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Depersonalization

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Depersonalization is an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body. When severe enough to interefere with activities of daily life it may lead to a diagnosis of Depersonalization disorder[1]..

In mild forms the experience may be desirable, such as in the use of recreational drugs, but it is usually referring to the severe form found in anxiety and in the most intense case, panic attacks. It is most often described as a symptom of emotions, such as panic or fear. A sufferer feels that he or she has changed and the world has become less real — it is vague, dreamlike, or lacking in significance. It can sometimes be a rather disturbing experience, since many feel that indeed, they are living in a "dream."

Chronic depersonalization refers to depersonalization disorder which is classified by the DSM-IV as a dissociative disorder. Derealization is a similar term to depersonalization, and the two are often used interchangeably. However, more specifically, derealization is the feeling that "nothing is real," while depersonalization is the feeling that one is literally "detached" from one's body or world. Though these feelings can happen to anyone, they are most prominent in anxiety disorders, clinical depression, bipolar disorder, and some types of epilepsy.

DescriptionEdit

Individuals who experience depersonalization feel divorced from both the world and from their own identity and physicality. Often a person who has experienced depersonalization claims that life "feels like a movie or things seem unreal, or hazy." Also a recognition of self breaks down (hence the name). DP can result in very high anxiety levels, which further increase the feelings of "fakeness."

One way to describe the physical manifestation of the feeling is to compare the very popular film technique called a Vertigo shot or Dolly Zoom. In this technique, the subject of the picture stays fixed on the shot while all the surrounding background is pulled away - providing a sense of vertigo or detachment. People may perceive this feeling in a cyclical manner, where the feeling is experienced back-to-back-to-back in rapid or non-rapid succession.

Sometimes the physical manifestation is more like a strobe light of senses. Information is processed at a much more staggered rate and therefore the subject feels as though his or her senses are being distorted and fragmented.

CausesEdit

Depersonalization is a side effect of dissociatives and hallucinogens, as well as common drugs such as caffeine,[2] alcohol,[3] and minocycline.[4] It is a classic withdrawal symptom from many drugs.[5][6][7][8]

Depersonalization can also accompany sleep deprivation and stress.

A study of undergraduate students found individuals high on the depersonalization/derealization subscale of the Dissociative Experiences Scale exhibited more pronounced cortisol response. Individuals high on the absorption subscale, which measures experiences of concentration to the exclusion of awareness of other events going on around them, showed weaker cortisol responses.[9]

TreatmentEdit

Treatment is dependent on the underlying cause.

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 ALS, Alzheimer's, Multiple Sclerosis (MS), Neuroborreliosis (Lyme Disease) or any other neurological disease affecting the brain.

If depersonalization is a psychological symptom then treatment may be dependent on the diagnosis. Depersonalization is often a symptom of borderline personality disorder, which can be treated in the long term with proper psychotherapy and psychopharmacology.[1].

Treatment of chronic depersonalization is considered in depersonalization disorder.

See alsoEdit

See alsoEdit

BibliographyEdit

  1. American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association. ISBN 0890420246.
  2. Stein MB. Uhde TW. Depersonalization disorder: effects of caffeine and response to pharmacotherapy. [Case Reports. Journal Article] Biological Psychiatry. 26(3):315-20, 1989 Jul.
  3. Raimo EB, Roemer RA, Moster M, Shan Y. : Alcohol-induced depersonalization, Biol Psychiatry. JUN 1999
  4. Cohen PR (2004). Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline. South. Med. J. 97 (1): 70-3.
  5. Marriott S, Tyrer P (1993). Benzodiazepine dependence. Avoidance and withdrawal. Drug safety : an international journal of medical toxicology and drug experience 9 (2): 93-103.
  6. Shufman E, Lerner A, Witztum E (2005). [Depersonalization after withdrawal from cannabis usage]. Harefuah 144 (4): 249-51, 303.
  7. Djenderedjian A, Tashjian R (1982). Agoraphobia following amphetamine withdrawal. The Journal of clinical psychiatry 43 (6): 248-9.
  8. Mourad I, Lejoyeux M, Adès J (1998). [Prospective evaluation of antidepressant discontinuation]. L'Encéphale 24 (3): 215-22.
  9. Giesbrecht T, Smeets T, Merckelbach H, Jelicic M (2007). Depersonalization experiences in undergraduates are related to heightened stress cortisol responses. J. Nerv. Ment. Dis. 195 (4): 282-7.

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NotesEdit

  • Lt. Col. Dave Grossman, in his book On Killing, suggests that military training artificially creates depersonalization in soldiers, suppressing empathy and making it easier for them to kill other human beings.
  • Existentialists use the term in a different context. The treatment of individuals by other people as if they were objects, or without regard to their feelings, has been termed depersonalization. Determinism has been accused of this. See also objectification.
  • R. D. Laing used depersonalization to mean a fear of the loss of autonomy in interpersonal relationships by the ontologically insecure.
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