Depersonalization - derealization syndrome: A case report
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Depersonalization-derealization syndrome is an under researched clinical phenomenon and is often under diagnosed. We present a case of 42 years old female, who presented with complaining of feeling that her stomach is always empty in spite of adequate food and water intake for the past 7 months. She also reported that all the emotions, bodily movements appeared as if they are not her own. However, reality testing was intact. Phenomenon of primary depersonalization derealization syndrome is relatively rare. Selective serotonin reuptake inhibitors (SSRIs) may be considered as a pharmacological treatment option for the treatment of the condition. Keywords: Depersonalization, Derealization, SSRIs.Keywords:
Derealization
Phenomenon
The present study was designed to assess whether individuals reporting experiences of depersonalization or derealization experience higher levels of anxiety than those subjects not reporting these experiences. 221 undergraduates volunteered to complete questionnaires on depersonalization and derealization and the IPAT Anxiety Scale. Analysis indicated that subjects experiencing depersonalization or derealization scored higher on the anxiety scale than those not reporting these experiences, while subjects who reported both depersonalization and derealization scored the highest. Significant positive correlations between number of depersonalization episodes, and frequency and number of derealization episodes, and significant negative correlations between level of diminution of depersonalization or derealization and reported over-all anxiety score were obtained. The results were explained using the model proposing that individuals experiencing continued depersonalization or derealization episodes suffer from a more generic anxiety or phobic-anxiety based disorder labeled “phobic-anxiety depersonalization syndrome.”
Derealization
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Abstract This study investigates the use of metaphor in the dissociative disorder depersonalization/derealization – the feeling of unreality or detachment from the senses or surrounding events. While the debilitating experience of depersonalization/derealization is prevalent, it is also under-acknowledged, such that it is often expressed through metaphor, with more typical metaphor described in diagnostic criteria. Using naturally occurring text from two prominent English language depersonalization/derealization support fora, in the current study a systematic survey is made of metaphor to communicate the experience of depersonalization/derealization in context. It is concluded that metaphor described in the formal diagnostic criteria for depersonalization/derealization does not completely represent metaphor use in the contexts investigated. A summary is made of metaphor for the experiences of depersonalization, and derealization, and depersonalization/derealization more generally, across both the contexts investigated, that may support vital understanding and diagnosis of this debilitating, under-recognized experience, across a wider demographic.
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Abstract Derealization is a dissociative disorder with the primary symptom of experiencing one’s surroundings as unreal, as if one were living in an elaborate dream. The disorder is usually associated with depersonalization, although according to Philip M. Coons (1996), it should not be considered a subset of depersonalization. Little research has been conducted on derealization unaccompanied by depersonalization. The following highlights a personal case study in which the characteristics of derealization are presented in an attempt to distinguish it from depersonalization and other dissociative disorders. In addition, examples of derealization from a broader perspective help distinguish it from a purely diagnostic mental symptom, thereby suggesting that it could be more of a philosophical view of life rather than a mental disorder.
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Depersonalization/derealization disorder is not commonly known. A nursing student experienced depersonalization/derealization attack just as she was taking her pharmacology examination at the end of the first year of nursing school. She was brought up in a supportive family. She reports no history of abuse or substance use. She succeeded well in high school and have had no serious panic episodes throughout her childhood and teen years. Jennifer tells the story of how on April 24th, 2017 her life changed.
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Borderline personality disorder (BPD) is a serious psychiatric illness, and it is often associated with dissociative symptoms. The purpose of this study was to assess the course of depersonalization and derealization symptoms in recovered and non-recovered borderline patients over 20 years of prospective follow-up. The Dysphoric Affect Scale (DAS) – a 50-item self-report measure was administered to 290 borderline inpatients at baseline, and the remaining participants (85%) at 10 follow-up interviews conducted over 20 years. The level of depersonalization and derealization experienced by borderline patients was assessed using three items (feeling unreal, feeling completely numb, and feeling like people and things aren't real) from the DAS. The patients who recovered from BPD reported significantly lower scores in all three inner states (62 - 63%) at baseline compared to those patients who did not recover. Furthermore, scores of recovered and non-recovered groups decreased significantly in all three inner states studied over 20 years of prospective follow-up. Overall, these results suggest that the severity of depersonalization and derealization symptoms decreased significantly over 20 years of prospective follow-up and had a strong association with BPD recovery status.
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Dissociative symptoms including depersonalization and derealization are commonly experienced by individuals suffering from panic disorder or posttraumatic stress disorder (PTSD). Few studies have been published investigating the specific treatment of these symptoms in individuals diagnosed with panic disorder or PTSD, despite evidence that the subset of individuals with panic disorder who experience depersonalization and derealization report more panic attacks as well as greater panic severity and functional impairment. Furthermore, it has been shown that these symptoms can impede treatment and recovery in PTSD. Finally, recent research has shown that interoceptive exposure generally enhances the efficacy of treatment outcome for PTSD and PTSD with comorbid panic. This study investigated the use of a novel interoceptive exposure technique for treatment of depersonalization and derealization in individuals with high anxiety sensitivity and/or symptoms of PTSD. Results indicated significant reductions on six of seven items as well as total score on an outcome measure of depersonalization and derealization. Thus, this technique appears to hold promise for utilization as a form of interoceptive exposure in the treatment of these symptoms.
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Abstract Depersonalization is marked by persistent or recurring symptoms, including perceptual alterations, distorted sense of time, feeling as though one is an outside observer of one's body, or feeling like an automaton or like one is living in a dream or a movie. These symptoms are often accompanied by derealization, the feeling that the world, oneself, or other people seem strange or unreal. This entry summarizes the literature on depersonalization and derealization, including (a) the new DSM ‐5 diagnosis of depersonalization disorder/derealization disorder, which combines symptoms of derealization and depersonalization into a single diagnostic entity; (b) prevalence data; (c) precipitants of symptoms; (d) course of the disorder; and (e) theoretical and treatment approaches for depersonalization/derealization.
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Depersonalization-derealization syndrome is an under researched clinical phenomenon and is often under diagnosed. We present a case of 42 years old female, who presented with complaining of feeling that her stomach is always empty in spite of adequate food and water intake for the past 7 months. She also reported that all the emotions, bodily movements appeared as if they are not her own. However, reality testing was intact. Phenomenon of primary depersonalization derealization syndrome is relatively rare. Selective serotonin reuptake inhibitors (SSRIs) may be considered as a pharmacological treatment option for the treatment of the condition. Keywords: Depersonalization, Derealization, SSRIs.
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Derealization
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