“My thoughts don’t seem to be mine,” “Who am I?”, “I don’t recognize myself in the mirror. “This type of thinking often occurs in people with depersonalization disorder, but also in people who experience moments of great anxiety.
The search for our own identity and our place in the world is a constant, we all wondered who we were, where we came from and where we were going, that’s normal. However, in depersonalization disorder, it occurs much more frequently and intensely.
- Depersonalization disorder is characterized by persistent or recurrent episodes of depersonalization.
- Dererialization.
- Or both.
- But what is depersonalization?Episodes of depersonalization are moments when there is a sense of unreality.
- Strangeness or detachment from oneself in general.
The depersonalized person may feel independent of his whole being (for example, “I am nobody”, “I have nothing of me”). The person may also feel subjectively separated from aspects of himself. This can include feelings (for example, a low emotional level: “I know I have feelings, but can’t I feel them?”
Feeling separated from oneself also includes feeling separated from thoughts, body parts, whole body or sensations (e. g. touch, self-perception, hunger, thirst, libido). It is also common for the notion of reality to diminish.
For example, the person experiences a robotic sensation, such as that of a robot, that lacks control over his speech or movements. The experience of depersonalization can sometimes be that of a divided self, with an observer part and a participant part. known as an “extracorporeal experience” when it occurs in its most extreme form.
The unitary symptom of? Depersonalization: It consists of several factors, including abnormal bodily experiences (e. g. unreality of the self and changes in perception), physical or emotional numbness, and temporal distortions with abnormal subjective memory.
Episodes of irrealization are characterized by a sense of unreality or detachment or unfamiliar with the world, the person may feel like a dream or bubble, as if there was a veil or a glass wall between him and the world around him. .
The medium can be considered artificial, colorless or lifeless. Dererialization is usually accompanied by subjective visual distortions Can it be blurred vision, increased visual acuity, a larger or narrower field of view, two-dimensional or flat, an exaggeration of three-dimensionality?Changes in the distance or size of objects may also occur (p. E. g. Macropsy or micropsy).
Macropsy is about seeing objects larger than they really are, the micropsy, in turn, is the opposite, that is, we see smaller objects than they really are.
Un-achievement also results in auditory distortions, silence, or accented voices or sounds. Diagnosing this disorder requires clinically significant discomfort or commitment in the social, professional or other fields.
It should be clarified that, for the diagnosis of this disorder, previous changes may not be the result of the use of drugs, medications or a disease (such as epilepsy). Nor should these changes be a criterion for schizophrenia, panic disorder. , major depression, acute stress disorder or post-traumatic stress disorder.
People with depersonalization / derealization disorder may have a difficult time describing their symptoms and may think they are crazy or going crazy. Another common experience is the fear of irreversible brain damage.
A common symptom is subjective change in the notion of time (e. g. very fast, very slow), as well as a subjective difficulty in vividly remembering and appropriating memories of the past.
Low body symptoms, such as saturation, tingling, or fainting, are also common. These people may feel an obsessive concern about whether they actually exist or to control their perceptions to determine if they are real.
In addition, it is not uncommon to find people with episodes of depersonalization with varying degrees of anxiety or depression, something curious that has been observed is that these people tend to react physiologically more intensely to emotional stimuli, these physiological changes occur by activation of the hypothalamus-pituitary-adrenal axis, the lower parietal lobe and the circuits of the prefrontal cortex.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a person diagnosed with a depersonalization/de-achievement disorder must meet the following diagnostic criteria:
A. Presence of persistent or recurring experiences of depersonalization, loss of achievement or both:
B. During depersonalization or loss of achievement experiments, the evidence of reality remains intact.
C. Symptoms cause clinically significant or social, professional or other discomfort.
D. Change cannot be attributed to the physiological effects of a substance (e. g. drugs, medicines) or another disease (e. g. epilepsy).
E. Change cannot be better explained by another mental disorder, such as schizophrenia, panic disorder, major depressive disorder, acute stress disorder, post-traumatic stress disorder, or other dissociative disorder.
On average, depersonalization/loss of achievement disorder begins to manifest at age 16, although it may begin in early or middle childhood. In fact, most diagnosed people remember having had symptoms at this stage.
More than 20% of cases occur after age 20 and only 5% after age 25. The appearance in the fourth decade of life or later is quite unusual. The onset can be extremely sudden or progressive. The duration of depersonalization/dererialization episodes can vary considerably, from short (hours or days) to prolonged (weeks, months, or years).
Given the rarity of the onset of the disorder after age 40, there may be underlying medical conditions in these cases, such as brain damage, seizure disorders or sleep apnea.
The progression of the disease is usually chronic. While in some people the intensity of symptoms can increase and decrease significantly, others refer to a constant level of intensity that, in extreme cases, can be recurrent for years or decades; on the other hand, increased intensity of symptoms can be caused by stress, mood impairment or anxiety symptoms, new stimulating circumstances and physical factors such as lighting or lack of sleep.
As I always like to say, not everyone with any of these symptoms will develop the disorder, however, if the above symptoms are present most of the time and seriously interfere with their daily lives, it may be necessary to call a specialist psychologist to have their situation analyzed.