Depersonalization: A Mental Disorder
Depersonalization is a psychological disorder affecting millions where it creates a state in which the individual no longer is able to perceive the reality of the self or the environment. The patient feels their body is unreal or changing. Some describe the feeling as actually dissolving or that he or she is outside their body.
Depersonalization Disorder has been classified by the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the DSM-IV-TR, as one of the dissociative disorders in which normal functions of memory, identity, perception and consciousness are separated. DPD is sometimes referred to as “depersonalization neurosis”.
Often triggered by a recent trauma or distant past or with an intense internal conflict that forces the mind to separate incompatible or unacceptable knowledge, information or feelings. This separation is in direct response to trauma and in a way shelters the patient from dealing with unpleasant feelings by numbing themselves completely.
Patients often describe their feelings of being unreal or unfeeling; their emotions dull or even robotic. In some cases, patients suffering from Depersonalization Disorder complain of sensory distortions affecting a single part of the body, typically a finger, limb or part of the face, which may be described as feeling as if made of cotton wool.
Depersonalization disorder can affect each person differently. For some, the feeling is often described as being outside one’s body or floating on the ceiling looking down at one’s self. Other individuals feel as if their body is literally dissolving or changing. The “unreal” sensation for many is like being in a dream; cognizant of the reality around them however completely emotionally detached. For many, it’s like watching themselves on a movie screen.
Not as rare as you might think, Depersonalization Disorder is a common experience in the general population. Often times the symptoms may come and go sporadically, while others experience different levels of severity. However, when the symptoms of DPD become severe enough to cause emotional distress, depression, or interfere with social functioning, the criteria of the DSM-IV-TR for Depersonalization are met.
The causes of DPD are not completely understood by the Medical Association. Recent advances in brain imaging and other forms of neurological testing, however, have confirmed that DPD is a distinct diagnostic entity and should not be considered a subtype of post-traumatic stress disorder (PTSD).
Several features of Depersonalization Disorder have been traced to differences in brain functioning. A group of British researchers found that the emotional detachment typical of sufferers of this disorder is associated with a lower level of nerve cell responses in regions of the brain that are responsible for emotional feeling, while an increased level of nerve cell responses were found in regions of the brain related to emotional regulation.
A group of American researchers concluded that patients with DPD had different patterns of responses to test of the hypothalamic-pituitary-adrenal axis. This is the part of the brain that responds to the ‘fight or flight’ reaction to stress. Other studies involving positron emission tomography, or PET, measurements of the glucose metabolism in different areas of the brain found that patients with Depersonalization disorder appear to have abnormal functioning of the sensory cortex. This part of the brain governs the senses of sight, hearing and perceptions of the location of one’s body in space.
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