Depersonalization is estimated to be the third most common psychiatric symptom, and frequently occurs during life-threatening experiences, such as accidents and assaults. It is also not uncommon for people to experience mild episodes of depersonalization when faced with a stressful situation such as giving a speech or taking an important exam. While some people report these experiences as upsetting, others have said they find them helpful and calming. It is a way for many people to set aside their current anxieties and more effectively deal with the task at hand.
Frequent or severe episodes of depersonalization may make the individual feel as though they are going crazy or living in a dream world. The episodes may interfere with one or more areas of the person's life, and may make it difficult to be productive at all. Individuals often find it extremely difficult to describe their symptoms, and may believe the symptoms mean they are psychotic. Reality testing is not impaired during a depersonalization episode, but the fear that they are "going crazy" may make some people reluctant to discuss their symptoms with their doctor and may increase anxiety which in turn can trigger more episodes of depersonalization.
When episodes of depersonalization are frequent and severe, a diagnosis of Depersonalization Disorder may be given.
| Diagnostic Criteria for Depersonalization Disorder: |
A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).
B. During the depersonalization experience, reality testing remains intact.
C. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).
| Symptoms of Depersonalization Disorder: |
Loss or change of feeling in body parts:
A feeling of numbness in one or more body parts. Loss of sensation, as though the body part does not belong or has become detached from the rest of the body. There might be little response to pain or other sensations, a defense that would be healthy and useful during an accident or life-threatening situation, but unhealthy and harmful during everyday life.
Distorted perceptions of your body:
A sense that parts of the body are changing in size or shape, or that your body is shrinking. A feeling that certain body parts do not seem to belong or appear fake or plastic. There might be a sense that specific body parts have been transplanted from other areas or even from other people.
Invisibility:
You may feel invisible or transparent, and that others are not able to see you. You may feel as though you blend in with the environment, or are moving at a different speed than those around you.
Not recognizing yourself in the mirror or in photographs:
Being unable to recognize yourself or feeling unfamiliar with the person looking back at you when you look into a mirror. Feeling that your reflection belongs to someone else, or to you at a different age than you are now.
Detachment from your emotions:
A lack of emotional response or an inability to feel certain emotions is not uncommon. You may feel cut off from your emotions or unable to access them at the appropriate times. There may be a sense that your feelings are dulled or flat, or that they are stored away somewhere deep inside of you. Many people these days feel the need to push their emotions aside when at work, just as they feel it necessary to leave their "work self" at the office before going home in the evening. If you are suffering from depersonalization you might feel that your emotions are no longer within reach, and do not return even when you want or need them to.
Feelings of unreality or of being a robot:
A sense that you are functioning automatically or on auto-pilot, or that something or someone else is controlling your thoughts, feelings, or actions. Many people experience a feeling of being unreal, or like an actor in a movie. You may have the thought that you are just "going through the motions" of life, or that there is no emotional connection to your actions and no thought behind anything you do.
Floating or out-of-body experiences:
You may feel as though you are hovering over your body or outside of yourself. You may have the experience of watching yourself from a distance, or of standing on the sidelines commenting on or even criticizing your own performance.
Talking to yourself:
Having a conversation with yourself out loud, as though you are speaking to a separate person. Possibly you will even answer yourself out loud as well, taking on the role of two separate individuals. Everyone has internal dialogues when making a decision, preparing a speech, or practicing for or rehearsing a future conversation, but during a depersonalization episode these dialogues are often out loud and take place much more frequently.
