Depersonalization disorder is a dissociative disorder that causes an altered perception of reality and disconnection from the body and environment. It is often caused by abuse, trauma, or stress and can be diagnosed through exclusion and personality tests. Treatment includes therapy and medication, with most patients making a full recovery.
Depersonalization disorder describes a condition in which the individual feels disconnected from their body. These people suffer from an altered perception of reality and may feel as if they are not a part of their body or environment. It may seem that their body is changing, dissolving or being left behind, as if they have become an observer of their own life.
Also known as depersonalization neurosis, depersonalization disorder is considered one of many dissociative disorders, as labeled by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). A dissociative disorder occurs when a person’s memory, identity, perception and consciousness become disconnected from one another and is usually caused by severe trauma, an intense level of internal conflict, or thoughts and feelings that l feels forbidden. In depersonalization disorder, it is perception that becomes disjointed.
The most common cause of this disorder is abuse, whether physical, mental, or sexual, but it can also be caused by post-traumatic stress disorder (PTSD), panic disorders, borderline personality disorder, or acute stress disorder. It can also be linked to another pre-existing dissociative disorder. Medications, sleep deprivation, and very high levels of stress can also lead to depersonalization disorder symptoms, though they won’t last long. For the diagnosis to be made, feelings of altered reality must be nearly constant. Feeling disconnected after a panic attack or PTSD episode doesn’t mean someone has depersonalization disorder.
Diagnosing this disorder is usually a matter of exclusion. Doctors will narrow down the list of possible disorders until depersonalization disorder is the only one left. Using diagnostic questionnaires can help doctors or psychologists pinpoint their diagnosis of dissociation disorder. From there, another survey can be used to narrow down the diagnosis to depersonalization disorder. The questions on these personality tests are open-ended, giving doctors a chance to learn more about an individual’s symptoms and the severity of the disorder, as well as the ability to possibly determine the cause.
In some cases, depersonalization disorder resolves on its own. If the condition is ongoing and disrupting the patient’s life, specialized therapy may be recommended. Cognitive behavioral or psychodynamic therapy may be helpful; hypnosis has also been used successfully in many cases. The type of therapy used is based on what best suits the patient’s needs.
In addition to therapy, some patients are also prescribed medications, such as lorezapam or doxepin. These medications may include tranquilizers, antidepressants, selective serotonin reuptake inhibitors (SSRIs). No drug has been shown to be more effective than the others; like therapy, it involves determining which drug, or combination of drugs, will best help the patient.
Most patients diagnosed with depersonalization disorder will make a full recovery. This is especially true if the cause of the disorder has been linked to a traumatic event in the patient’s past, as therapy can help the patient deal with these past events. Some patients will experience chronic depersonalization disorder, with episodes that may occur after periods of extreme stress, but these episodes are manageable with medication.
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