Depersonalization disorder is characterized by an unpleasant state of disturbed perception in the sense of self or world. The person is aware of the subjective nature of this experience. The symptom of depersonalization is quite common as a minor feature of other syndromes (e.g., depersonalization is the third most common psychiatric symptom), but depersonalization disorder is quite rare.
Depersonalization disorder is classified as a dissociative disorder in DSM-IV (though it has a separate place in ICD-10). There is continued debate however about the etiology of depersonalization disorder and whether it is related to the dissociative disorders.
Depersonalization Disorder is a state of heightened self-observation where a person "looks at themselves from the outside", and observes their own physical actions or mental processes as if they were an observer instead. This often brings a sense of unreality, and an alteration in the perception of the environment around them, as well as the person fearing they are not in full control of themselves.
They feel separated from themselves or outside their own bodies. People with this disorder feel like they are "going crazy". Depression, anxiety, and social anxiety are often comorbid with depersonalization disorder.
An episode of depersonalization disorder can be as brief as a few seconds or continue for several years.
Clinical picture of Depersonalization disorder
Patients describe feelings of being unreal and experiencing an unreal quality to perceptions. They say that their actions feel mechanical and that their emotions are dulled Insight is retained into the subjective nature of their experiences. These symptoms may be intense, and accompanied bydeja vuand by changes in the experience of passage of time. Some patients complain of sensory distortions affecting a single part of the body.
Depersonalization affects men and women equally. The onset is often in adolescence or early adulthood, with the condition starting before the age of 25 in about half the cases (Sierra, 2009). The symptoms usually begin suddenly often when the person feels aroused. Once established, the disorder often persists for years, though with periods of partial or complete remission.
Symptoms of Depersonalization Disorder
- Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body
(e.g., feeling like one is in a dream). - During the depersonalization experience, reality testing remains intact.
- The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Treatment of Depersonalization Disorder
Since dissociative disorders seem to be triggered as a response to trauma or abuse, treatment for individuals with such a disorder may stress psychotherapy, although a combination of psychopharmacological and psychosocial treatments is often used. Many of the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, and can be relieved by addressing the causes of the anxiety and depression. While the same drugs used to anxiety and depression (e.g., antianxiety medication or antidepressants) are often prescribed to a person in treatment for a dissociative disorder, the symptoms of anxiety and depression can also benefit from psychotherapy.
