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depersonalization, derealisation, and dissociation

11/11/22


hello cherubs! isn't today's date sooooo cool?? because, you know, 11 + 11 is 22?


I'm the only one? ha ha okay....


 

anyways, today is going to be learning about three interesting topics: depersonalization, derealisation, and dissociation. these three topics are essential in understanding mental health & the issues that come with them.




first, let's start off with what these three big words mean. if you're like me, you might not have even heard of them! and that's okay, we will learn together(:


depersonalization is "a state in which one's thoughts and feelings seem unreal or not to belong to oneself, or in which one loses all sense of identity."


derealization can be similar and sometimes the two terms even coincide together, but the true definition of derealization is "a mental state where you feel detached from your surroundings."


and lastly dissociation. dissociation is basically a catch all term for the two previous terms, but can be described as "a mental process of disconnecting from one's thoughts, feelings, memories, or sense of identity."



 

let's start by diving into depersonalization. it can be described as "the persistent feeling of observing oneself from outside one's body or having a sense that surroundings aren't real."


this can appear as:

  • feeling like your body is wrong

  • feeling like your memories aren't real

  • feeling like you're outside your own body/looking down on yourself from above

  • feeling detached from yourself, like you aren't real

  • feeling complete numbness, like your body isn't responding and your senses and feelings are off

  • not feeling in control of speech or movements

  • not being able to recognize our reflection as your own


The National Health Service tells us that depersonalization can be caused by a lot of things such as: previous traumatic experiences or emotional, physical, or sexual abuse during childhood.


depersonalization can be triggered by severe stress due to relationships, finances or work, depression or anxiety, or from the use of illegal/recreational drugs.


According to Mayo Clinic, derealization can be normal, but is only an indicator of underlying disease when symptoms persist, becoming overwhelming, all consuming and reduce ability to function normally.


you should see a doctor if your symptoms: become disturbing or emotionally disruptive, are persistent and reoccurring, or interfere with work, relationships, or daily activities.


diagnosis requires a doctor's evaluation and potentially some tests to rule out other issues. treatment consists of psychotherapy and sometimes anti anxiety and antidepressant medications.


through psychotherapy, techniques can look like:

  • cognitive techniques to help block obsessive thinking of the unreal

  • behavioral techniques to help people become absorbed in tasks that distract them from the depersonalization

  • grounding techniques uses the five senses to help them feel more connected to the world around them

  • psychodynamic techniques to help people work through intolerable conflicts, negative feelings, and experiences that they feel the need to detach from

  • moment-to-moment tracking and labeling of dissociation to teach people to recognize and identify their feelings

things you can do right now to help cure depersonalization:

  • acknowledge your feelings

  • take deep breaths

  • listen to music

  • read a book

  • call a friend

  • challenge your intrusive thoughts

things that will help long term:

  • talk therapy

  • exercise

  • sleep

  • education


 

next up, we are going to learn about derealization. derealization is a mental state of feeling detached from your surroundings. while it is similar to depersonalization, it has distinct differences including:

  • people and objects around you may seem unreal

  • you may feel like you're inside a dream or 'fog'

  • a see-through wall or veil is separating you from your surroundings

  • the world appears lifeless, muted or fake

  • sounds are distorted: too loud or too soft

  • time sees to stand still, speed up, or slow down

a lot of times these symptoms happen in 'episodes' meaning the don't last long and come and go. they can end in a few minutes or last for months at a time. the distinct difference between these mental states and true psychotic disorders is that you know something is off and you are able to identify it.


causes of derealization can sometimes be linked to health conditions, but can also appear on their own from trauma or stress.


here are some health issues linked to derealization:

  • seizures

  • dementia

  • drug abuse

  • depression

  • schizophrenia

  • panic attacks

ideas of stressors causing derealization can be:

  • abuse of any type

  • witnessing domestic violence

  • parents or guardians with severe mental disorders

  • unexpected death of a loved one

  • PTSD

  • trauma from an accident or natural disaster


derealization often starts in late childhood to early adulthood, 95% of cases are diagnosed before age 25. derealization cannot be diagnosed through lab tests. doctors may use MRIs, EKG, or urine samples to see there are any toxic chemicals within your body.


sometimes, if your primary doctor isn't able to identify any causes, they will refer you to a mental health professional. they will diagnosis you if:

  • you have constant or bouts of symptoms

  • you know that what you are seeing or experiencing isn't real

  • you are deeply distressed or your symptoms severely interfere with your life


many people with derealization can self-medicate and fully recover from their episodes or they are able to learn how to get through the episodes calmly. treatment of derealization is similar to the treatment for depersonalization, but can include: talk therapy and/or medication.


five things you need to know right now about derealization:

  1. it's not dangerous

  2. it's extremely common

  3. it's perfectly natural

  4. it doesn't matter what's caused it

  5. you can recover


 

and lastly, we are going to learn about that catch-all term, dissociation. dissociation is a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity.


people who experience a tragic event will often time feel a sense of dissociation during and sometimes days or weeks after the event has taken place. in most cases, dissociation will resolve itself. but that isn't always the case.


dissociative disorders can include: dissociative amnesia, dissociative fugue, and dissociative identity disorder. we will talk in length about these disorders in a little bit but first, let's discuss the symptoms of dissociation.


symptoms will depend on type and severity but can include:

  • feeling disconnected from yourself

  • problems with handling intense emotions

  • sudden and unexpected shifts in mood-- for example, feeling sad for no reason

  • depression or anxiety problems, or both

  • feeling as though the world is distorted or not real (derealization)

  • memory problems that aren't linked to medical conditions or physical injury

  • other cognitive problems such as concentration problems

  • significant memory lapses such as forgetting personal information

  • feeling compelled to behave a certain way

  • identity confusion-- for example, behaving in a way that the person would normally find offensive or abhorrent

so let's get into the different types of dissociative disorders:


first up, dissociative amnesia:

***cue my mother singing the 5SOS song***


dissociative amnesia is when a person can't remember the details of a traumatic or stressful event, although they understand that they are experiencing memory loss. this type of amnesia can last from a few days to a few years.


the four categories of dissociative anxiety include:

  • localized amnesia-- for a time, the person has no memory of the traumatic event at all.

  • selective amnesia-- the person has patchy or incomplete memories of the traumatic event

  • generalized amnesia-- the person has trouble remembering the details of their entire life

  • systematized amnesia-- the person may have a very particular and specific memory loss


next up, dissociative fugue:


dissociative fugue is when the person, without warning, can't remember who they are and has no memory of their past. the person doesn't realize they are dissociating and creates a new identity, which can last from days to months. when they come out of this fugue, they are confused and have no recollection of the 'new life' they made.


dissociative identity disorder:


dissociative identity disorder is one of the most controversial of the dissociative disorders among psychologists. it is also one of the most severe.


the condition typically coincides with multiple personality states within the same person. the person is typically not aware of the personality changes and counts them as memory lapses. the other states may have different personalities, behaviors, and attitudes that are completely different than the person's normal personality. this personality can switch typically under stress & when it happens the person usually has dissociative amnesia too.



causes of dissociative disorders:

  • typically, it comes from childhood trauma

  • physical abuse/ neglect

  • sexual abuse

  • unpredictable or frightening family environments

  • traumatic events such as: natural disaster or war


complications can arise from not getting help such as:

  • life difficulties such as broken relationships or job stress

  • sleep problems such as insomnia

  • sexual problems

  • severe depression

  • anxiety disorders

  • eating disorders such as anorexia or bulimia

  • problematic drug use including alcoholism

  • self-harm including suicide


dissociative disorders alway require a medical professional's diagnosis. diagnosis is tricky because of the complexity and severity and symptoms can look like other medical symptoms such as:

  • physical causes of amnesia such as head trauma or brain tumors

  • mental illnesses such as OCD, panic disorder, and PTSD

  • the use of illegal and recreational drugs that can mimic symptoms

  • dissociative disorders and other mental health disorders can coincide and cause different symptoms


generally, treatment can take many years to become effective, options include:

  • a safe environment

  • psychiatric drugs

  • hypnosis

  • psychotherapy

  • stress management

  • treatment for other disorders


it is imperative that you reach out and go to a professional so that they can either diagnosis you or give you referral to the correct type of care that you need. these conditions aren't as life threatening as other mental illnesses, but it is better to get help sooner rather than later.




 

THIS INFORMATION IS NOT MINE. BELOW ARE THE SOURCES THAT I USED TO HELP CREATE THIS BLOG POST:




 

I hope you guys enjoyed learning something new with me! I had fun researching and learning too!


I'll see you guys in the next one!!


xx Loryn




Comments


If you are in need, please seek help from the resources below:

Call 911 if you or someone you know is in immediate danger.

988 Suicide & Crisis Lifeline: Call or text 988 for a 24-hours, confidential support to anyone in suicidal crisis or emotional distress.

SAMHSA’s National Helpline: 1-800-662-HELP (4357), a free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals or families facing mental and/or substance use disorders.

The American Counseling Association also provides a lengthy list of resources, https://www.counseling.org/knowle.../mental-health-resources

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