Depersonalization is an anomaly of the mechanism by which an individual has self-awareness. It is a feeling of watching oneself act, while having no control over a situation. Sufferers feel they have changed, and the world has become less real, vague, dreamlike, or lacking in significance. It can be a disturbing experience, since many feel that, indeed, they are living in a "dream". Chronic depersonalization refers to
depersonalization disorderDepersonalization disorder is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one's mental processes or body...
, which is classified by the DSM-IV as a dissociative disorder. Though degrees of depersonalization and
derealizationDerealization is an alteration in the perception or experience of the external world so that it seems unreal. Other symptoms include feeling as though one's environment is lacking in spontaneity, emotional coloring and depth. It is a dissociative symptom of many conditions, such as psychiatric and...
can happen to anyone subject to temporary severe anxiety/stress, chronic depersonalization is more related to individuals who have experienced a severe
traumaPsychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
or prolonged stress/anxiety. Depersonalization-derealization is the single most important symptom in the spectrum of dissociative disorders, including
dissociative identity disorderDissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....
and "dissociative disorder not otherwise specified" (DD-NOS). It is also a prominent symptom in some other non-dissociative disorders, such as
anxiety disorderAnxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
s,
clinical depressionMajor depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
,
bipolar disorderBipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
,
borderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
,
obsessive-compulsive disorderObsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions...
,
migraineMigraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...
and
sleep deprivationSleep deprivation is the condition of not having enough sleep; it can be either chronic or acute. A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. It adversely affects the brain and cognitive function. Few studies have compared the...
. It can be considered desirable, such as in the use of recreational drugs.
In
social psychologySocial psychology is the scientific study of how people's thoughts, feelings, and behaviors are influenced by the actual, imagined, or implied presence of others. By this definition, scientific refers to the empirical method of investigation. The terms thoughts, feelings, and behaviors include all...
, and in particular
self-categorization theorySelf-categorization theory is a theory of social categorization that includes categorization of the self as a key feature. The theory was developed by John Turner and colleagues, and along with social identity theory it is a constituent part of the social identity approach...
, the term
depersonalization has a different meaning and refers to "the stereotypical perception of the self as an example of some defining social category".
Description
Individuals who experience depersonalization feel divorced from their own personal physicality by sensing their body sensations, feelings, emotions and behaviors as not belonging to the same person or identity. Often a person who has experienced depersonalization claims that things seem unreal or hazy. Also, a recognition of
selfThe self is an individual person as the object of his or her own reflective consciousness. The self has been studied extensively by philosophers and psychologists and is central to many world religions.-Philosophy:...
breaks down (hence the name). Depersonalization can result in very high
anxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
levels, which further increase these perceptions.
Depersonalization is a subjective experience of unreality in one's sense of self, while
derealizationDerealization is an alteration in the perception or experience of the external world so that it seems unreal. Other symptoms include feeling as though one's environment is lacking in spontaneity, emotional coloring and depth. It is a dissociative symptom of many conditions, such as psychiatric and...
is unreality of the outside world. Although most authors currently regard depersonalization (self) and derealization (surroundings) as independent constructs, many do not want to separate derealization from depersonalization.
Prevalence
Depersonalization is the third most common psychological symptom, after feelings of
anxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
and feelings of
depressionDepression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
. Depersonalization is a symptom of anxiety disorders, such as
panic disorderPanic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral change lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks...
. It can also accompany
sleep deprivationSleep deprivation is the condition of not having enough sleep; it can be either chronic or acute. A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. It adversely affects the brain and cognitive function. Few studies have compared the...
(often occurring when suffering from
jet lagJet lag, medically referred to as desynchronosis, is a physiological condition which results from alterations to the body's circadian rhythms; it is classified as one of the circadian rhythm sleep disorders...
),
migraineMigraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...
,
epilepsyEpilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
(especially
temporal lobe epilepsyTemporal lobe epilepsy a.k.a. Psychomotor epilepsy, is a form of focal epilepsy, a chronic neurological condition characterized by recurrent seizures. Over 40 types of epilepsies are known. They fall into two main categories: partial-onset epilepsies and generalized-onset epilepsies...
),
obsessive-compulsive disorderObsessive–compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions...
,
stressStress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...
, and
anxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
;
Interoceptive exposureInteroceptive exposure is a behavioral therapy technique used in the treatment of panic disorder. It refers to carrying out exercises that bring about the physical sensations of a panic attack, such as hyperventilation and high muscle tension, and can be contrasted with in vivo exposure, which...
is a non-pharmacological method that can be used to induce depersonalization.
A study of undergraduate students found that individuals high on the depersonalization/derealization subscale of the
Dissociative Experiences ScaleThe Dissociative Experiences Scale is a psychological self-assessment questionnaire that measures dissociative symptoms. It contains twenty-eight questions and returns an overall score as well as four sub-scale results. DES is intended to be a screening test, since only 17% of patients with scores...
exhibited a more pronounced
cortisolCortisol is a steroid hormone, more specifically a glucocorticoid, produced by the adrenal gland. It is released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat,...
response. Individuals high on the absorption subscale, which measures a subject's experiences of concentration to the exclusion of awareness of other events, showed weaker cortisol responses.
Pharmacological And Situational Causes
Depersonalization may also be a desirable effect, such as in the case of recreational drugs. It is an effect of
dissociativesDissociatives are a class of psychoactive drugs which are said to reduce or block signals to the conscious mind from other parts of the brain...
and
psychedelicThe term psychedelic is derived from the Greek words ψυχή and δηλοῦν , translating to "soul-manifesting". A psychedelic experience is characterized by the striking perception of aspects of one's mind previously unknown, or by the creative exuberance of the mind liberated from its ostensibly...
s, as well as possible side effect of
caffeineCaffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
,
alcoholIn chemistry, an alcohol is an organic compound in which the hydroxy functional group is bound to a carbon atom. In particular, this carbon center should be saturated, having single bonds to three other atoms....
,
cannabisCannabis, also known as marijuana among many other names, refers to any number of preparations of the Cannabis plant intended for use as a psychoactive drug or for medicinal purposes. The English term marijuana comes from the Mexican Spanish word marihuana...
, and
minocyclineMinocycline is a broad-spectrum tetracycline antibiotic, and has a broader spectrum than the other members of the group. It is a bacteriostatic antibiotic, classified as a long-acting type...
. It is a classic
withdrawalWithdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and alcohol...
symptom from many drugs.
Benzodiazepine dependenceBenzodiazepine dependence or benzodiazepine addiction is a condition during which a person is dependent on benzodiazepine drugs. Dependence can be either a psychological dependence, physical dependence, or a combination of the two...
, which can occur with long term use of benzodiazepines, can induce chronic depersonalization symptomatology and perceptual disturbances in some people, even in those who are taking a stable daily dosage, and it can also become a protracted feature of the
benzodiazepine withdrawal syndromeBenzodiazepine withdrawal syndrome—often abbreviated to benzo withdrawal—is the cluster of symptoms which appear when a person who has taken benzodiazepines long term and has developed benzodiazepine dependence stops taking benzodiazepine drug or during dosage reductions...
.
Lieutenant Colonel
Dave GrossmanLieutenant Colonel Dave Grossman is an author who has specialized in the study of the psychology of killing, which has been termed 'killology'.In February 1998 Grossman retired from the military as Professor of Military Science at Arkansas State University...
, in his book
On KillingOn Killing: The Psychological Cost of Learning to Kill in War and Society is a book by Lt.Col. Dave Grossman exploring the psychology of the act of killing and the military and law enforcement establishments' attempt to understand and deal with the consequences of killing.The book is heavily based...
, suggests that military training artificially creates depersonalization in soldiers, suppressing
empathyEmpathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...
and making it easier for them to kill other human beings.
A hypothesis, posited by writer David Zweig, called Fiction Depersonalization Syndrome, suggests that depersonalization may be triggered by being immersed in a highly mediated environment.
Treatment
Treatment is dependent on the underlying cause, whether it is organic or psychological in origin. If depersonalization is a symptom of neurological disease, then diagnosis and treatment of the specific disease is the first approach. Depersonalization can be a cognitive symptom of such diseases as
amyotrophic lateral sclerosisAmyotrophic lateral sclerosis , also referred to as Lou Gehrig's disease, is a form of motor neuron disease caused by the degeneration of upper and lower neurons, located in the ventral horn of the spinal cord and the cortical neurons that provide their efferent input...
, Alzheimer's,
multiple sclerosisMultiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
(MS), neuroborreliosis (
Lyme diseaseLyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
), or any other neurological disease affecting the brain. For those suffering from depersonalization with
migraineMigraine is a chronic neurological disorder characterized by moderate to severe headaches, and nausea...
, tricyclic antidepressants are often prescribed.
If depersonalization is a symptom of psychological causes such as developmental trauma, treatment depends on the diagnosis. In case of
dissociative identity disorderDissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....
or DD-NOS as a developmental disorder, in which extreme developmental
traumaPsychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
interferes with formation of a single cohesive identity, treatment requires proper psychotherapy, and—in the case of additional (co-morbid) disorders such as eating disorders—team of specialists treating such an individual. It can also be a symptom of
borderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
, which can be treated in the long term with proper psychotherapy and psychopharmacology.
The treatment of chronic depersonalization is considered in
depersonalization disorderDepersonalization disorder is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one's mental processes or body...
.
A recently-completed study at Columbia University in New York City has shown positive effects from transcranial magnetic stimulation (TMS) to treat depersonalization disorder. Currently, however, the
FDAThe Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
has not approved TMS to treat DP.
A recent Russian study showed that naloxone, a drug used to reverse the intoxicating effects of opioid drugs, can successfully treat depersonalization disorder. According to the study: "In three of 14 patients, depersonalization symptoms disappeared entirely and seven patients showed a marked improvement. The therapeutic effect of naloxone provides evidence for the role of the endogenous opioid system in the pathogenesis of depersonalization."
Research
The Depersonalisation Research Unit at the Institute of Psychiatry in London is a world leader in research in
depersonalization disorderDepersonalization disorder is a dissociative disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. Diagnostic criteria include persistent or recurrent experiences of feeling detached from one's mental processes or body...
. Researchers there use the acronym DPAFU (Depersonalisation and Feelings of Unreality) as a shortened label for the disorder.
See also
- Alienation
The term social alienation has many discipline-specific uses; Roberts notes how even within the social sciences, it “is used to refer both to a personal psychological state and to a type of social relationship”...
- Brain fog
Cognitive dysfunction is defined as unusually poor mental function, associated with confusion, forgetfulness and difficulty concentrating...
- Catatonic state
- Cognition
In science, cognition refers to mental processes. These processes include attention, remembering, producing and understanding language, solving problems, and making decisions. Cognition is studied in various disciplines such as psychology, philosophy, linguistics, and computer science...
- Compassion fatigue
Compassion fatigue is a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s...
- Derealization
Derealization is an alteration in the perception or experience of the external world so that it seems unreal. Other symptoms include feeling as though one's environment is lacking in spontaneity, emotional coloring and depth. It is a dissociative symptom of many conditions, such as psychiatric and...
- Dissociation (psychology)
- Ego death
Ego death is an experience that reveals the illusory aspect of the ego, sometimes undergone by mystics, shamans, monks, psychologists, and others interested in exploring the depths of the mind....
- Hallucinogen persisting perception disorder
Hallucinogen persisting perception disorder is a disorder characterized by a continual presence of visual disturbances that are reminiscent of those generated by the ingestion of hallucinogenic substances. Previous use of hallucinogens by the person is needed, though not sufficient, for...
- Human spirit
Human spirit is a component of human philosophy, psychology and religion - the spiritual or mental part of humanity. While the term can be used with the same meaning as "human soul" , human spirit is sometimes used to refer to the impersonal, universal or higher component of human nature in...
- Out-of-body experience
An out-of-body experience is an experience that typically involves a sensation of floating outside of one's body and, in some cases, perceiving one's physical body from a place outside one's body ....
- Post-traumatic stress disorder
Posttraumaticstress disorder is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,...
- Psychedelic experience
The term "psychedelic experience" is vague – characterized by polyvalence or ambiguity due to its nature – however in modern psychopharmacological science as well as philosophical, psychological, neurological, spiritual-religious and most other ideological discourses it is understood as an altered...
- Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
- Spiritual crisis
Spiritual crisis is a form of identity crisis where an individual experiences drastic changes to their meaning system typically because of a spontaneous spiritual experience...