Depersonalization/Derealization Disorder

Introduction

Depersonalization/ Derealization Disorder is a dissociative disorder that features recurrent feelings of detachment from the outside world. While Depersonalization breaks the connection between a person and his identity, Derealization is a similar condition in which connection with the outside world is lost. If left unchecked, patients can feel distressed, depressed and even anxious. However, by consulting a therapist at the right time, the disorder can be treated and a patient can live life normally.
Read on to learn more about what is Depersonalization/ Derealization Disorder, depersonalization disorder symptoms, and everything on depersonalization disorder treatment.

What is Depersonalization /Derealization Disorder?

Depersonalization/ Derealization Disorder is a psychological problem that is characterized by recurrent feelings of disconnection from the world around. A patient feels that he or she is living life from a third-person point of view just like living a dream.
Such episodes can be momentary or extend for long periods. When the frequency of these happenings becomes more frequent, these can be a source of stress and anxiety.

Derealization vs Depersonalization

Depersonalization is a feeling of detachment from self whereas Derealization is the feeling of detachment from the world.
Depersonalization does not create socially alienated individuals. There is a detachment from the self which does not originate from injuries caused to the central nervous system.
Derealization, on the other hand, is a condition wherein a person is detached from the outside world. Derealization is mainly caused by injuries to the central nervous system leading a person to become socially isolated individuals.

Statistics and Facts

According to the reports made public by National Institute of Health in India (NIH), the prevalence rate of personality disorders is low. 0.15 per 1000 patients are diagnosed with the disorder annually. Globally, approximately 1-2% of the global population is suffering from the disorder. However, the report also suggests that the number could be low because of underdiagnosis of the problem or due to other cultural factors.

Common Myths and Misconceptions

Myth 1: Depersonalization/ Derealization Disorder can be converted into schizophrenia.
Fact 1: Depersonalization/ Derealization Disorder and schizophrenia are two different disorders. The two disorders are completely different and exhibit differently.

Myth 2: Depersonalization/ Derealization Disorder cannot be treated completely. A person has to live with it.
Fact 2: False. Depersonalization/ Derealization Disorder can be treated completely with therapy. Regular counselling sessions help a person in recovery.

Myth 3: Medication can completely treat Depersonalization/ Derealization Disorder.
Fact 3: False. There is no particular medication that can treat Depersonalization/ Derealization Disorder. Therapy is the best mode of treatment for patients.

Types of Depersonalization /Derealization Disorder

1 Short-Term Derealization

Short-term Depersonalization/Derealization disorder is when a patient experiences momentary feelings of detachment from the surroundings. Short-term Derealization does not have any long-lasting side effects and symptoms often fade away after some time.

2 Long-Term Derealization

Certain people experience episodes for months and years. This disconnection from the world and oneself is associated with trauma or any major neurological issue. As opposed to short-term derealization, symptoms of long-term derealization can disrupt the daily functioning of a person.

3 Types of Depersonalization:

- Autopsychic Depersonalization
The patient feels like an automated being wherein there is a sense of detachment from one’s self.

- Somatopsychic Depersonalization
Patients have their own perspectives of their identity. They also have their version of their looks and appearance.

- Allopsychic Depersonalization
Also called Derealisation, patients feel that the external world is unreal and not meant for them.
All these symptoms can be experienced by a patient simultaneously or independently depending on the psyche of the patient.

What causes Depersonalization /Derealization Disorder?

1. Causes of Short-Term Derealization

Short-term Depersonalization/Derealization disorder can be caused because of stress or anxiety. Those addicted to any substance like drugs or alcohol are also more likely to develop this condition. Any lifestyle change that alters the circadian rhythm can also cause Depersonalization/Derealization disorder.

2. Causes of Long-Term Derealization

If Derealization episodes persist for more than a few weeks, short-term Derealization could be due to events like wars, accidents, childhood trauma and so on. Neurological conditions like seizures, migraines, and traumatic brain injuries can also lead to Depersonalization/Derealization disorder. Patients are not always able to fully recover from a major accident and accept that they survived the problem.

What are the symptoms of Depersonalization/Derealization Disorder?

1. Episodic Symptoms

Patients suffering from Depersonalization/ Derealization Disorder have episodes that can last for hours or days. Look out for patients experiencing such events and seek immediate professional help. Patients feel so when they are out of their comfort zone or are in a situation that originally triggered the disorder.

2. Depersonalization Symptoms

Patients suffering from Depersonalization Disorder feel automated or robotic and are unable to control their actions. They are not able to describe their emotions and feel disconnected from their memories.

3. Derealization Symptoms

Derealization Disorder includes symptoms like distorted visions in which everything seems foggy and unclear to a patient. They have a distorted sense of motion, time and space. Symptoms of Depersonalization overlap with those of Derealization, therefore, seeking a professional for a professional is necessary.

4. Impaired Functioning

Patients may fear irreversible brain damage as they constantly obsess over their existence. Due to all these factors patients feel socially and mentally impaired which spoils their quality of life. A poor emotional quotient destroys the coping mechanism and makes recalling memories difficult.

How is Depersonalization /Derealization Disorder diagnosed?

Diagnosis of Depersonalization/ Derealization Disorder is based on DSM-5-TR criteria. To be eligible for a diagnosis, the patient must experience recurrent episodes of Depersonalization or Derealization or both.
Symptoms must inhibit proper functioning in routine and cannot be explained by another medical or psychiatric condition. Medical professionals rule out causes like substance addiction, neurological problems or any other health problem that could have led to this.
Magnetic Resonance Imaging (MRI) scans and various toxicology tests further help narrow down the prognosis. Lastly, psychological tests and structural interviews like the Multidimensional Inventory of Dissociation confirm the diagnosis.

How is Depersonalization /Derealization Disorder treated?

To treat Depersonalization/ Derealization Disorder, there is a particular medication. Therefore, the primary course of treatment is psychotherapy which equips patients with better coping skills and a sense of identity. The main therapeutic approaches are:

• Psychodynamic Therapy
  With psychodynamic therapy, therapists can explore the past of patients. Unconscious feelings, experiences and conflicts are explored to understand the cause of the problem. The aim is to create healthier responses and gain better emotional stability. Therapists also expose patients to situations that trigger symptoms of Depersonalization or Derealization to equip them better and create a coping mechanism.
• Cognitive Behavioural Therapy (CBT)
  Cognitive Behavioural Therapy is a therapy that helps a patient to recognise and later their negative thought patterns. Patients are trained to think rationally and observe their surroundings before engaging their senses. With CBT, patients are encouraged to participate in meaningful activities while being gradually exposed to stimuli that trigger Depersonalization/ Derealization Disorder.
• Dialectical Behavioural Therapy (DBT)
  For patients who have a weak emotional quotient owing to Depersonalization/ Derealization Disorder, DBT is one of the most effective therapies. Therapists administer this therapy to improve the interpersonal relationships of patients and work on their compromised social skills. Patients can stay grounded in the present and dissociative episodes are reduced. DBT
• Eye Movement Desensitisation and Reprocessing (EMDR)
  Therapists try to analyse the response of patients to traumatic experiences of a patient by analysing their eye movement. Eye Movement Desensitisation and Reprocessing (EMDR) therapy uses bilateral stimulation to process traumatic memories and live a normal life by gradually exposing them to the consequences.
  Patients reframe their distressing experiences and control their emotional reactions. This approach is particularly designed to address trauma-related Derealization.

Living with Depersonalization /Derealization Disorder

• Patients living with Derealization / Depersonalisation Disorder lead a difficult life. Since they lose a sense of identity, patients feel confused and disoriented.
• Processing emotions properly is difficult as patients observe themselves from a third-person point of view. Therefore, seek professional help as soon as possible.
• Patients might not be able to concentrate at work or carry out their routine. Patients find it difficult to follow instructions as an individual’s sense of reality is warped.
• Patients diagnosed with Derealization / Depersonalisation Disorder must avoid consumption of drugs and alcohol. Such substances trigger confusion and can lead to severe episodes.

How to Support Loved Ones Suffering From Depersonalization /Derealization Disorder?

• Be compassionate when you are with them because nothing works better than empathy. Patients need emotional support to feel better. Therefore, making fun of their problem and not giving them an adequate amount of privacy will never work.
• Patients must be given enough time and space to think. Overloading them with a lot of information about the disorder or pushing them into therapy can have an adverse effect on their psychology.
• Suggest therapy but do not impose it on them. Patients could be reluctant in the beginning. Therefore, going to a psychologist at first is more important to learn about the disorder. Then go for therapy so that the patient does not get overwhelmed.
• Learn about Depersonalization/ Derealization Disorder as much as you can. By gaining more awareness about the problem, exhibited symptoms can be better understood. Family and friends can warn the patient about the problem and lead a normal life.

Jagruti Treatment and Recovery

• Customised Treatment Plan
  Mental health professionals at Jagruti Rehab Centre offer customised treatment plans to patients. The treatment depends on the severity of the problem and various other factors like age, personal circumstances and social background as well.
  Therapists ensure that the patients and their families are aware of the treatment before the process begins. Senior citizens are provided with assistance at all times. Recreational areas are also available at the premises.
• 24/7 Medical Services
  Nursing and other medical staff are present at the centre round-the-clock. Patients who are not able enough to help themselves are provided personal assistance. Jagruti Rehab Centre has also tied up with the best medical hospitals that provide emergency services.
  Since patients with comorbidities are also admitted to the facility, special care is taken of them as well. Various methods of payment are available for people to compensate for the services at their convenience.
• Online and Offline Therapies
  Not every patient can opt for an offline or a residential treatment plan. Therefore, Jagruti Rehab Centre offers online therapy sessions that can be attended from the comfort of home.
  Therapists can opt for online treatment plans and analyse the behaviour of patients to frame treatments. Patients are under constant supervision. Confidentiality of patients is maintained at all times.
• Relapse Prevention Treatment
  Relapse prevention is essential and one of the most effective parts of the treatment. Therapists at Jagruti Rehab Centre ensure that there is no recurrence of any symptom and that patients can behave properly in triggering situations.
  Family therapy is offered at the centre. The purpose of holding sessions with friends and family of the patient is to make symptom management easier at home for a complete recovery.