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Depersonalization is a side effect of [[dissociatives]] and [[hallucinogens]], as well as common drugs such as [[caffeine]], [[alcohol]], and [[minocycline]].<ref>{{cite journal |last=Stein |first=M. B. |title=Depersonalization Disorder: Effects of Caffeine and Response to Pharmacotherapy |journal=Biological Psychiatry |volume=26 |issue=3 |pages=315–20 |month=July | year=1989 |doi=10.1016/0006-3223(89)90044-9}}</ref><ref>{{cite journal |last=Raimo |first=E. B. |coauthors=R. A. Roemer, M. Moster and Y. Shan |title=Alcohol-Induced Depersonalization |journal=Biological Psychiatry |month=June | year=1999}}</ref><ref name="pmid14746427">{{cite journal |last=Cohen |first=P. R. |title=Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline |journal=Southern Medical Journal |volume=97 |issue=1 |pages=70–73 |year=2004 |pmid=14746427 |doi=}}</ref> It is a classic [[withdrawal]] symptom from many drugs.<ref name="pmid8104417">{{cite journal |last=Marriott |first=S. |coauthors=P. Tyrer |title=Benzodiazepine dependence: avoidance and withdrawal |journal=Drug Safety |volume=9 |issue=2 |pages=93–103 |year=1993 |pmid=8104417 |doi=10.2165/00002018-199309020-00003}}</ref><ref name="pmid15889607">{{cite journal |last=Shufman |first=E. |coauthors=A. Lerner and E. Witztum |title=[Depersonalization after withdrawal from cannabis usage] |language=Hebrew |journal=Harefuah |volume=144 |issue=4 |pages=249–51 and 303 |year=2005 |pmid=15889607}}</ref><ref name="pmid7085580">{{cite journal |last=Djenderedjian |first=A. |coauthors=R. Tashjian |title=Agoraphobia following amphetamine withdrawal |journal=The Journal of Clinical Psychiatry |volume=43 |issue=6 |pages=248–49 |year=1982 |pmid=7085580}}</ref><ref name="pmid9696914">{{cite journal |last=Mourad |first=I. |coauthors=M. Lejoyeux and J. Adès |title=[Prospective evaluation of antidepressant discontinuation] |language=French |journal=L'Encéphale |volume=24 |issue=3 |pages=215–22 |year=1998 |pmid=9696914}}</ref>
Depersonalization is a side effect of [[dissociatives]] and [[hallucinogens]], as well as common drugs such as [[caffeine]], [[alcohol]], and [[minocycline]].<ref>{{cite journal |last=Stein |first=M. B. |title=Depersonalization Disorder: Effects of Caffeine and Response to Pharmacotherapy |journal=Biological Psychiatry |volume=26 |issue=3 |pages=315–20 |month=July | year=1989 |doi=10.1016/0006-3223(89)90044-9}}</ref><ref>{{cite journal |last=Raimo |first=E. B. |coauthors=R. A. Roemer, M. Moster and Y. Shan |title=Alcohol-Induced Depersonalization |journal=Biological Psychiatry |month=June | year=1999}}</ref><ref name="pmid14746427">{{cite journal |last=Cohen |first=P. R. |title=Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline |journal=Southern Medical Journal |volume=97 |issue=1 |pages=70–73 |year=2004 |pmid=14746427 |doi=}}</ref> It is a classic [[withdrawal]] symptom from many drugs.<ref name="pmid8104417">{{cite journal |last=Marriott |first=S. |coauthors=P. Tyrer |title=Benzodiazepine dependence: avoidance and withdrawal |journal=Drug Safety |volume=9 |issue=2 |pages=93–103 |year=1993 |pmid=8104417 |doi=10.2165/00002018-199309020-00003}}</ref><ref name="pmid15889607">{{cite journal |last=Shufman |first=E. |coauthors=A. Lerner and E. Witztum |title=[Depersonalization after withdrawal from cannabis usage] |language=Hebrew |journal=Harefuah |volume=144 |issue=4 |pages=249–51 and 303 |year=2005 |pmid=15889607}}</ref><ref name="pmid7085580">{{cite journal |last=Djenderedjian |first=A. |coauthors=R. Tashjian |title=Agoraphobia following amphetamine withdrawal |journal=The Journal of Clinical Psychiatry |volume=43 |issue=6 |pages=248–49 |year=1982 |pmid=7085580}}</ref><ref name="pmid9696914">{{cite journal |last=Mourad |first=I. |coauthors=M. Lejoyeux and J. Adès |title=[Prospective evaluation of antidepressant discontinuation] |language=French |journal=L'Encéphale |volume=24 |issue=3 |pages=215–22 |year=1998 |pmid=9696914}}</ref>


The symptom of depersonalization is the third most common psychological experience, after feelings of anxiety and feelings of depression. Depersonalization can also accompany [[sleep deprivation]], [[stress (medicine)|stress]] and [[anxiety]] as well as being a symptom of anxiety disorders such as [[panic disorder]].<ref>{{cite journal |author=Sierra-Siegert M, David AS |title=Depersonalization and individualism: the effect of culture on symptom profiles in panic disorder |journal=J. Nerv. Ment. Dis. |volume=195 |issue=12 |pages=989–95 |year=2007 |month=December |pmid=18091192 |doi=10.1097/NMD.0b013e31815c19f7 |url=}}</ref>
The symptom of depersonalization is the third most common psychological experience, after feelings of anxiety and feelings of depression.{{fact}} Depersonalization can also accompany [[sleep deprivation]], [[stress (medicine)|stress]], and [[anxiety]]; it is a symptom of anxiety disorders, such as [[panic disorder]].<ref>{{cite journal |author=Sierra-Siegert M, David AS |title=Depersonalization and individualism: the effect of culture on symptom profiles in panic disorder |journal=J. Nerv. Ment. Dis. |volume=195 |issue=12 |pages=989–95 |year=2007 |month=December |pmid=18091192 |doi=10.1097/NMD.0b013e31815c19f7 |url=}}</ref>


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.<ref name="pmid17435477">{{cite journal |last=Giesbrecht |first=T. |coauthors=T. Smeets, H. Merckelbac and M. Jelicic |title=Depersonalization experiences in undergraduates are related to heightened stress cortisol responses |journal=J. Nerv. Ment. Dis. |volume=195 |issue=4 |pages=282–87 |year=2007 |pmid=17435477 |doi=10.1097/01.nmd.0000253822.60618.60}}</ref>
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.<ref name="pmid17435477">{{cite journal |last=Giesbrecht |first=T. |coauthors=T. Smeets, H. Merckelbac and M. Jelicic |title=Depersonalization experiences in undergraduates are related to heightened stress cortisol responses |journal=J. Nerv. Ment. Dis. |volume=195 |issue=4 |pages=282–87 |year=2007 |pmid=17435477 |doi=10.1097/01.nmd.0000253822.60618.60}}</ref>
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Treatment is dependent on the underlying cause.
Treatment is dependent on the underlying cause.


If depersonalization is a symptom of neurological disease, then diagnosis and treatment of the specific disease is the first approach. Depersonalization can be a cognitive symptom of such diseases as [[amyotrophic lateral sclerosis]], [[Alzheimer's]], [[Multiple Sclerosis]] (MS), neuroborreliosis ([[Lyme Disease]]) or any other neurological disease affecting the brain.
If depersonalization is a symptom of neurological disease, then diagnosis and treatment of the specific disease is the first approach. Depersonalization can be a cognitive symptom of such diseases as [[amyotrophic lateral sclerosis]], [[Alzheimer's]], [[Multiple Sclerosis]] (MS), neuroborreliosis ([[Lyme Disease]]), or any other neurological disease affecting the brain.


If depersonalization is a psychological symptom then treatment may be dependent on the diagnosis. Depersonalization is often a symptom of [[borderline personality disorder]], which can be treated in the long term with proper psychotherapy and psychopharmacology.<ref>{{cite journal |author=Sierra M, Baker D, Medford N, ''et al'' |title=Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases |journal=Clin Neuropharmacol |volume=29 |issue=5 |pages=253–8 |year=2006 |pmid=16960469 |doi=10.1097/01.WNF.0000228368.17970.DA |url=}}</ref>
If depersonalization is a psychological symptom, then treatment may be dependent on the diagnosis. Depersonalization is often a symptom of [[borderline personality disorder]], which can be treated in the long term with proper psychotherapy and psychopharmacology.<ref>{{cite journal |author=Sierra M, Baker D, Medford N, ''et al'' |title=Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases |journal=Clin Neuropharmacol |volume=29 |issue=5 |pages=253–8 |year=2006 |pmid=16960469 |doi=10.1097/01.WNF.0000228368.17970.DA |url=}}</ref>


Treatment of chronic depersonalization is considered in [[depersonalization disorder]].
Treatment of chronic depersonalization is considered in [[depersonalization disorder]].

Revision as of 10:51, 11 November 2008

Depersonalization (or depersonalisation) 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. It is a feeling of watching oneself act, while having no control over a situation.[1] It can be considered desirable, such as in the use of recreational drugs, but it usually refers to the severe form found in anxiety and, in the most intense cases, panic attacks. A sufferer feels that he or she has changed and the world has become less real, vague, dreamlike, or lacking in significance. It can sometimes be a rather disturbing experience, since many feel that indeed, they are living in a "dream."

Chronic depersonalization refers to 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. However, more specifically, derealization is the feeling that "nothing is real," while depersonalization is the feeling that one is "detached" from one's body or world. (Though these feelings can happen to anyone who is under temporary severe anxiety/stress, for chronic depersonalization, which individuals experience after suffering severe trauma, see depersonalization disorder.) Derealization and depersonalization disorder are most prominent in anxiety disorders, clinical depression, bipolar disorder, sleep deprivation, and some types of epilepsy.

Description

Individuals who experience depersonalization feel divorced from both the world and from their own physicality by acting as a completely different identity.[2] Often a person who has experienced depersonalization claims that life "feels like a movie" or things seem unreal or hazy. Also a recognition of self breaks down (hence the name). Depersonalization can result in very high anxiety levels, which further increases these perceptions.[3]

One way to describe the physical manifestation of the feeling is to compare it to a film technique called the vertigo shot or dolly zoom. In this technique, the subject of the picture stays fixed on the shot while all the surrounding background is pulled away - providing a sense of vertigo or detachment. People may perceive this feeling in a cyclical manner, where the feeling is experienced back-to-back in succession.

Sometimes the physical manifestation is more like a strobe light of the senses. Information is processed at a much more staggered rate and therefore the subject feels as though his or her senses are being distorted and fragmented.

Causes

Depersonalization is a side effect of dissociatives and hallucinogens, as well as common drugs such as caffeine, alcohol, and minocycline.[4][5][6] It is a classic withdrawal symptom from many drugs.[7][8][9][10]

The symptom of depersonalization is the third most common psychological experience, after feelings of anxiety and feelings of depression.[citation needed] Depersonalization can also accompany sleep deprivation, stress, and anxiety; it is a symptom of anxiety disorders, such as panic disorder.[11]

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.[12]

Treatment

Treatment is dependent on the underlying cause.

If depersonalization is a symptom of neurological disease, then diagnosis and treatment of the specific disease is the first approach. Depersonalization can be a cognitive symptom of such diseases as amyotrophic lateral sclerosis, Alzheimer's, Multiple Sclerosis (MS), neuroborreliosis (Lyme Disease), or any other neurological disease affecting the brain.

If depersonalization is a psychological symptom, then treatment may be dependent on the diagnosis. Depersonalization is often a symptom of borderline personality disorder, which can be treated in the long term with proper psychotherapy and psychopharmacology.[13]

Treatment of chronic depersonalization is considered in depersonalization disorder.

  • Matthew Perry's character, Hudson Milbank, suffers from Depersonalization disorder in the movie Numb.
  • The alternative rock/metal band Linkin Park sing about depersonalization in a number of their songs, including "Numb" and "Crawling."
  • Lt. Col. Dave Grossman, in his book On Killing, suggests that military training artificially creates depersonalization in soldiers, suppressing empathy and making it easier for them to kill other human beings.
  • Spike Spiegel of Cowboy Bebop had barely survived an attempt on his life from the syndicate he used to work for named Red Dragon, and since his recovery, he became a bounty hunter, going on very life-threatening tasks to find out if he's really alive or "living in a dream". He explained this to Faye Valentine in the final episode when he decided to put to rest once and for all, the demons of his past by confronting the man who betrayed him with his life on the line.
  • Existentialists use the term in a different context. The treatment of individuals by other people as if they were objects, or without regard to their feelings, has been termed depersonalization. Determinism has been accused of this. See also objectification.
  • R. D. Laing used depersonalization to mean a fear of the loss of autonomy in interpersonal relationships by the ontologically insecure.
  • In the memoir Girl Interrupted, Susanna Kayson describes her experience in a mental institution, where she later bit into her hand bacause she had "to see if she had bones" she was later diagnosed with a Depersonalization Attack. Also seen in the movie adaptation.

See also

References

  1. ^ American Psychiatric Association (2004). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision). American Psychiatric Association. ISBN 0890420246.
  2. ^ Depersonalization Disorder at Merck Manual of Diagnosis and Therapy Home Edition
  3. ^ Daniel. "Depersonalization disorder: A feeling of being 'outside' your body" (html). Retrieved 2007-09-08.
  4. ^ Stein, M. B. (1989). "Depersonalization Disorder: Effects of Caffeine and Response to Pharmacotherapy". Biological Psychiatry. 26 (3): 315–20. doi:10.1016/0006-3223(89)90044-9. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ Raimo, E. B. (1999). "Alcohol-Induced Depersonalization". Biological Psychiatry. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  6. ^ Cohen, P. R. (2004). "Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline". Southern Medical Journal. 97 (1): 70–73. PMID 14746427.
  7. ^ Marriott, S. (1993). "Benzodiazepine dependence: avoidance and withdrawal". Drug Safety. 9 (2): 93–103. doi:10.2165/00002018-199309020-00003. PMID 8104417. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  8. ^ Shufman, E. (2005). "[Depersonalization after withdrawal from cannabis usage]". Harefuah (in Hebrew). 144 (4): 249–51 and 303. PMID 15889607. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  9. ^ Djenderedjian, A. (1982). "Agoraphobia following amphetamine withdrawal". The Journal of Clinical Psychiatry. 43 (6): 248–49. PMID 7085580. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  10. ^ Mourad, I. (1998). "[Prospective evaluation of antidepressant discontinuation]". L'Encéphale (in French). 24 (3): 215–22. PMID 9696914. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  11. ^ Sierra-Siegert M, David AS (2007). "Depersonalization and individualism: the effect of culture on symptom profiles in panic disorder". J. Nerv. Ment. Dis. 195 (12): 989–95. doi:10.1097/NMD.0b013e31815c19f7. PMID 18091192. {{cite journal}}: Unknown parameter |month= ignored (help)
  12. ^ Giesbrecht, T. (2007). "Depersonalization experiences in undergraduates are related to heightened stress cortisol responses". J. Nerv. Ment. Dis. 195 (4): 282–87. doi:10.1097/01.nmd.0000253822.60618.60. PMID 17435477. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  13. ^ Sierra M, Baker D, Medford N; et al. (2006). "Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases". Clin Neuropharmacol. 29 (5): 253–8. doi:10.1097/01.WNF.0000228368.17970.DA. PMID 16960469. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
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