Depersonalization
Depersonalization can consist of a detachment within the self, regarding one's mind or body, or being a detached observer of oneself.[1] Subjects feel they have changed and that the world has become vague, dreamlike, less real, lacking in significance or being outside reality while looking in. It can be described as feeling like one is on "autopilot" and that the person's sense of individuality or selfhood has been hindered or suppressed.[2]
Chronic depersonalization refers to
Though degrees of depersonalization and derealization can happen to anyone who is subject to temporary anxiety or stress, chronic depersonalization is more related to individuals who have experienced a severe trauma or prolonged stress/anxiety. Depersonalization-derealization is the single most important symptom in the spectrum of dissociative disorders, including dissociative identity disorder and "dissociative disorder not otherwise specified" (DD-NOS). It is also a prominent symptom in some other non-dissociative disorders, such as anxiety disorders, clinical depression, bipolar disorder, schizophrenia,[5] schizoid personality disorder, hypothyroidism or endocrine disorders,[6] schizotypal personality disorder, borderline personality disorder, obsessive–compulsive disorder, migraines, and sleep deprivation; it can also be a symptom of some types of neurological seizure.
In social psychology, and in particular self-categorization theory, the term depersonalization has a different meaning and refers to "the stereotypical perception of the self as an example of some defining social category".[7]
Description
Individuals who experience depersonalization feel divorced from their own personal self by sensing their body sensations, feelings, emotions, behaviors, etc. as not belonging to the same person or identity.[8] Often a person who has experienced depersonalization claims that things seem unreal or hazy. Also, a recognition of a self breaks down (hence the name). Depersonalization can result in very high anxiety levels, which further increase these perceptions.[9]
Depersonalization is a subjective experience of unreality in one's self, while derealization is unreality of the outside world. Although most authors currently regard depersonalization (personal/self) and derealization (reality/surroundings) as independent constructs, many do not want to separate derealization from depersonalization.[10]
Prevalence
Depersonalization is a symptom of anxiety disorders, such as panic disorder.[11][12] It can also accompany sleep deprivation (often occurring when experiencing jet lag), migraine, epilepsy (especially temporal lobe epilepsy,[13] complex-partial seizure, both as part of the aura and during the seizure[14]),
—especiallyIn the general population, transient depersonalization and derealization are common, having a
Depersonalization occurs 2-4 times more in women than in men.[17]
A similar and overlapping concept called
For the purposes of evaluation and measurement depersonalization can be conceived of as a construct and scales are now available to map its dimensions in time and space.[clarification needed][19] A study of undergraduate students found that individuals high on the depersonalization/derealization subscale of the Dissociative Experiences Scale exhibited a more pronounced cortisol response in stress. 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.[20]
In
Pharmacological and situational causes
Depersonalization has been described by some as a desirable state, particularly by those that have experienced it under the influence of mood-altering
Benzodiazepine dependence, 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 syndrome.[30][31]
Lieutenant Colonel
Graham Reed (1974) claimed that depersonalization occurs in relation to the experience of falling in love.[33]
Depersonalization as a psychobiological mechanism
Depersonalization is a classic response to acute
Psychologically depersonalization can, just like dissociation in general, be considered a type of coping mechanism. Depersonalization is in that case unconsciously used to decrease the intensity of unpleasant experience, whether that is something as mild as stress or something as severe as chronically high anxiety and post-traumatic stress disorder.[34]
The decrease in anxiety and psychobiological hyperarousal helps preserving adaptive behaviors and resources under threat or danger.[4]
Depersonalization is an overgeneralized reaction in that it doesn't diminish just the unpleasant experience, but more or less all experience – leading to a feeling of being detached from the world and experiencing it in a more bland way. An important distinction must be made between depersonalization as a mild, short-term reaction to unpleasant experience and depersonalization as a chronic symptom stemming from a severe mental disorder such as
Chronic symptoms may represent persistence of depersonalization beyond the situations under threat.[4]
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
If depersonalization is a symptom of psychological causes such as developmental trauma, treatment depends on the diagnosis. In case of
The treatment of chronic depersonalization is considered in
A 2001 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."[36] The anticonvulsant drug lamotrigine has shown some success in treating symptoms of depersonalization, often in combination with a selective serotonin reuptake inhibitor and is the first drug of choice at the depersonalisation research unit at King's College London.[35][37][38]
Research
The Depersonalisation Research Unit at the Institute of Psychiatry in London conducts research into
In a 2020 article in the Journal Nature, Vesuna, et al. describe experimental findings which show that layer 5 of the retrosplenial cortex is likely responsible for dissociative states of consciousness in mammals.
See also
- Alienation
- Brain fog
- Catatonic state
- Cognition
- Derealization
- Dissociation (psychology)
- Ego death
- Falling (sensation)
- Hallucinogen persisting perception disorder
- Human spirit
- Nina Searl
- Out-of-body experience
- Post-assault treatment of sexual assault victims
- Post-traumatic stress disorder
- Psychedelic experience
- Psychological trauma
- Śūnyatā
- Spiritual crisis
- Weltschmerz
References
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- ^ Depersonalization Disorder at Merck Manual of Diagnosis and Therapy Home Edition[permanent dead link]
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- ^ a b c Dissociative Disorders (2017), GENERAL POPULATION STUDIES OF DISSOCIATIVE DISORDERS, Epidemiology of Depersonalization and Derealization Symptoms.
- ^ "Depersonalization-derealization disorder - Symptoms and causes". Mayo Clinic. Archived from the original on 2017-10-08. Retrieved 2019-11-20.
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Other references
- Loewenstein, Richard J; Frewen, Paul; Lewis-Fernández, Roberto (2017). "20 Dissociative Disorders". In Sadock, Virginia A; Sadock, Benjamin J; Ruiz, Pedro (eds.). Kaplan & Sadock's Comprehensive Textbook of Psychiatry (10th ed.). Wolters Kluwer. ISBN 978-1-4511-0047-1.