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What is depersonalization disorder?
Depersonalization disorder is marked by periods of feeling disconnected or
detached from one’s body and thoughts (depersonalization). The disorder is
sometimes described as feeling like you are observing yourself from outside your
body or like being in a dream. However, people with this disorder do not lose
contact with reality; they realize that things are not as they appear. An
episode of depersonalization can last anywhere from a few minutes to many years.
Depersonalization also might be a symptom of other disorders, including brain
disease and seizure disorders.
Depersonalization disorder is one of a group of conditions called
dissociative disorders. Dissociative disorders are mental illnesses that involve
disruptions or breakdowns of memory, consciousness or awareness, identity and/or
perception—mental functions that normally operate smoothly. When one or more
of these functions is disrupted, symptoms can result. These symptoms can
interfere with a person’s general functioning, including social and work
activities, and relationships.
What are the symptoms of depersonalization disorder?
The primary symptom of depersonalization disorder is a distorted perception
of the body. The person might feel like he or she is a robot or in a dream. Some
people might fear they are going crazy and might become depressed, anxious, or
panicky. For some people, the symptoms are mild and last for just a short time.
For others, however, symptoms can be chronic (ongoing) and last or recur for
many years, leading to problems with daily functioning or even to disability.
What causes depersonalization disorder?
Little is known about the causes of depersonalization disorder, but
biological and environmental factors might play a role. Like other dissociative
disorders, depersonalization disorder often is triggered by intense stress or a
traumatic event—such as war, abuse, accidents, disasters, or extreme violence—that
the person has experienced or witnessed.
How common is depersonalization disorder?
Depersonalization is a common symptom of many psychiatric disorders and often
occurs in dangerous situations, such as assaults, accidents or serious
illnesses. Depersonalization as a separate disorder is quite rare.
How is depersonalization disorder diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a
complete medical history and physical examination. Although there are no
laboratory tests to specifically diagnose dissociative disorders, the doctor
might use various diagnostic tests—such as X-rays and blood tests—to rule
out physical illness or medication side effects as the cause of the symptoms.
If no physical illness is found, the person might be referred to a
psychiatrist or psychologist, health care professionals who are specially
trained to diagnose and treat mental illnesses. Psychiatrists and psychologists
use specially designed interview and assessment tools to evaluate a person for a
dissociative disorder.
How is depersonalization disorder treated?
Most people with depersonalization disorder who seek treatment are concerned
about symptoms such as depression or anxiety, rather than the disorder itself.
In many cases, the symptoms will go away over time. Treatment usually is needed
only when the disorder is lasting or recurrent, or if the symptoms are
particularly distressing to the person.
The goal of treatment, when needed, is to address all stresses associated
with the onset of the disorder. The best treatment approach depends on the
individual and the severity of his or her symptoms, but most likely will include
some combination of the following treatment methods:
- Psychotherapy — Psychotherapy, a type of counseling, is
the main treatment for dissociative disorders.
- Cognitive therapy — This type of therapy focuses on
changing dysfunctional thinking patterns and resulting feelings and behaviors.
- Medication — There is no medication to treat the
dissociative disorders themselves. However, a person with a dissociative
disorder who also suffers from depression or anxiety might benefit from
treatment with a medication such as an antidepressant or anti-anxiety
medication.
- Family therapy — This helps to teach the family about the
disorder and its causes, as well as to help family members recognize symptoms of
a recurrence.
- Creative therapies (art therapy, music therapy) — These
therapies allow the patient to explore and express his or her thoughts and
feelings in a safe and creative way.
- Clinical hypnosis — This is a treatment method that uses
intense relaxation, concentration and focused attention to achieve an altered
state of consciousness, allowing people to explore thoughts, feelings and
memories they might have hidden from their conscious minds. The use of hypnosis
for treating dissociative disorders is controversial due to the risk of creating
false memories.
What is the outlook for people with depersonalization disorder?
Complete recovery is possible for many patients. The symptoms associated with
this disorder often go away on their own or after treatment to help the person
deal with the stress or trauma that triggered the symptoms. However, without
treatment to work out the underlying problems, additional episodes of
depersonalization can occur.
Can depersonalization disorder be prevented?
Although it might not be possible to prevent depersonalization disorder, it
might be helpful to begin treatment in people as soon as they begin to show
symptoms. Further, quick intervention following a traumatic event or emotionally
distressing experience might help reduce the risk of developing dissociative
disorders.
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