Depersonalization Disorder

Depersonalization Disorder Definition

Depersonalization Disorder (DPD) is an emotional dissociative disorder characterized by the individual’s though of perceiving his/her body from the outside, with no real contacts with self. But they still do not detach from reality as they can fathom the discrepancies of the occurrences, which make them panic. It can severely impair a person’s work and social interaction, if it is persistent.

DPD belongs to the group of Dissociation disorders.

Depersonalization Disorder ICD 9 Code

The ICD 9 code of this disorder is 300.6.

Depersonalization Disorder Prevalence

DPD often goes unreported. Due to this reason, nothing is known about the prevalence of the disease in general. However, National Institute of Mental Health (NIMH) conducted a survey through which it was clear that almost half the adult population had experienced few short bouts of depersonalization in their whole lifetime. Almost 40% of the hospitalized psychiatric patients are vulnerable to it. Another study done in Winnipeg in the year 1991 showed the incidence to be around 2.4% of the entire residents. This, however, reduced by 2008 when another study showed the prevalence to be from 0.8% to 2%.  Depersonalization affects both sexes equally, with average onset noted to be in young adults (20 years or more).

Depersonalization Disorder Symptoms

There is an absence of clinical signs in this disorder although there are some features that are clearly marked in DPD patients. One of the primary symptoms is the feeling of being an external observer or dream-like state. It applies to the feeling of detachment from their body. This can lead to extremely anxious behavior and make it more intense.

Patients have a feeling that their body, including their actions and speech, is not fully in their control. They become stressed and get engulfed with negative stimuli. They are frightened by the thoughts of becoming mad and eventually get depressed.

A sort of numbness to the surrounding world may set in, making patients feel like a robot being controlled externally. Even body parts get numb and a patient gets a feeling that he/she is floating and observing the body from afar.

Mild instances of depersonalization might seem to be normal. However, people who always feel the same should seek expert help.

Depersonalization Disorder Causes

Although the triggers responsible for the onset of this condition have been identified, the exact cause of this disorder is not known yet. Individuals are at risk of getting this disorder in the following conditions:

  • When they suffer from depressive disorder and excessive stress.
  • When they have suffered interpersonal damages in childhood which can be sexual, emotional or physical.
  • When they live in self-centered cultures.

Individuals suffering from this disorder with specific cognitive issues are generally due to childhood abuse or adult life trauma. They lack short-term verbal as well as visual memory apart from spatial intelligence and concentration.

Studies conducted in early-2002 do not indicate the function of genes in causing this disorder. This condition is not a subtype of Post-Traumatic Stress Disorder, as evident from the neurological testing.

Studies by American scholars show that the pattern in which the patients responded to the HPA tests are different from those having PTSD. PET tests conclude that the sensory cortex functions normally in these patients.

Researches by British scientists establish that reduced level of nerve cell responses, that influence emotions, is related to the characteristics of depersonalization consisting emotional detachment. Another association can be made to the changes in society since 18th century in western societies. Changes in social units might have resulted in causing dissociative disorders in individuals affected by them.

Depersonalization Disorder Diagnosis

As a part of diagnosis, several tests can be prescribed in order to strike off the other possibilities. Often normal individuals may feel the same when depraved of sleep, due to epilepsy, drug addiction as well as side effects of some medication. So, a detailed medical history and physical checkup forms an integral part of the process.

In order to find out dissociative disorders, a certain questionnaire or quiz serves the purpose fittingly. Even for this purpose, a standard questionnaire as a diagnostic instrument will be implemented. To make this disorder stand out, the Structured Clinical Interview meant for DSM-IV Dissociative Disorders (apart from SCID-D) can be used. By SCID-D, a more detailed form of interrogation is used in which the patients can relate their experiences in detail when asked about them. These sessions may be as long as 1.5 hours in duration.

Depersonalization Severity Scale (DSS) helps in distinguishing this disease from different other dissociative disorders. It also helps in differentiating it from disorders resulting out of trauma. DDIS or Dissociative Disorders Interview Schedule seeks to know about secondary characteristics of dissociative identity disorder, signs of schizophrenia and drug abuse beside few others.

Clinical assessments are done by clinical psychologist, psychiatrist, mental health professional and clinical social worker. Due to the absence of laboratory tests for diagnosing this condition, these are the only resorts.

Depersonalization Disorder Treatment

DPD often goes away on its own. However, an expert treatment plan needs to be devised if it does not resolve naturally. Some of the effective ways to cure or manage this disorder are:

Attention exercises

By regularly following and performing attention exercises, a lot of the dissociation issues can be tackled. It has been proven that sustained healing can be effective in brain coordination.  By performing therapies, such as meditation, the brain can be amalgamated. The feeling of looking at the body from outside can diminish if focus is strengthened by regular practice of certain exercises.

There is a lack of effective treatment for this disorder, which is why cognitive behavioral therapy is often recommended to some patients.

Medications

Benzodiazepine tranquilizers, which include alprazolam, lorazepam and clorazepate, are some of the drugs administered to the patients. Other medications comprise tricyclic antidepressants like desipramine, amitriptyline and doxepin. Since 1999, Selective serotonin reuptake inhibitors have been introduced. SSRIs include Prozac, Paxil and Zoloft.

Lifestyle management

Apart from medicines, lifestyle management and alternative therapies have been propounded to relieve stress. In fact, relaxation therapies have been found to be highly effective in these patients.

Counseling

Counseling by an expert psychologist helps in understanding the reasons for its occurrence. This helps in eliminating the reasons sometimes. By managing depression, some of the symptoms can be dealt with.

A recent study at Columbia University suggested that Transcranial Magnetic Stiumulaiton (TMS) can be highly beneficial in the treatment of this disorder. However, it awaits FDA approval for the use in treatment of depersonalization.

How Long Does Depersonalization Disorder Last?

DPD can be both short term and long term. A particular episode of depersonalization may last only minutes or even several years. It may start off in episodes but later it may become persistent. Brain disorders and fits can also produce it as a symptom.

Depersonalization Disorder Prognosis

The recovery rate from this disorder is good. If DPD is related to trauma, patients may recover fully. Some of the cases, that may be associated with stressful life, might become chronic. Episodes of this problem can recur if patients live a stressful life.

Famous People with Depersonalization Disorder

DPD is not a common disorder. Naturally, not many famous personalities have been reported to have this condition. Celebrities like Adam Duritz, the front man of the band Counting Crows, have openly admitted to being diagnosed with it.