Depersonalization disorder

Also Known As: Depersonalization disorder, Depersonalization-derealization syndrome

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-TRthis disorder is classified as a dissociative disorder; in the ICD-10 it is called depersonalization-derealization syndrome and classified as an independent neurotic disorder.[1] Common descriptions of symptoms are: feeling disconnected from one's physicality; feeling as though one is not completely occupying the body; not feeling in control of one's speech or physical movements; feeling detached from one's own thoughts or emotions; a sense of automation, going through the motions of life but not experiencing it or participating in it; loss of conviction with one's identity; feeling a disconnection from one's body; inability to accept one's reflection as one's own; difficulty relating oneself to reality and the environment; feeling as though one is in a dream; and out-of-body experiences.[2] Depersonalization is described as suffering from episodes of surreal experiences. Some of these experiences have been also reminiscent of panic attacks and paroxysmal anxiety. While many people experience brief moments of depersonalization, in others it may last much longer and can become a persistent problem.[3] Diagnostic criteria for Depersonalization disorder include, among others, persistent or recurrent experiences of feeling detached from one's mental processes or body.[4] A diagnosis is made when the dissociation is persistent and interferes with the social and occupational functions necessary for everyday living. Providing an accurate description through investigation has proved challenging due to the subjective nature of depersonalization, the ambiguity of the language used to describe episodes of depersonalization and because the experiences of depersonalization overlap with those of derealization, which are two separate disorders.[5]

Depersonalization disorder is thought to be largely caused by severe traumatic lifetime events including childhood abuse, accidents, 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.[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]

While depersonalization disorder was once considered rare among the general population, lifetime experiences with the disorder are common in about 1%-2% of the general populace. While these numbers may seem small, depersonalization experiences were frequently described by a majority of the population but in varying intensities.[5]

Depersonalization disorder is associated with cognitive disruptions in early perceptual and attentional processes.[8]

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