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Derealization and Depersonalization

Hailey + Megan


Introduction


Dissociative disorders are mental illnesses that involve the disconnection between memory, identity, emotion, perception, behavior and sense of self. Under dissociative disorders, there are Dissociative Identity Disorder, Dissociative Amnesia, as well as Derealization-depersonalization Disorder. Around 1%-2% of all people have derealization/depersonalization disorder, however, about 50% of people have felt some form of depersonalisation or derealisation at some point in their lives.


Derealisation, Depersonalisation and Derealisation-Depersonalisation Disorder


Depersonalization is a type of detachment from oneself and one's identity, as if you’re an outside observer of your own life.

Derealization is when things or people around seem completely unreal, as if you’re an outsider, feeling detached from your own surroundings.


These experiences of depersonalisation or derealisation are classified as a disorder when they are not caused by drugs or other mental illnesses, as well as when the symptoms make it hard for a person to go through their daily lives.


Experience of Depersonalization


  • Feeling like an outsider, observing your own thoughts and feelings

  • Feeling like you are moving your body parts or seeing them move as an outside observer

  • Feeling like what you say or do is outside of your control

  • Feeling as if your memories may not be your own

  • Feeling like you are a robot or as if you are in a dream


Experience of Derealization


  • Feeling like you are being alienated from your surroundings

  • Feeling as if you are living in a dream or in a fictional world

  • Feeling as if you are in a fog and cloudy place

  • The world appears to be fake and lifeless

  • Objects and sounds become distorted

  • Feeling as if time goes by in different paces

  • Feeling as if you’re separated from the rest of the world


Symptoms of Depersonalisation-Derealisation Disorder


  • Suicidal thoughts

  • Feeling numb emotionally and mentally

  • Amnesia that cannot be attributed to mental disorders and/or brain damage

  • Out-of-body experiences


Possible causes and risk factors

The disorder is usually caused by episodes of severe stress, especially during childhood like abuse, neglect, trauma. It can be inflicted on them or witnessed by them but done to others, as well as natural disasters. Furthermore, it can also be an underlying condition or if a person has another mental illness (e.g. depression, OCD, PTSD). It can also be a symptom of the other condition. Lastly, it can be caused by recreational drugs such as ketamine, a drug specifically taken to have a depersonalisation experience, often described as an “out-of-body” experience. Alcohol and cannabis are also other drugs that could trigger depersonalisation


Treatment


There is no cure for depersonalization-derealization disorder. But there are treatments that help reduce the symptoms.


1. Psychotherapy

  • Cognitive behavioral therapy: to learn and identify patterns or unhelpful behavior and to relieve symptoms of psychological problems to improve patients’ quality of life

  • Psychodynamic therapy: to bring up self-awareness and self-reflection and to focus on patients’ psychological roots of emotional sufferings

  • Grounding techniques: to connect the person more into the world and the present moment through focusing on sensing through the five senses.


2. Medication

  • Anti-anxiety drugs and/or antidepressants are prescribed to some that have underlying mental health conditions

  • Reduces depression/anxiety symptoms and in extension reduces depersonalisation/derealisation

  • In 2013, doctors were found to have used a combination of Lamictal, a medication typically prescribed for Bipolar Disorder, as well as a type of SSRI.




SOURCES


"Dissociation and depersonalization: Causes, risk factors, and ...." https://www.medicalnewstoday.com/articles/262888.

"What Are Dissociative Disorders? - American Psychiatric Association." https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders.

"Derealization: Symptoms, Causes, Diagnosis, and Treatment." 20 Dec. 2019, https://www.webmd.com/mental-health/mental-derealization-overview.

"Depersonalization-derealization disorder - Symptoms and causes." 16 May. 2017, https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911.

"Chapter 7—Brief Psychodynamic Therapy - NCBI." https://www.ncbi.nlm.nih.gov/books/NBK64952/.

"Depersonalization/Derealization Disorder: Symptoms & Treatment." 15 Oct. 2020, https://my.clevelandclinic.org/health/diseases/9791-depersonalizationderealization-disorder.

Dissociative Disorders | NAMI: National Alliance on Mental Illness." https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders



Researcher: Hailey and Megan

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