Mental Health Formula: About Depersonalization Derealization Disorder

Denis Lukin

The Formula for Mental Health. On Depersonalization-Derealization disorder

Abstract

Depersonalization-derealization disorder affects 1-2 percent of the population, and there are no effective ways to combat it. People suffering from this disorder experience tormenting sensations and discomfort. This book proposes several effective methods for dealing with depersonalization-derealization disorder that are easy to remember and extremely useful. The book describes what depersonalization-derealization disorder is, explains the nature of its origin, and presents methods for overcoming it.

What is depersonalization-derealization disorder? It is a tormenting, uncomfortable state, a disorder that causes suffering and inconvenience. Its symptoms are as follows: the patient sometimes (constantly) feels that they "see themselves from the outside," "cannot control their body or its parts," "loses clarity in perceiving the surrounding reality," and there is a sensation that the person is, as it were, not living their life but passively experiencing it, observing from the side themselves, their life, and their actions, as if it's not really them at all (up to descriptions like "living as if in an aquarium or under a glass bell jar, as if behind dirty glass, life passes me by, I don't feel it"); there is a painfully experienced sensation of one's own altered state, "not-being-oneself," difference from one's former, real self; a sensation of not belonging to oneself, an inability to control one's body, one's life, one's feelings and emotions; a sensation that the patient lives as if in a fog or in a dream, or as if a movie is being filmed around them or some fairy tale or theatrical performance is unfolding, and they are a player in this movie or theatrical action, and that all this is happening as if not to them; a sensation of altered state, "not-being-itself," unusualness or distance, detachment, unreality of the surrounding world (often, perception of the world is tinged with depressive tones, the world may seem gloomy, gray, joyless, boring, or hostile to the patient, having lost bright colors, hues, smells); a sensation of being separate from one's body, outside the body, or a sensation of strangeness and not belonging to oneself of individual body parts (hands, legs, head); difficulty in perceiving the surrounding reality. Sometimes the patient may feel as if they see themselves from the outside or as if they are dead. Complaints about the loss of emotions are very common. Derealization is a feeling of alienation from real reality, a sensation that the surrounding world has changed in some incomprehensible way or has become unreal, artificial, unnatural. Depersonalization is alienation from one's own mental and physiological processes, a painful experience by the patient of their own altered state, loss of self-identity, loss of one's own Self. The perceptual disturbance in this case does not affect the physical properties of surrounding objects but concerns their essence. Patients with derealization emphasize that they see objects, in principle, of the same color and size, but perceive the surroundings as something unnatural. For example, they perceive surrounding objects as some kind of theatrical scenery, or everything happening around reaches consciousness not immediately, but as if through a glass wall. Patients with depersonalization characterize themselves as having lost the fullness of sensations, feel themselves unusual, not like everyone else, as if turned inside out. In general, depersonalization and derealization disorder is a state of altered sensation of perception of one's Self or altered sensation of perception of surrounding reality. This is expressed in the person feeling that the surrounding world becomes less bright, it seems to fade, as if the lights are being turned off, everything becomes somewhat darker, less vivid. The person sees the world during this time as if through frosted glass. Sensations become more even, there is no such sharpness of perception, contrast of the surrounding world. Often this state frightens the patients themselves; they are afraid to admit it, driving away the unpleasant thoughts in every way. Also, the state of depersonalization and derealization can be expressed in a change in the sensation of perception of one's own Self, perception of one's own functions, one's body. This can be expressed in the person not feeling sufficient satisfaction from their usual daily physiological processes that constantly occur in our body. For example, taste may decrease or be completely lost; people stop sensing the taste of food. Absolutely all food becomes tasteless. A sensation of persistent insomnia may arise, as if the person constantly doesn't sleep or does sleep but doesn't get enough sleep, as if the nights were sleepless. Also, disturbances in the perception of one's own Self can be expressed in the person feeling alienation from their emotions, their sensations, and it seems to them that they do not experience emotions. It seems to them that they experience neither anger, nor joy, nor love. They know that they should be experiencing some specific feeling at that moment, but that feeling is absent. And this causes horror in the person with this syndrome of depersonalization and derealization; they feel that this is abnormal. That is, the sensations of alienation from one's own emotions and feelings bring strong discomfort. Also, the state of alienation of one's own Self is expressed in the person beginning to see the world as if from the side, as if watching a movie about themselves. As if they are separate, and their body and vision of what is happening around them are separate, and they are as if an external observer. And this also causes horror and discomfort, and people are afraid to admit it, and because this fear is often accompanied by the fear of mental illness, a persistent conviction of madness arises. And people sometimes think that this only happens to them, and think that no one else experiences this. That they are the only and unique ones with this happening to them. And it is sometimes difficult for them to explain to themselves what is happening to them and difficult to explain to others what is wrong with them, since the people around them most likely have not experienced this disorder and, naturally, will not understand this person, but will perceive it as a real, severe case of madness, although this is actually not the case.

Depersonalization-derealization disorder can develop against the background of:

* severe emotional shock;

* neuroses;

* emotional exhaustion or professional burnout;

* use of psychotropic substances;

* pathology of the pituitary-adrenal axis;

* presence of concomitant mental illnesses (bipolar affective personality disorder, schizotypal and panic disorders, schizophrenia, depression);

* neurological diseases (amyotrophic lateral sclerosis, Alzheimer's disease, multiple sclerosis, Lyme disease).

Most often, depersonalization-derealization disorder is caused by severe stress, serious psychotraumatic impacts that have occurred during the patient's life, for example, rape, sexual seduction in childhood, beatings, swearing, humiliation and mistreatment in childhood, accidents, disasters, the death or serious illness of a loved one, one's own serious illness, war, imprisonment, torture. The use of drugs and other psychoactive substances can be a provoking or aggravating factor for the disorder, and sometimes directly causes the disorder in predisposed individuals. It is unknown whether genetic factors play a role in the development of the disease, but there is evidence that certain pathophysiological changes occur with this disorder.

According to epidemiological studies, the prevalence of depersonalization-derealization disorder is 1-2%.

People with this disorder feel like observers of their own lives. Many of them feel the unreality of their existence, the vagueness of memories, or feel the automatization of their actions and words (a sensation of being a robot, a doll). Physical and emotional detachment are often characteristic. Alienation from thinking and memory manifests as a sensation of "emptiness" in the head – an absence of thoughts and memories. The sense of familiarity disappears; the familiar environment is perceived as alien; there is no felt contact with the interlocutor during communication. Some people may experience alexithymia – the inability to describe or recognize one's feelings and emotions. The world seems lifeless or artificial; objects are subjectively distorted in shape, size, clarity, etc. Time is also distorted. In severe states, a person cannot mentally recreate the image of a loved one or a specific place. In some cases, problems with orientation in time and space appear. There is an absence of feelings of melancholy, anger, compassion, joy. Due to the inability to subjectively assess the degree of blunting of emotional perception, it is difficult to make a quantitative assessment of the manifestations of depersonalization and derealization.

The manifestations of the disorder negatively affect life activity. This condition is often accompanied by anxiety and depression. Some people experience fear of having serious brain pathologies or, conversely, are obsessed with the thought of the unreality of their existence and check this in various ways. Often this leads to increased anxiety and the appearance of obsessive ideas, which contributes to the worsening of symptoms. A person with depersonalization-derealization disorder always recognizes the non-objectivity of their sensations. The sense of reality differentiates this disorder from psychotic disorders.

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