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Depersonalisation disorder

With depersonalisation disorder, a person will feel detached from their body or feel their body is not real. They may also experience mild to moderate derealisation and mild identity confusion.

The person may feel like they are observing themselves from outside their body or feel like they are in a dream.

Unlike other dissociation disorders, the person is still in touch with reality and realises that things are not as they appear.

An episode of depersonalisation can last for anything from a few minutes to many years. Depersonalisation may also be a symptom of other disorders, including brain disease and seizure disorders.

Depersonalisation disorder is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, consciousness or awareness, identity and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person's general functioning, including social and work activities, and relationships.

What are the symptoms of depersonalisation disorder?

The primary symptom of depersonalisation disorder is a distorted perception of the body. The person might feel like a robot or in a dream. Some people fear they are going crazy and can become depressed, anxious or panicky. For some people, the symptoms are mild and last only for a short time. For others, however, symptoms can be chronic (ongoing) and last or recur for many years, leading to problems with daily functioning or even to disability.

What causes depersonalisation disorder?

Little is known about the causes of depersonalisation disorder, but biological and environmental factors might play a role. Like other dissociative disorders, depersonalisation disorder is often triggered by intense stress or a traumatic event--such as war, abuse, accidents, disasters or extreme violence--that the person has experienced or witnessed.

How common is depersonalisation disorder?

Depersonalisation is a common symptom of many psychiatric disorders and often occurs in dangerous situations, such as assaults, accidents or serious illnesses. Depersonalisation as a separate disorder is quite rare.

How is depersonalisation disorder diagnosed?

If symptoms are present, your GP will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests specifically to diagnose dissociative disorders, your GP can use various diagnostic tests, such as X-rays and blood tests, to rule out physical illness or medication side effects as the cause of the symptoms.

If no physical illness is found, the person may be referred to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a dissociative disorder.

How is depersonalisation disorder treated?

Most people with depersonalisation disorder who seek treatment are concerned about symptoms such as depression or anxiety, rather than the disorder itself. In many cases, the symptoms will go away in time. Treatment is usually only needed when the disorder persists or is recurrent, or if the symptoms are particularly distressing to the person.

The goal of treatment, when needed, is to address all stresses associated with the onset of the disorder. The best treatment approach depends on the individual and the severity of the symptoms, but will most likely include some combination of the following treatment methods:

  • Psychotherapy: This kind of therapy for mental and emotional disorders uses psychological techniques designed to encourage communication of conflicts and insight into problems.
  • Cognitive therapy: This type of therapy focuses on changing dysfunctional thinking patterns.
  • Medication: There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety may benefit from treatment with medication such as an antidepressant or anti-anxiety drug.
  • Family therapy: This kind of therapy helps to educate the family about the disorder and its causes, as well as to help family members recognise symptoms of a recurrence.
  • Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express their thoughts and feelings in a safe and creative way.
  • Clinical hypnosis: This is a treatment technique that uses intense relaxation, concentration and focused attention to achieve an altered state of consciousness or awareness, allowing people to explore thoughts, feelings and memories they might have hidden from their conscious minds.

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