What is Depersonalisation disorder?
Depersonalization disorder (DPD) is a mental disorder in which the sufferer has persistent or recurrent feelings of depersonalization and/or derealization. In the DSM-5 it was combined with Derealization Disorder and renamed to Depersonalization/Derealization Disorder (DDPD). In the DSM-5 it remains classified as a dissociative disorder, while in the ICD-10 it is called depersonalization-derealization syndrome and classified as a neurotic disorder.
Symptoms can be classified as either depersonalization or derealization. Depersonalization is described as feeling disconnected or estranged from one's body, thoughts, or emotions. Individuals experiencing depersonalization may report feeling as if they are in a dream or are watching themselves in a movie. They may feel like an outside observer of their own thoughts or body, and often report feeling a loss of control over their thoughts or actions. While depersonalization is a sense of detachment from one's self, derealization is described as detachment from one's surroundings. Individuals experiencing derealization may report perceiving the world around them as foggy, dreamlike/surreal, or visually distorted.
In addition to these depersonalization derealization disorder symptoms, the inner turmoil created by the disorder can result in depression, self-harm, low self-esteem, anxiety attacks, panic attacks, phobias, etc. It can also cause a variety of physical symptoms, including chest pain, blurry vision, nausea, and the sensation of pins and needles in one's arms or legs.
Diagnostic criteria for depersonalization derealization disorder includes, among other symptoms, persistent or recurrent feelings of detachment from one's mental or bodily processes or from one's surroundings. A diagnosis is made when the dissociation is persistent and interferes with the social and/or occupational functions of daily life. However, accurate descriptions of the symptoms are hard to provide due to the subjective nature of depersonalization/derealization and sufferers' ambiguous use of language when describing these episodes.
Depersonalization derealization disorder is thought to be caused largely by severe traumatic lifetime events, including childhood abuse, accidents, natural disasters, war, torture, and bad drug experiences. It is unclear whether genetics play a role; however, there are many neurochemical and hormonal changes in individuals suffering with depersonalization disorder. The disorder is typically associated with cognitive disruptions in early perceptual and attentional processes.
Although the disorder is an alteration in the subjective experience of reality, it is not a form of psychosis, as sufferers maintain the ability to distinguish between their own internal experiences and the objective reality of the outside world. During episodic and continuous depersonalization, sufferers can distinguish between reality and fantasy. In other words, their grasp on reality remains stable at all times.
While depersonalization derealization disorder was once considered rare, lifetime experiences with the disorder occur in approximately 1%–2% of the general population. The chronic form of this disorder has a reported prevalence of 0.1 to 1.9% While these numbers may seem small, depersonalization/derealization experiences have been reported by a majority of the general population, with varying degrees of intensity. While brief episodes of depersonalization or derealization can be common in the general population, the disorder is only diagnosed when these symptoms cause significant distress or impair social, occupational, or other important areas of functioning.