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Depersonalization disorder
Last reviewed: 23.04.2024
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Depersonalization disorder is a constant or recurrent feeling of detachment from one's own body or mental processes; while a person usually feels himself a third-party observer of his life. The starting point of this disorder is often severe stress. The diagnosis is based on anamnestic information. Treatment consists in psychotherapy.
The feeling of depersonalization is a common phenomenon, often arising in connection with life-threatening situations, such as accidents, violence, serious illnesses and injuries; depersonalization can also be a symptom of many mental disorders and paroxysmal conditions. You can talk about depersonalization disorder, if depersonalization is permanent or repetitive and is not associated with other mental and physical illnesses. This disorder occurs in about 2% of people in the general population.
[Symptoms of depersonalization disorder
The patients are disturbed by the perception of themselves, their bodies and their lives, which can cause them considerable discomfort. A person can feel unreal, like an automaton, or perceive himself like a dream. Often the symptoms are short-lived and are accompanied by anxiety, panic or phobic manifestations. However, the symptoms can be chronic.
The patient often experiences serious difficulties in describing the symptoms and may be afraid to go insane. Patients always keep in mind that their "unreal" experience is not real, but rather is a feature of perception.
Diagnostics
The diagnosis is made on the basis of existing symptoms after the elimination of somatic diseases, substance abuse, other psychiatric disorders (especially anxiety and depression) and other dissociative disorders. Psychological tests and special interviews are useful.
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Treatment of depersonalization disorder
Treatment should address all the stresses associated with the onset of the disorder, including earlier ones, such as childhood violence or emotional neglect, which may predispose to the development of a mental disorder at an older age, the beginning of depersonalization. A number of patients are successfully assisted by various techniques of psychotherapy (for example, psychodynamic, cognitive-behavioral, hypnosis). Cognitive techniques help to block obsessive thoughts about the unreality of existence. Behavioral techniques help to involve the patient in activities that distract from depersonalization. Grounding techniques can help a patient feel real-life at the moment.
It is also necessary to treat other mental disorders that often accompany or complicate depersonalization. Anxiolytics and antidepressants help some patients, especially those with coexisting anxiety and depression exacerbating depersonalization.
Forecast
The sensation of depersonalization is often short-lived and passes by itself. Even if depersonalization is present constantly or periodically, some patients do not have serious problems if they suppress this sensation, focusing on other thoughts, thinking about something. Other patients are decompensated because of a chronic sense of detachment or because of concomitant anxiety and depression.
Many patients recover completely, especially if the symptoms are manifested due to stress, which can be coped with during treatment, and if the symptoms are not protracted. Some patients gradually recover without any intervention. In some patients, depersonalization becomes chronic and refractory to therapy.