Depersonalization disorder is an altered state of mind in which someone feels separated from themselves, their surroundings, or both. Some experts refer to it as derealization disorder. It is normal to have these feelings occasionally, or as a result of some medications, health conditions, or recreational drugs. When feelings of detachment are frequent and interfere with a person's life, depersonalization disorder is a possible diagnosis.
Depersonalization disorder is a dissociative disorder. Other mental illnesses in this category include dissociative amnesia and dissociative identity disorder. Someone with a dissociative disorder has problems with emotion, perception, behavior, memory, identity, and sense of self. These disorders can disrupt every area of mental functioning and are often associated with previous psychological trauma.
People with depersonalization disorder feel as if their thoughts, feelings, and actions are happening in a dream. Symptoms include feeling detached from ordinary sensations and emotionally numb. Other signs include experiencing real-life events unfolding as if the person is watching a movie or feeling that ordinary objects are the wrong size or color.
Risk factors for depersonalization disorder include severe psychological trauma in childhood or adulthood, profound stress related to finances or relationships, and recreational drug use. Some personality traits make people more likley to develop this disorder, particularly avoiding or being unable to adapt to difficult situations. Prolonged depression or anxiety with panic attacks are also increase one's risk.
Diagnosing depersonalization disorder can be difficult. According to one study done in India, this may be because depersonalization disorder often occurs with anxiety and depression and the latter becomes the only diagnosis. Explaining symptoms can be difficult, and they can be misinterpreted as delusions, illusions, or hallucinations, further complicating the diagnosis.
Because anyone can experience passing feelings of depersonalization, diagnosis requires the episodes to be so severe that they interfere with a person's ability to function normally. Other possible causes, like drug use or mental disorders like schizophrenia, must also be ruled out. Signs of depersonalization disorder generally start in early childhood. People very rarely develop symptoms for the first time in adulthood.
During each episode, a person with depersonalization disorder is aware of their thoughts and what is happening in the world around them. They understand that they feel detached and can start to fear significant brain damage or that they do not really exist. Episodes can last anywhere from hours to days and keep coming back for weeks or years.
There is no definitive cause of depersonalization disorder, though it is likely that both environmental and biological factors are involved. Trauma triggers many dissociative disorders, but not everyone who experiences trauma develops one. Those who do may be less reactive to emotions or have an underlying personality disorder, as well.
That depersonalization disorder often occurs alongside other mental health problems or is triggered by them makes treatment difficult. For the treatment to be successful, therapists and psychologists should tailor treatment plans to the individual's needs and factor in other symptoms and conditions.
The main treatment for depersonalization disorder is psychotherapy. The goal is to learn how to control symptoms until they lessen in severity or disappear completely. This is done by understanding the disorder, learning distraction techniques and coping strategies, and addressing any past trauma or underlying mental health conditions. Medication to treat concurring anxiety and depression can also help.
In some cases, a physical health problem may cause symptoms resembling depersonalization disorder. Tests can help doctors rule out these causes or facilitate a diagnosis. These and medical conditions and a full psychiatric evaluation. Doctors also consider what prescription medications the person is taking to make sure that they are not causing the problem.
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