As human beings, we traverse many emotions, thoughts, and perceptions, each contributing to our unique experiences. Occasionally, one may encounter periods of disconnect, where reality feels elusive, and the world appears distant and unfamiliar. These transient moments of detachment can be perplexing, leaving individuals to wonder if they are the only ones experiencing such sensations.?
For some, this can also be much more than just an experience. It can also denote a mental health disorder named depersonalization disorder.?
Depersonalization disorder, often referred to as DPD, is a complex and less commonly known mental health condition categorized under dissociative disorders. It is characterised by a persistent feeling of detachment from oneself as if one is observing their own thoughts, emotions, and actions from a distance. This sense of unreality can extend to the external world, leading to a secondary phenomenon known as derealization, where the surroundings feel strange, dreamlike, or artificial.
The symptoms of depersonalization disorder can vary from person to person, but common experiences include:
The hallmark symptom of DPD is a persistent sense of detachment from oneself. Individuals may describe feeling like an outside observer of their thoughts, emotions, and actions. A study published in the journal "Psychiatry Research" (Sierra & Berrios, 2000) found that individuals with DPD experienced reduced self-awareness and felt detached from their own identity and physical self.??
People with DPD often report feeling emotionally numb, as if their emotions are muted or distant. A study by Michal et al. (2013) published in the "Journal of Affective Disorders" found that individuals with DPD showed reduced emotional reactivity compared to healthy controls, supporting the notion of emotional detachment in the disorder.
DPD is frequently accompanied by derealization, where the external world appears strange, dream-like, or lacking in depth. A study published in the "Journal of Trauma & Dissociation" (Simeon, Guralnik, Knutelska, Hollander, & Schmeidler, 2001) found that derealization was a common feature in individuals with DPD.?
Individuals with DPD may experience an altered perception of time. Time may feel distorted, elongated, or compressed. A study published in the "Journal of Anxiety Disorders" (Hunter et al., 2004) reported that individuals with DPD showed altered time perception during specific tasks.
Studies have indicated that individuals with DPD may experience depersonalization and derealization episodes frequently, often daily or even continuously for extended periods (Simeon et al., 2001).?
Some studies have suggested that individuals with DPD may experience cognitive impairments, such as difficulties with attention, concentration, and memory (Hunter et al., 2004).
Depersonalization disorder is frequently associated with other mental health conditions, such as anxiety disorders, mood disorders, and post-traumatic stress disorder (PTSD). A study published in "The Journal of Clinical Psychiatry" (Simeon, 2004) found high rates of comorbid anxiety disorders in individuals with DPD.
Here are some potential factors that have been hypothesized to contribute to the development of DPD:
High levels of stress, trauma, or adverse life events are often associated with the onset or exacerbation of depersonalization disorder. Traumatic experiences, such as physical or emotional abuse, accidents, or witnessing violence, can trigger dissociative symptoms, including depersonalization, as a coping mechanism to detach from overwhelming emotions. A study published in the "Journal of Nervous and Mental Disease" (Lipsanen et al., 2003) found that childhood trauma was associated with an increased risk of depersonalization symptoms.
Depersonalization disorder frequently co-occurs with anxiety disorders and depression. There is evidence suggesting that depersonalization can be a defence mechanism in response to overwhelming anxiety or depression, allowing individuals to distance themselves from distressing emotions. A study published in the "Journal of Anxiety Disorders" (Hunter et al., 2004) reported a high prevalence of anxiety and depressive disorders in individuals with DPD.
Some research has suggested that alterations in brain function and neurotransmitter systems may be involved in the development of DPD. Studies using functional magnetic resonance imaging (fMRI) have shown differences in brain activity patterns in individuals with DPD compared to healthy controls (Phillips et al., 2001).??
Individuals with a history of emotional dysregulation, difficulties in emotional processing, or problems with self-identity may be more susceptible to experiencing depersonalization symptoms.?
Depersonalization episodes can be triggered or exacerbated by the use of certain substances, particularly hallucinogenic drugs or dissociative anaesthetics. Substance-induced depersonalization is generally temporary but can be distressing during its duration.
Here are some treatment options commonly used for Depersonalization Disorder:
CBT is considered the most effective psychotherapy for depersonalization disorder. It aims to help individuals recognize and challenge negative thought patterns and beliefs related to depersonalization. CBT can also teach coping strategies to manage anxiety and stress associated with DPD. A study published in the "Journal of Clinical Psychiatry" (Simeon et al., 2011) demonstrated the effectiveness of CBT in reducing depersonalization symptoms.?
In some cases, exposure therapy may be used to gradually confront triggers or situations that elicit depersonalization episodes. This approach helps individuals desensitize to their triggers and reduce the avoidance of anxiety-provoking situations.?
Mindfulness techniques, such as mindfulness-based cognitive therapy (MBCT), can help individuals stay present and focused, reducing ruminations about depersonalization experiences.
Self-help techniques, such as grounding exercises and relaxation techniques, can help individuals stay connected to the present moment and manage feelings of detachment. Engaging in activities that promote a sense of self-awareness and grounding can be beneficial.
Identifying and avoiding triggers that provoke depersonalization episodes can be helpful. This may include avoiding excessive stress, sleep deprivation, or the use of substances that may exacerbate symptoms.
Psychoeducation about depersonalization disorder can help individuals understand their symptoms and normalize their experiences. Education about the disorder can also reduce anxiety and provide a sense of validation.??
Treatment outcomes may vary, and some individuals may experience significant improvement with appropriate interventions.?