Depersonalization Disorder: Feeling Unreal

Depersonalization is estimated to be the third most common psychiatric symptom, and frequently occurs during life-threatening experiences, such as accidents and assaults. It is also common for people to experience mild episodes of depersonalization when faced with a stressful situation such as giving a speech or taking an important exam. While some people report these experiences as upsetting, others have said they find them helpful and calming. It is a way for many people to set aside their current anxieties and more effectively deal with the task at hand.

Frequent or severe episodes of depersonalization may make the individual feel as though they are going crazy or living in a dream world. The episodes may interfere with one or more areas of the person's life, and may make it difficult to be productive at all. Individuals often find it extremely difficult to describe their symptoms, and may believe the symptoms mean they are psychotic. Reality testing is not impaired during a depersonalization episode, but the fear that they are "going crazy" may make some people reluctant to discuss their symptoms with their doctor, and may increase anxiety which in turn can trigger more episodes of depersonalization.

When episodes of depersonalization are frequent and severe, a diagnosis of depersonalization disorder may be given. Some common symptoms of this disorder are listed below:

Loss or change of feeling in body parts:

A feeling of numbness or loss of sensation in one or more body parts, as though the body part does not belong or has become detached from the rest of the body, is a common symptom of this disorder. There might be little response to pain or other sensations, a defense that would be healthy and useful during an accident or life-threatening situation, but unhealthy and harmful during everyday life.

Distorted perceptions of the body:

Someone with this disorder may have a sense that parts of their body are changing in size or shape, or that their body is shrinking. They may also experience a feeling that certain body parts do not seem to belong or appear fake or plastic. There might be a sense that specific body parts have been transplanted from other areas or even from other people.

Invisibility:

Individuals with depersonalization disorder may feel invisible or transparent, and that others are not able to see them. They may feel as though they blend in with the environment, or are moving at a different speed than those around them.

Not recognizing self in the mirror or in photographs:

Being unable to recognize themselves, or feeling that their reflection is unfamiliar, is one of the more common symptoms of this disorder. Feeling that their reflection belongs to someone else, or not feeling a connection to images of themselves in photographs can be very anxiety provoking and confusing.

Detachment from emotions:

A lack of emotional response or an inability to feel certain emotions is not uncommon. Individuals with depersonalization disorder may feel cut off from their emotions or unable to access them at the appropriate times. There may be a sense that their feelings are dulled or flat, or that they are stored away somewhere deep inside of them. Many people these days feel the need to push their emotions aside when at work, just as they feel it necessary to leave their "work self" at the office before going home in the evening. For those who are suffering from depersonalization, emotions may no longer feel within reach, and do not return even when they want or need them to.

Feelings of unreality or of being a robot:

Depersonalized individuals may have the sense that they are functioning automatically or on auto-pilot, or that something or someone else is controlling their thoughts, feelings, or actions. Many people experience a feeling of being unreal, or like an actor in a movie. Those with this disorder may have the thought that they are just "going through the motions" of life, or that there is no emotional connection to their actions and no thought behind anything they do.

Floating or out-of-body experiences:

They may feel as though they are hovering over their body or outside of it, and may have the experience of watching themselves from a distance, or of standing on the sidelines commenting on or even criticizing their own performance.

Talking to yourself:

Those with this disorder tend to have conversations with themselves out loud, as though they are speaking to a separate person. Possibly they will even answer out loud as well, taking on the role of two separate individuals. Everyone has internal dialogues when making a decision, preparing a speech, or practicing for or rehearsing a future conversation, but during a depersonalization episode these dialogues are often out loud and take place much more frequently.