Depersonalization disorder describes a condition where the individual feels disconnected from his or her body. These people suffer from an altered perception of reality, and may feel as though they are not a part of their body or environment. It may feel like their body is changing, dissolving, or being left behind, as though they have become an observer of his or her own life.
Also known as depersonalization neurosis, depersonalization disorder is considered one of the many dissociative disorders, as labeled by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A dissociative disorder is when a person's memory, identity, perception, and consciousness become disconnected from each other, and is usually caused by severe trauma, an intense level of internal conflict, or thoughts and feelings that the individual feels are forbidden. In depersonalization disorder, it is perception that becomes disjointed.
The most common cause of this disorder is abuse, either physical, mental, or sexual, but it may also be caused by post-traumatic stress disorder (PTSD), panic disorders, borderline personality disorders, or acute stress disorder. It may also be connected to a previously existing other dissociative disorder. Drugs, sleep deprivation, and very high levels of stress may also lead to the symptoms of depersonalization disorder, although they wouldn’t last long. In order for the diagnosis to be made, the feelings of altered reality must be almost constant. Feeling disconnected after a panic attack or a PTSD episode does not mean that someone is suffering from depersonalization disorder.
Diagnosing this disorder is usually a matter of exclusion. Doctors will narrow down the list of possible disorders until depersonalization disorder is the only one left. The use of diagnostic questionnaires can help doctors or psychologists to pinpoint their diagnosis of a dissociation disorder. From there, another survey may be used to narrow the diagnosis down to depersonalization disorder. The questions on these personality tests are open-ended, giving doctors a chance to find out more about an individuals symptoms and severity of the disorder, as well as a chance to possibly determine the cause.
In some cases, depersonalization disorder will resolve on its own. If the condition is ongoing, and disruptive to the patient's life, specialized therapy may be recommended. Cognitive-behavioral or psychodynamic therapy may be beneficial; hypnosis has also been used successfully in many cases. The type of therapy used is based on which will best suite the needs of the patient.
In addition to therapy, some patients are also prescribed medications, such as lorezapam or doxepin. These medications may include tranquilizers, anti-depressants, selective serotonin reuptake inhibitors (SSRIs). No one medication has been proven to be more effective than the others; like the therapy, it is a matter of determining which medication, or combination of medications, will best help the patient.
The majority of patients whohave been diagnosed with depersonalization disorder will make a full recovery. This is especially true if the cause of the disorder was linked to a traumatic event in the patient's past, as therapy can help the patient to deal with these past events. Some patients will experience chronic depersonalization disorder, with episodes that may occur after periods of extreme stress, but these episodes are manageable through medication.