Depersonalization

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Depersonalization is an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body.[1] An individual feels that he or she has changed and the outside world has become less real. Many describe it as living in a dream, or in a movie. It can be transient, episodic, or chronic, and the causes include substance use and medical or mental health conditions. Most people find feelings of detachment unpleasant and distressing although it may be sought as an enjoyable effect of a drug.

The most common and short-lived experiences come from sleep deprivation and stress. Dissociative and hallucinogenic drugs may produce a sense of detachment which will dissipates along with the intoxicating effects. Depersonalization is a side effect of dissociatives and hallucinogens, as well as alcohol.[2] It can occur as part withdrawal from drugs such as benzodiazepines,[3] cannabis,[4] amphetamines,[5] and antidepressants.[6] Symptoms of depersonalization and derealization can occur from vestibular disease and may result from distorted sensory information being mismatched with other sensory systems.[7]

Several mental disorders are accompanied by episodes of depersonalization, most commonly panic attacks and borderline personality disorder. Chronic depersonalization occurs in depersonalization disorder which is classified by the DSM-IV as a dissociative disorder.

Derealization is a similar term to depersonalization, and the two are often used interchangeably as they both describe an experience of detachment. The distinction is derealization is the feeling the outside world has become less real, while depersonalization is the feeling of bodily unreality.

A study of undergraduate students found individuals high on the depersonalization/derealization subscale of the Dissociative Experiences Scale exhibited more pronounced cortisol response. Individuals high on the absorption subscale, which measures experiences of concentration to the exclusion of awareness of other events going on around them, showed weaker cortisol responses.[8]

References

  1. American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association. ISBN 0890420246.
  2. Raimo EB, Roemer RA, Moster M, Shan Y. : Alcohol-induced depersonalization, Biol Psychiatry. JUN 1999
  3. Marriott S, Tyrer P (1993). "Benzodiazepine dependence. Avoidance and withdrawal". Drug safety : an international journal of medical toxicology and drug experience 9 (2): 93-103. PMID 8104417.
  4. Shufman E, Lerner A, Witztum E (2005). "[Depersonalization after withdrawal from cannabis usage]" (in Hebrew). Harefuah 144 (4): 249-51, 303. PMID 15889607.
  5. Djenderedjian A, Tashjian R (1982). "Agoraphobia following amphetamine withdrawal". The Journal of clinical psychiatry 43 (6): 248-9. PMID 7085580.
  6. Mourad I, Lejoyeux M, Adès J (1998). "[Prospective evaluation of antidepressant discontinuation]" (in French). L'Encéphale 24 (3): 215-22. PMID 9696914.
  7. Sang FY, Jáuregui-Renaud K, Green DA, Bronstein AM, Gresty MA (2006). "Depersonalisation/derealisation symptoms in vestibular disease". J. Neurol. Neurosurg. Psychiatr. 77 (6): 760–6. DOI:10.1136/jnnp.2005.075473. PMID 16464901. Research Blogging.
  8. Giesbrecht T, Smeets T, Merckelbach H, Jelicic M (2007). "Depersonalization experiences in undergraduates are related to heightened stress cortisol responses". J. Nerv. Ment. Dis. 195 (4): 282-7. DOI:10.1097/01.nmd.0000253822.60618.60. PMID 17435477. Research Blogging.