Depersonalization disorder | |
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Classification and external resources | |
Specialty | Psychiatry |
ICD-10 | F48.1 |
ICD-9-CM | 300.6 |
MeSH | D003861 |
Depersonalization disorder (DPD), also known as depersonalization-derealization syndrome, is a mental disorder in which the person has persistent or recurrent feelings of depersonalization and/or derealization. Symptoms can be classified as either depersonalization or derealization. Depersonalization is described as feeling disconnected or estranged from one's self. Individuals experiencing depersonalization may report feeling as if they are an outside observer of their own thoughts or body, and often report feeling a loss of control over their thoughts or actions. In some cases, individuals may be unable to accept their reflection as their own, or they may have out-of-body experiences. While depersonalization is a sense of detachment from one's self, derealization is described as detachment from one's surroundings. Individuals experiencing derealization may report perceiving the world around them as foggy, dreamlike/surreal, or visually distorted. In addition to these depersonalization-derealization disorder symptoms, the inner turmoil created by the disorder can result in depression, self-harm, low self-esteem, anxiety attacks, panic attacks, phobias, etc. It can also cause a variety of physical symptoms, including chest pain, blurry vision, visual snow, nausea, and the sensation of pins and needles in one's arms or legs.
Depersonalization-derealization disorder is thought to be caused largely by severe traumatic lifetime events, including childhood abuse, accidents, natural disasters, war, torture, and bad drug experiences. It is unclear whether genetics plays a role; however, there are many neurochemical and hormonal changes in individuals with depersonalization disorder. The disorder is typically associated with cognitive disruptions in early perceptual and attentional processes.
Diagnostic criteria for depersonalization-derealization disorder include, among other symptoms, persistent or recurrent feelings of detachment from one's mental or bodily processes or from one's surroundings. A diagnosis is made when the dissociation is persistent and interferes with the social and/or occupational functions of daily life. However, accurate descriptions of the symptoms are hard to provide due to the subjective nature of depersonalization/derealization and persons' ambiguous use of language when describing these episodes. In the DSM-5 it was combined with Derealization Disorder and renamed Depersonalization/Derealization Disorder (DDPD). In the DSM-5 it remains classified as a dissociative disorder, while the ICD-10 calls it depersonalization-derealization syndrome and classifies it as a neurotic disorder. Although the disorder is an alteration in the subjective experience of reality, it is not a form of psychosis, as the person is able to distinguish between his own internal experiences and the objective reality of the outside world. During episodic and continuous depersonalization, the person can distinguish between reality and fantasy. In other words, the grasp on reality remains stable at all times.