Depersonalization Disorder: Symptoms, Causes And Treatment
Let’s imagine that we had never seen ourselves in a mirror and one day by chance we saw our reflected image: it is likely that at first we would feel some surprise and even wonder if that person is us. Let’s also imagine that we had a camera behind us and we were watching the image as if it were a movie: probably our actions reflected on a screen would be somewhat strange to us, as if we were spectators of them rather than actors.
Now let’s imagine that these sensations of strangeness could not be explained by novelty or context: this is what happens to people who suffer from a specific type of disorder, depersonalization disorder
A type of dissociative disorder is called depersonalization disorder, which is characterized by assuming a certain break between mental faculties or a discontinuation or disconnection between them. In the case of depersonalization disorder, it is one’s own recognition or familiarity with oneself that has been disconnected.
Depersonalization disorder is characterized by the existence of an experience of great strangeness towards oneself The feeling of being unreal appears, of not being an actor but an observer of our own actions, absence of an “I” and/or feeling of mental and physical numbness. Although a sensation of this type may not be symptomatic sporadically, the existence of this disorder will be considered when these sensations occur habitually and/or persistently.
The presence of a feeling of disembodiment or of not being in one’s own body, an experience of lack of belonging to one’s own body, is common. All of this generates clinically significant discomfort and suffering and/or a limitation in the person’s daily life.
The experience of this disorder can be truly distressing, given the sensation of not being real despite the subject knowing at a conscious level that it is It is not strange that a great fear can appear at the idea of losing one’s sanity, or even identifying oneself as the living dead. Problems with concentration and performance in multiple tasks, including work, usually appear. Depression and anxiety are often common if the problem is not resolved, and in some cases suicidal thoughts may appear.
It is important to keep in mind that we are not dealing with a case of delirium or psychotic disorder, and the judgment of reality is also preserved (although there may also be strangeness towards the environment, we still know that it is real) and it is not caused by other mental disorders. , medical illnesses or substance abuse. Despite this, it is worth mentioning that depersonalization can appear as a symptom in these contexts, although in this case we would be talking about depersonalization as a symptom and not as a disorder per se.
Another linked alteration: derealization
Depersonalization disorder can occur only as a strangeness towards oneself, but it is relatively common for sensations of strangeness towards one’s own person also occur towards the perception of reality
We are talking about derealization, in which there are difficulties in perceiving the reality of things, often identifying the sensation as being dreaming and perceiving the world as something unreal and false. Time and space are perceived as altered and the world begins to give a sensation of artificiality and distortion.
The possible causes of the appearance of depersonalization disorder can be multiple, There is no single possible cause for this and the specific causes of its appearance are unknown in most cases.
However, as a dissociative disorder, which is generally associated with the experience of highly stressful situations. Continuous psychosocial stress, the presence of sexual abuse in childhood or currently, the presence of high levels of panic, situations of grief due to the death of loved ones or other traumatic events can be probable causes or relatively frequent triggers.
At a biological level, it has been observed in some experiments that patients with this disorder have less activation in the sympathetic autonomic system and a reduction in electrodermal activity. Less activation of the insula and activation in the ventrolateral prefrontal cortex have also been observed when faced with unpleasant stimuli. This pattern seems to reflect defensive behavior when presented with aversive stimuli, reducing the emotional response to them and producing part of the symptoms.
Likewise, although we would no longer be talking about the disorder itself but rather about depersonalization as a symptom, These episodes can also appear in cases of poisoning due to substance abuse, poisoning, head trauma or confusional states.
Treatment of depersonalization
Depersonalization can be treated through psychotherapy, although in many cases we are dealing with a chronic or chronic disorder. They can disappear only to return in situations of stress and anxiety
In general, the treatment will depend on the situations that triggered the disorder, making it necessary to work with the subject on the moment of appearance of the disorder, the sensations they generate and what they associate with it. It will also be necessary to carry out psychoeducation and work on possible complications, such as the appearance of depression. Training in problem solving and stress management can be helpful, as well as trying to strengthen the connection with oneself (for example through rooting techniques). You can work from multiple perspectives, such as cognitive restructuring typical of the cognitive-behavioral current or psychodynamics.
Sometimes the application of different psychotropic drugs may also be useful, although there is little evidence in this regard. However, some studies seem to indicate that some substances have some effectiveness, for example the anticonvulsant known as lamotrigine or opioid antagonists such as naltrexone.
