Personal depersonalization is an abnormal condition characterized by a violation of the individual’s self-awareness, alienation of all or several processes occurring in the psyche, and a feeling of one’s own unreality. In other words, the subject ceases to feel himself as an integral personality. With this illness, the personality is, as it were, fragmented into two components of the individual’s “I”: one is the observing part, and the other is the acting one. The part that observes perceives the part that acts as isolated from itself, alien. In other words, the subject believes that his voice and physical body, thoughts and feelings belong to someone else. However, an individual in such a state is not deprived of the ability to objectively assess the situation and sense of reality.
This syndrome may not always be a pathological mental disorder. Occasionally, a similar state is observed in almost seventy percent of individuals and is detected as a feeling of the unreality of what is happening, a short-term feeling of not belonging to oneself. This state is more often detected in a person during the formation of his self-awareness. Cases of depersonalization, even if they occur systematically, are not considered a pathology. This condition is considered to be a mental anomaly of the individual only when it occurs in a stable form, and also when its manifestations do not go away over a relatively long period.
What is depersonalization
The term "depersonalization" is derived from the Latin words de (meaning "absence") and persona (meaning "personality").
Thus, it can be literally translated as “absence, loss of personality.” Let us define what depersonalization is. Personal depersonalization in psychology is a feeling of detachment of a person from himself. It’s as if two personalities live in one subject: one does it, the other watches it. Any actions or reactions of the first personality seem completely alien to the second. At the same time, a person maintains clarity of mind and can soberly assess the situation around him; he understands the incorrectness of his condition.
In a state of depersonalization, a person does not feel like the master of his own body, thoughts, emotions, feelings, memory, reactions. It’s as if he’s watching himself from the outside. In rare cases, an isolated feeling of derealization (a feeling of unreality of everything that happens around a person, the world is seen as if in a fog) or depersonalization (distorted self-perception) occurs. More often than not, both occur simultaneously.
Important! In 90% of cases, depersonalization syndrome develops against the background of other mental disorders or somatic diseases.
Causes of depersonalization
In psychology, depersonalization is characterized by a change in the state of consciousness, which, first of all, is expressed in disturbances in the affective sphere. In more severe cases, disorders may also occur in the intellectual sphere. In other words, the subject stops feeling what he usually felt before under similar circumstances and begins to feel what he did not feel before. Hence, depersonalization is often also called disorientation. Since the course of this disease can be protracted, chronic and due to the fact that many outstanding cultural creators suffered from it, there is depersonalization of creative activity (for example, depersonalization painting or music and even science).
The causes of personality depersonalization are most often hidden behind intense stress, often associated with a direct threat to the life of the subject or a danger to the life of immediate relatives. Often in women, possible trauma and a threat to the health of their child can trigger the occurrence of depersonalization.
The occurrence of this syndrome may also depend on the following reasons:
- hormonal disorders that provoke an imbalance of the endocrine system (for example, disorders of the pituitary gland and defects in the functioning of the adrenal glands);
— experienced stressful conditions;
- suffering from illnesses such as epilepsy or schizophrenia;
- the presence of organic brain lesions (for example, a tumor);
- consumption of substances that affect the psyche, and in predisposed subjects, alcohol-containing drinks.
Manifestations of depersonalization due to the influence of cannabis are considered quite typical.
In many sick individuals, various predisposing factors for the development of depersonalization were found, such as a history of neurological pathology, vegetative-vascular dystonia, fainting, and susceptibility to increased blood pressure.
Many patients with this syndrome suffered in childhood cases of seizures, birth or traumatic brain injuries, severe infectious diseases with very high body temperature and neurological symptoms provoked by this condition.
Experts have proven that “personal depersonalization” syndrome is more often found in females under thirty years of age than in the male population.
One of the leading factors provoking the emergence of feelings of depersonalization is considered to be the transfer of severe stressful situations that caused anxiety-panic emotional disorder or a depressive state. In such conditions, mental defense mechanisms are reflexively activated, which force individuals to hide from the influence of external danger or internal fears.
The reasons for personal depersonalization are also often hidden in intrapersonal conflicts that create psychological inconsistency and divide the psyche into two, hostile halves or alien to each other.
It is possible to identify several variations in the course of the described illness, depending on the direction of the feeling of fantasticality and unreality: somatodepersonalization, autodepersonalization and derealization.
Somatodepersonalization is a disorder in the perception of the size of one’s own body or a disturbance in the sensation of it. For example, the limbs appear asymmetrical and the body appears made of wood, swollen and heavy. However, at the same time, the individual who experiences the listed manifestations realizes the unreality of the sensations being experienced.
With autodepersonalization, patients complain about modification of themselves, often finding it difficult to explain what specific modification has occurred. There is a disappearance or discoloration of emotional experiences. Such manifestations are quite disturbing for patients. Due to alienation from their own person, they lose their personal opinion, the number of friends decreases. With a prolonged course of this type of depersonalization, the intellectual sphere suffers.
Derealization consists of modification in the patient’s perception of everything around him. Sick people complain about the presence of some invisible barrier between themselves and the outside world, about changes in its appearance, lack of expression, dullness and colorlessness. Often, patients note that conditions have changed, but it is difficult for them to describe exactly how the conditions have been transformed.
Some experts also distinguish the following types of depersonalization: anesthetic and allopsychic.
Anesthetic depersonalization consists of a decreased response to the feeling of pain due to the presence of long-term painful sensations. Allopsychic depersonalization is a disorder in the processes of perceiving one’s own personality, reminiscent of a split personality.
Characteristics of depersonalization
Depersonalization syndrome can also occur in a healthy person (occurs in 1/3 of the entire population of the planet), for example, against the background of fatigue and exhaustion, the use of psychoactive substances, while falling asleep and waking up. We talk about psychiatry when there is no improvement, the condition does not change, it worsens, or episodes of depersonalization are often repeated.
Derealization-depersonalization syndrome in psychiatry is a mental disorder. If we are talking about a mental disorder, the syndrome rarely occurs as an independent disease. More often, depersonalization is a phenomenon characteristic of other disorders:
- depression;
- anxiety and bipolar disorder;
- OCD (obsessive-compulsive disorder);
- PTSD (post-traumatic stress disorder).
Sometimes the syndrome is combined with schizophrenia and borderline personality disorder.
Important! Episodes of depersonalization can last from a few hours to several months. The syndrome can also have a chronic course with remissions and relapses.
History of the discovery of the diagnosis
Depersonalization syndrome was first described in the publications of the French psychiatrist Jean Esquirol in 1838, as well as in the works of Jacques de Tours in 1840.
They drew attention to the symptoms that existed in some patients, which were expressed in a feeling of alienation of their own personality and body. The first work entirely devoted to this syndrome was published by Krishaber, and contained 38 clinical observations.
The term “depersonalization” as a designation for the loss of one’s “I”, separation from one’s personality, was proposed in 1898 by Ludovic Dugas, a French philosopher and philologist. Later, Dugas published a work in which he summarized the experience of studying the syndrome that had accumulated over all the years.
Among domestic authors, depersonalization syndrome was described in their works by V.Yu. Vorobyov, A.B. Smulevich, A.A. Magbaryan, Yu.L. Nuller.
Symptoms
Clinical symptoms and signs of personality depersonalization:
- altered self-perception (a person observes himself from the outside);
- cognitive distortions (it seems to a person that his arms, legs, body have changed shape, become larger or smaller);
- altered sense of self, such as a distorted perception of one's weight;
- indifference to others, inability to show higher feelings and emotions (empathize, love);
- doubts about the reality of one’s own memories or their lack of emotion (describes a traumatic experience as if he simply read it somewhere and did not experience it himself);
- inability to think figuratively.
Clinical picture and symptoms
Depersonalization can develop gradually or suddenly, and symptoms and frequency vary from patient to patient. Signs of the disorder include:
- feeling of unreality of the surrounding world;
- confusion, lack of understanding of what is happening;
- perception of one's body parts as foreign;
- a feeling of one’s own insignificance, helplessness, isolation, abandonment;
- decrease in intellectual abilities, spiritual level, emotional sphere;
- loss of outlook on life, foundations and beliefs;
- distorted perception of the body, denial of the existence of body parts;
- lack of pleasure from food, satiety;
- increased anxiety;
- inability to adequately evaluate time and space;
- perception and vision of oneself from the outside, as an outside observer;
- a feeling of a second “I”, a split personality;
Most patients with depersonalization do not lose control over their actions, can control the thought process, are able to control the expression of emotions, retain intellectual abilities, have a critical perception of their actions and experiences, and are aware of the unreality of their sensations.
Types of syndrome
Psychologists and psychiatrists distinguish three types of depersonalization:
- Autopsychic depersonalization (distorted perception of one’s “I”). A person does not recognize his reactions in familiar conditions, loses interests, and sees nothing in common with his friends. Sometimes patients separate their soul, mentality from their body and say that their “I” is located a few centimeters higher, to the left, to the right. Or they feel like they are in several places at once.
- Allopsychic depersonalization (derealization, that is, distorted perception of the external world). More often, patients specify changes in the external picture (dim, bright, blurry, etc.). Sometimes they simply report that something has changed. In other cases, the client says that a real wall has arisen between him and the world, as if he is behind glass.
- Somatopsychic depersonalization (distorted perception of the body and its work). A person does not feel his body, for example, whether he is dressed or not. Or the patient sees his body as distorted, for example, a thin person perceives himself as fat. It happens that a person visually perceives himself adequately, but feels inadequately; for example, he sees that his body is slender, but at the same time he feels incredibly large.
What does it represent?
Depersonalization is a dissociative identity disorder. That is, those that are characterized by violations of some mental functions, for example, memory, consciousness, perception of one’s own identity.
A person can simply read a book and at some point, instead of letters, see his hands, as if printed on sheets. This will cause confusion in terms of how to deal with this and what to do.
He seems to find himself in the position of a passive observer who, in principle, cares little about what is happening, but at the same time he continues to watch. As if waiting to see how this other one would get out of this situation.
An interesting fact is that he is not able to control his body the same way as before the attack. And he believes that everything that arises at the moment in his head, that is pronounced, and every movement is not his, it all belongs to a completely stranger, a person previously unknown to him.
The world around him is two-dimensional, unreal, clouded. And depersonalization occurs in every hundredth person. Moreover, about 70% of people experienced its symptoms during moments of stress or high tension.
It’s just that the disease did not develop further, but turned out to be episodic, situational. Even the pressure of positive emotions can undermine our health.
A similar effect is usually caused by narcotic substances; under their influence, consciousness is disconnected from reality.
Reasons for development
The feeling of depersonalization is a defense mechanism of the psyche, a reaction to severe and prolonged anxiety. When internal tension becomes so strong that a person is about to break down, the subconscious mind decides to remove part of the personality. In this case, it seems to the person that everything bad and traumatic happens not to him, but to someone else.
At the same time, a one-time depersonalization syndrome in a healthy person can be caused by a strong shock, for example, an accident, the death of someone close, or a terrorist attack. In this case, the feeling goes away on its own. However, if PTSD develops, then depersonalization syndrome may persist.
In addition, another disorder may be the cause of depersonalization syndrome:
- bipolar disorder;
- manic-depressive syndrome;
- epilepsy;
- schizophrenia;
- affective disorder;
- panic attacks;
- neuroses.
Other causes of depersonalization disorder:
- organic lesions of the central nervous system;
- alcoholism and other chemical dependencies;
- hormonal disorders;
- tumors in the brain;
- drug abuse.
Interesting! Derealization and depersonalization syndrome (namely, a mental disorder) occurs in approximately 1.5% of people. Most often it develops during adolescence.
Causes
Stress
Stress is one of the main reasons. It is clear that our psyche is subjected to shocks every day, without this there is no way. But if it so happens that they turn out to be extremely strong in their intensity, time is needed in order to manage to restore resources while fighting them.
But every day, receiving a new blow, this becomes impossible. Why the only way out is protection.
How does the psyche usually defend itself? By reducing sensitivity, as if momentarily devaluing what is happening. To use a metaphor, it’s as if he’s injecting anesthesia so that, after numbing the affected area to avoid panic, he can conduct a sober analysis and make a decision.
And no one knows what exactly she will consider a health threat in order to turn on the protection function. For some it may be a broken mirror, for others it may be the violent death of a close relative.
By the way, lack of sleep is the same stress factor for the body as a force majeure situation at work.
Therefore, take care of your health, go to bed on time, don’t stay up late if you need to wake up early. You will learn how to cope with insomnia on your own from this article.
Neurobiological theories
There are several theories about the causes of depersonalization, which have not yet been proven, but have a chance of survival.
For example, some scientists believe that the human brain produces large amounts of endorphins, happiness hormones, which contain substances similar to opioids.
The primary function of opioid receptors is to produce anesthesia, but they also have the added bonus of providing pleasure when drugs enter the body.
So, if there are too many of them, the pleasure center in the brain simply turns off to avoid problems. Following it is the entire limbic system, which is responsible for the emotional sphere.
And another theory is the idea that the balance of glutamic acid is disturbed, as a result of which changes occur in the structure of the brain.
Result of other mental disorders
In depression, bipolar personality disorder, schizophrenia, even epilepsy and other similar diseases, depersonalization appears as one of the symptoms.
That is why it is so important to contact specialists, at least for a consultation, so that they can determine what is happening to the patient and how to improve their well-being.
Overdose
May occur with drug use. And also if there is an overdose of medications. Therefore, to make a diagnosis, it is important that the person is not in a state of intoxication.
So, if you have, for example, alcohol addiction, be sure to read the article, which provides information on how to get rid of it, what steps to take and where to go.
Then, perhaps, the symptoms of this disorder will also cease to bother you.
Mechanism of development of the disorder
Depersonalization disorder develops against the background of abnormal functioning of certain parts of the brain: the hypothalamic-pituitary-adrenal axis, the amygdala. The first section is responsible for the production of cortisol, the stress hormone. The second is for emotions. Disruption of these departments may be associated with severe stress or emotional abuse, or organic damage.
In the case where depersonalization syndrome is a protective mechanism, its development principle can be explained as follows: the psyche seems to turn off the part of the brain responsible for emotions so that a person can soberly assess a critical situation.
Important! The manifestation of depersonalization disorder can be vivid, acute (patients clearly remember this day, time, place) or smooth (the person finds it difficult to answer when it started). Most often there is an abrupt onset.
Treatment principle
After the diagnosis is established, many patients are immediately interested in how to get rid of depersonalization on their own. In general, only the attending physician can tell how to treat depersonalization, depending on the cause of its development. Treatment should be aimed at eliminating the underlying disease, accompanied by symptoms of impaired self-awareness.
If there are no signs of other mental disorders, symptomatic therapy is practiced. To get rid of depersonalization, the following groups of drugs are prescribed:
- tranquilizers - to reduce anxiety;
- antidepressants – to normalize serotonin production;
- neuroleptics - to reduce the risk of relapse of symptoms of the disorder.
If the functioning of the adrenal glands is disrupted and cortisol production is reduced, hormonal therapy may be indicated to normalize the function of this organ.
Diagnosis and treatment of depersonalization
There is no specific test for identifying depersonalization syndrome. The main diagnostic method is a conversation with a psychologist. The specialist observes the client’s behavior and reactions and collects anamnesis. The diagnosis is made if one or both of the symptoms are identified (according to the patient): “This is not happening to me,” “The world has changed, it looks like a toy, it’s not real.” At the same time, clarity of mind is observed, the person understands that something wrong is happening to him.
Diagnostics
Psychological tests, special structured questionnaires and conversations with a psychologist are of great benefit.
With depersonalization, treatment is aimed at eliminating provoking factors. Since this disorder is observed in various mental disorders, differential diagnosis plays a major role.
It is important to be able to distinguish depersonalization from depressive disorder and schizophrenia. Unfortunately, today the diagnosis of “schizotypal disorder” is mistakenly made in half of the cases of depersonalization in a patient.
Diazepam tests help to differentiate between personality depersonalization and anxiety and depressive disorders. The patient is given an intravenous diazepam solution and a reaction is expected. With depression, no visible changes in self-perception occur, and after some time the patient feels drowsy and simply falls asleep. With anxiety disorders, all the patient’s “excitement” quickly disappears, and short-term euphoria may appear. In the case of a violation of self-awareness or depersonalization disorder, after about half an hour, the acute symptoms go away, the patient feels the so-called enlightenment - emotions become brighter, the world takes on colors, one’s body no longer seems alien.
What it is
Depersonalization is a disorder of perception. In psychology, the definition first appeared in the 19th century. The causes of this syndrome are quite varied.
Today this disease is included in the clinical picture of many mental disorders, including:
- manic-depressive syndrome;
- depressive personality disorder;
- schizophrenia;
- epilepsy.
Renal failure, VSD, and hypertension are associated with this phenomenon. The disease is often observed in neurosis. It can be the result of a panic attack, phobia, severe emotional shock, physical fatigue and sudden fear.
Sometimes this condition is a reaction to the following factors:
- epilepsy attack;
- neurosurgical operations;
- TBI;
- brain tumor;
- stroke, micro-stroke;
- taking alcohol, drugs or psychoactive drugs.
Depersonalization is especially dangerous in depression. It causes homicidal and suicidal tendencies. This condition leads to aggressive actions and can end very sadly.
Features of the flow
Symptoms of depersonalization develop suddenly in most patients. Most of the patients belong to the age group from 15 to 30 years. Sometimes the disease occurs in children under 10 years of age, is less common after the age of 30, and is practically not observed in older people.
The attack can last from several minutes to several years. At the beginning of the disease, all symptoms may temporarily disappear.
Personal depersonalization is practically not treatable with tranquilizers, antidepressants, and antipsychotics. Resistance can be reduced using plasmapheresis. The syndrome often acts as a defense mechanism of the body, and helps to increase the overall level of immunity.
If the syndrome develops against the background of a schizotypal or depressive disorder, then it refers to “negative symptoms.” This means that resistance to treatment is emerging. In this case, drugs with anti-negative effects are prescribed (Amisulpride, Quetiapine, SSRI Escitalopram).
Depersonalization can be caused by taking psychotropic drugs. Misdiagnosis of depressive and anxiety disorders, as well as erroneous prescription of medications leads to the development of the disorder.
These drugs include antipsychotics and antidepressants of the SSRI group. It is also possible for the syndrome to develop with insufficient treatment of anxiety disorders, with the prescription of too powerful antidepressants, with increased anxiety and depression at the beginning of antidepressant therapy.
Remission can occur over several months or suddenly. Therefore, it is necessary to carefully monitor the patient’s condition to prevent drug poisoning due to the disappearance of resistance.
