Depersonalization

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Depersonalization

Definition

Depersonalization is a mental state in which people feel detached or disconnected from their personal identities or selves. This may include the sense that one is “outside” oneself, or is observing one’s own actions, thoughts, or body.

Description

People experiencing depersonalization may feel so detached that they feel more like robots than human beings. However, such people always are aware that this is just a feeling; there is no delusion that one is a lifeless robot or that one has no personal identity. The sense of detachment that characterizes the state may result in mood shifts, difficulty thinking, and loss of some sensations—a state that can be described as numbness or sensory anesthesia.

Depersonalization can also occur transiently in people in many different stress-inducing situations, including sleep deprivation, test taking, or being in a traffic accident. The feeling of detachment also can arise as a result of anesthesia or from using nitrous oxide. In addition, people experience depersonalization in different ways. People may feel like they are floating on the ceiling, watching themselves, or as though they are in a dream. Individuals with depersonalization may feel that events and the environment are unreal or strange, a state called derealization. Derealization, a dissociation symptom, differs from depersonalization in that it is the environment that seems unreal or dreamlike.

Episodes of depersonalization can last from a few seconds to years. The frequency may increase after traumatic events such as exposure to combat, accidents, or other forms of violence or stress. Treatment depends on the context of the depersonalization episode or episodes.

Depersonalization can be a symptom of other disorders, including panic disorder, borderline personality disorder, post-traumatic stress disorder (PTSD), acute stress disorder , or one of several dissociative disorders, including depersonalization disorders. A person will not be diagnosed with depersonalization disorder as the primary problem if the episodes of depersonalization occur only during panic attacks or following a traumatic stressor.

Depersonalization is a common experience in the general adult population, although twice as many women as men receive treatment for it. However, when a patient’s symptoms are severe enough to cause significant emotional distress or to interfere with normal functioning, they may meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (the DSM-IV-TR) for “depersonalization disorder.”

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text rev. Washington, D.C.: American Psychiatric Association, 2000.

“Depersonalization Disorder.” The Merck Manual of Diagnosis and Therapy, eds. Mark H. Beers, MD, and Robert Berkow, MD. Sec. 15, Chap. 188. Whitehouse Station, NJ: Merck Research Laboratories, 2001.

Medical Economics staff. Physicians’ Desk Reference. 56th ed. Montvale, NJ: Medical Economics Company, 2002.

ORGANIZATIONS

International Society for the Study of Dissociation (ISSD). 8201 Greensboro Drive, Suite 300. McLean, VA 22102. Telephone: (703) 610-9037. Web site: <http://www.issd.org/index_actual.html>.

National Institute of Mental Health. 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663. Telephone: (301) 443-4513. Web site: <www.nimh.nih.gov>.

National Organization for Rare Disorders. P. O. Box 8923, New Fairfield, CT 06812-8923. Telephone: (203) 746-6518. Web site: <www.rarediseases.org>.

Society for Traumatic Stress Studies. 60 Revere Drive, Suite 500, Northbrook, IL 60062. Telephone: (708) 480-9080.