But my office is in my home, so my main external focus is my work....where i never have DR. Probably, an office outside of my home, with more people around, would have helped the cause. I take a low dose of paxil, which gets me out of my head, and thus lessens the DR indirectly. I've tried to adopt the method of John Nash, "A Beautiful Mind", who learned to ignore his hallucinations. I try to ignore DR, or think of it as a hiccup that doesn't need my attention. I go with the flow as they say. Paradoxical Intention helps too. It comes and goes. It's who I am.