The core symptom of depersonalization disorder is the subjective experience of "unreality in one's sense of self",[9]
and as such there are no clinical signs. People who are diagnosed with
depersonalization also experience an almost uncontrollable urge to
question and think about the nature of reality and existence as well as
other deeply philosophical questions.[8]
Dissociation is defined as a "disruption in the usually integrated
functions of consciousness, memory, identity and perception, leading to a
fragmentation of the coherence, unity and continuity of the sense of
self. Depersonalisation is a particular type of dissociation involving a
disrupted integration of self-perceptions with the sense of self, so
that individuals experiencing depersonalisation are in a subjective
state of feeling estranged, detached or disconnected from their own
being."[2]
Occasional moments of mild depersonalization are normal;[13] strong, severe, persistent, or recurrent feelings are no
Depersonalization disorder (DPD) is a mental disorder in which the sufferer is affected by persistent or recurrent feelings of depersonalization and/or derealization. In the DSM-IV-TR it is classified as a dissociative disorder, while in the ICD-10 it is called depersonalization-derealization syndrome and is classified as an independent neurotic disorder.[1]
Common descriptions of symptoms from sufferers include feeling
disconnected from one's physicality or body, feeling detached from one's
own thoughts or emotions, and a sense of feeling as if one is dreaming
or in a dreamlike state. In some cases, a person may feel an inability
to accept their reflection as their own, or they may even have out-of-body experiences.[2]
The disorder can also be described as suffering from recurrent episodes
of surreal experiences, which may in some cases be reminiscent of panic attacks.
Depersonalization disorder is thought to be caused largely by severe traumatic lifetime events, including childhood abuse, accidents, natural disasters, war, torture, panic attacks and bad drug experiences.
It is unclear whether genetics play a role; however, there are many
neurochemical and hormonal changes in individuals suffering with
depersonalization disorder.[5] The disorder is typically associated with cognitive disruptions in early perceptual and attentional processes.[6]
Although the disorder is an alteration in the subjective experience of reality, it is not related to psychosis,
as sufferers maintain the ability to distinguish between their own
internal experiences and the objective reality of the outside world.
During episodic and continuous depersonalization, sufferers are able to
distinguish between reality and fantasy, and their grasp on reality
remains stable at all times.[7]
Contents
Symptoms
The core symptom of depersonalization disorder is the subjective experience of "unreality in one's sense of self",[9]and as such there are no clinical signs. People who are diagnosed with
depersonalization also experience an almost uncontrollable urge to
question and think about the nature of reality and existence as well as
other deeply philosophical questions.[8]
Individuals who experience depersonalization can 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. Also, a recognition of self breaks down (hence the name).
Depersonalization can result in very high anxiety levels, which can
intensify these perceptions even further.
Common descriptions: Feeling disconnected from one's physicality;
feeling like one is not completely occupying the body; not feeling in
control of one's speech or physical movements; and feeling detached from
one's own thoughts or emotions; experiencing one's self and life from a
distance; a sense of just going through the motions; feeling as though
one is in a dream or movie; and even out-of-body experiences.[2
Individuals with the disorder commonly describe a feeling as though
time is 'passing' them by and they are not in the notion of the present.
These experiences which strike at the core of a person's identity and
consciousness may cause a person to feel uneasy or anxious.
Factors that tend to diminish symptoms are comforting interpersonal
interactions, intense physical or emotional stimulation, and relaxation.[10]
Some factors are identified as relieving symptom severity such as diet
or exercise; alcohol and fatigue are listed by others as worsening
symptoms.[11]
First experiences with depersonalization may be frightening, with
patients fearing loss of control, dissociation from the rest of society
and functional impairment.[4]
The majority of patients suffering from depersonalization disorder
misinterpret the symptoms, thinking that they are signs of serious
mental illness or brain dysfunction. This commonly leads to an increase
of anxiety experienced by the patient which contributes to the worsening
of symptoms.[12]
