Depersonalisation — what is it?
Welcome back to “Be Many!”! Today I’m going to introduce you to a symptom of dissociative identity disorder (DID) — depersonalisation. It can also occur in other psychiatric conditions such as anxiety disorders or depression, in physical illness or as a disorder in its own right. About 2% of people meet the diagnostic criteria for depersonalisation. At least 50% have temporary symptoms. But what is it exactly?
“I experience myself as disconnected from my surroundings or they seem unreal, as if there is a veil between me and the outside world.”
“Out of the blue I feel alien, as if I am not real or as if I am cut off from the world.”
“I feel as if I am outside of my body.”
“I feel disconnected from memories of events in my life, as if I had no part in them.”
“Familiar voices (including my own) sound distant or unreal.”
Depersonalisation symptoms include (MSD Manuals): Feeling detached from their body, mind, feelings or sensations. Patients feel like an outside observer of their life. Many patients also report feeling unreal or like an automaton (without control over what they say or do). They feel emotionally and physically numb or feel detached, with little emotion. Some patients are unable to recognise or describe their emotions (= alexithymia). They often feel disconnected from their memories and are unable to remember them clearly. This circumstance in particular makes depersonalisation so central to dissociative identity disorder.
However, depersonalisation can also have other causes:
- Abuse (psychological, physical, emotional)
- Domestic violence
- Severely mentally impaired parents
- Unexpected death of a close person
- Others: Substances such as marijuana, ketamine, hallucinogens.
Depersonalisation is a severe clinical picture. Unlike schizophrenia, patients have an intact sense of reality, i.e. they have the knowledge that their unreal experiences do not correspond to reality. The prognosis is good — patients’ suffering often improves without intervention. However, in some cases depersonalisation is refractory (i.e. does not respond to therapy). Therapeutically, psychotherapy is used to try to address the problem. You will probably recognise depersonalisation within dissociative identity disorder. I hope I have given you a brief insight. See you soon!