What is depersonalization – derealization disorder?

What is depersonalization – derealization ?

Derealisation or depersonalization disorder is a condition in which a person feels detached from themselves or their environment, not experiencing reality or feeling as if they are in an unreal world.

People often feel disconnected from their body or their thoughts and feel as if they are in another world or in a dream. The environment in which they find themselves may also be perceived as unreal or dreamlike.

Such perceptions are often anxiety-provoking and can have a significant impact on daily life, but are not caused by drug use or other medical conditions.

What are the symptoms of derealization – depersonalization ?

Although the symptoms of depersonalization vary from person to person, the main symptoms are as follows:

• Experiencing oneself as an “outside observer”: One’s experience is viewed from a third-person perspective rather than a first-person perspective. The feeling of observing oneself outside one’s own body instead of being in one’s own body.
• Loss of feelings: The inability to feel positive or negative emotions, diminished emotions, or the absence of emotions.
• Altered perception: Distortions in the perception of time, the environment or one’s own body. For example, that the world is slowing down or speeding up, moving away or coming closer.
• Insecurity of identity: The belief that one’s identity, personality or sense of self is distorted or fragmented.
• Somatisation: The appearance or increase of physical symptoms such as headaches, nausea, chills, etc. These symptoms are psychological. These symptoms are psychological.
• Loss of sense of reality: Believing that you have been replaced by another reality or that you are in a dream/illusion.
• Anxiety and panic attacks: Intense anxiety, tension and panic attacks can occur during depersonalisation attacks.
• Depression: Depersonalisation is often accompanied by depression. It may be accompanied by feelings of hopelessness and worthlessness.
• Traumatic experiences: Traumatic experiences can be a trigger for the onset of depersonalisation symptoms.

What are the causes of derealisation?

Derealization and depersonalization can have many causes. They most often occur in conjunction with other mental disorders such as anxiety, depression and trauma.

The causes of depersonalization are many and often interrelated. They include psychological factors such as stress and trauma, but also biological factors such as genetic predisposition and environmental influences.

Research into depersonalization has increased in recent years as more and more people seek help for this disorder:

• Psychological stress and trauma: depersonalization often occurs in situations of severe stress or after traumatic events such as abuse, accidents, war or natural disasters.
• Extreme emotional stress: This can occur in situations such as severe depression, anxiety or burnout.
• Substance abuse: The use of certain drugs, especially cannabis, hallucinogens and ecstasy, can cause episodic or persistent feelings of depersonalisation.
• Neurobiological factors: Research suggests that changes in certain brain regions involved in processing emotions and perceptions may be involved.
• Genetic predisposition: There is evidence that genetic predisposition may lead to dissociative states and disorders.
• Developmental factors: Difficult childhood experiences (such as emotional neglect or unstable family relationships) are thought to lead to depersonalization disorder.

How is Depersonalization Disorder diagnosed?

The DSM-5 (Diagnostic and Statistical Manual of Psychiatric Disorders of the American Psychiatric Association) has defined the following diagnostic criteria for derealization and depersonalization disorder

• A frequent or persistent feeling of being detached from oneself and of feeling, perceiving, or thinking outside of reality.
• This feeling interferes with the person’s normal functioning or ability to function in social, occupational or other important areas.
• The feeling is not a direct result of another psychiatric or medical condition.
• The feeling cannot be considered a symptom of another disorder.
• The feeling lasts at least 6 months.

DSM-5 diagnostic criteria are used to diagnose depersonalisation disorder. The assessment is carried out by a psychiatrist or psychologist and the diagnosis is made according to the relevant diagnostic criteria.

Depersonalization test –  Derealization test

Answer the following questions to find out if you suffer from depersonalisation.

1. Do you sometimes feel detached from your body or your thoughts?
2. Do you have difficulty feeling emotions or do your emotions feel muted?
3. Do your surroundings sometimes seem unreal or like a dream?
4. Do you sometimes feel like an outsider in your own life?
5. Do you feel that your memories don’t belong to you or that you didn’t experience them directly?
6. Do you find it difficult to recognise yourself in the mirror? Do you feel strange in your own body?
7. Do you have moments when you feel disconnected from the world around you or the people in your life?
8. Do you feel that your daily activities are automatic without you being aware of it?
9. Do you sometimes feel that you have no control over your own actions or thoughts?
10. Do you feel an inner emptiness or a sense that something is missing?

If you answered ‘yes’ to most of the questions, this may indicate the presence of depersonalisation symptoms. However, it is not possible to make a definitive diagnosis based on these tests alone. We recommend that you seek professional advice.

How can depersonalization be overcome? How can it be treated?

To get rid of depersonalization , the underlying causes must be identified and an appropriate treatment plan drawn up. Treatment should be carried out by a psychiatrist or psychologist. However, the following methods of treating derealisation may be helpful:

Treatment for derealization may vary depending on the severity and duration of the symptoms and the underlying causes. People with depersonalisation disorder should see a psychiatrist or psychologist for a psychiatric assessment. Treatment may include a range of approaches to relieve symptoms and prevent relapse. Some treatment options include:

• Psychotherapy: Therapies such as cognitive behavioural therapy (CBT) and emotion-focused therapy (FFT) can be effective in treating depersonalisation disorder. Therapy helps to address the thoughts and behaviours that are causing the person’s depersonalisation symptoms.
• Medication: Medications such as antidepressants, antipsychotics, and anxiolytics can help relieve the symptoms of depersonalisation disorder. These medications are used depending on the severity and cause of the symptoms.
• Reduce stress: Stress and anxiety can trigger or worsen depersonalisation. You can relax by regularly practising stress-relieving techniques such as meditation, yoga or deep breathing exercises.
• Maintain a healthy lifestyle: A healthy diet, regular exercise, and adequate sleep can help reduce the symptoms of depersonalisation.
• Activities that relax you: Relaxing activities such as reading a book, listening to music or taking a walk in nature can help to cope with depersonalisation.
• Social support: Connecting with a support network such as family, friends or a support group can help you cope with depersonalisation

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Further articles:

What to do about loneliness? Why do I feel lonely?

Am I introverted? What should I look out for?

References:

• Abrams, D. B. (2001). Social Identity, Psychology of. In Elsevier eBooks (pp. 14306–14309). Elsevier BV.
• Gentile, J. P. (n.d.). STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder. PubMed Central (PMC).
• Hunter, E., Salkovskis, P. M., & David, A. S. (2014). Attributions, appraisals and attention for symptoms in depersonalisation disorder. Behaviour Research and Therapy, 53, 20–29.