Depersonalization (or depersonalisation) is an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, one's mental processes or body. It is a feeling of watching oneself act, while having no control over a situation.[1] It can be considered desirable, such as in the use of recreational drugs, but it usually refers to the severe form found in anxiety and, in the most intense cases, panic attacks. A sufferer feels that he or she has changed and the world has become less real, vague, dreamlike, or lacking in significance. It can sometimes be a rather disturbing experience, since many feel that, indeed, they are living in a "dream".
Chronic depersonalization refers to depersonalization disorder, which is classified by the DSM-IV as a dissociative disorder. Derealization is a similar term to depersonalization, and the two are often used interchangeably. However, more specifically, derealization is the feeling that "nothing is real", while depersonalization is the feeling that one is "detached" from one's body or world. (Though these feelings can happen to anyone who is under temporary severe anxiety/stress, for chronic depersonalization, which individuals experience after suffering severe trauma, see depersonalization disorder.) Derealization and depersonalization disorder are most prominent in anxiety disorders, clinical depression, bipolar disorder, sleep deprivation, and some types of epilepsy.
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Individuals who experience depersonalization feel divorced from both the world and from their own physicality by acting as a completely different identity.[2] Often a person who has experienced depersonalization claims that life "feels like a movie" or things seem unreal or hazy. Also a recognition of self breaks down (hence the name). Depersonalization can result in very high anxiety levels, which further increases these perceptions.[3]
One way to describe the physical manifestation of the feeling is to compare it to a film technique called the vertigo shot or dolly zoom. In this technique, the subject of the picture stays fixed on the shot while all the surrounding background is pulled away, providing a sense of vertigo or detachment. People may perceive this feeling in a cyclical manner, where the feeling is experienced back-to-back in succession.
Sometimes the physical manifestation is more like a strobe light of the senses. Information is processed at a much more staggered rate and therefore the subject feels as though his or her senses are being distorted and fragmented.
Depersonalization is a side effect of dissociatives and hallucinogens, as well as common drugs such as caffeine, alcohol, and minocycline.[4][5][6] It is a classic withdrawal symptom from many drugs.[7][8][9][10]
The symptom of depersonalization is the third most common psychological experience, after feelings of anxiety and feelings of depression. Depersonalization can also accompany sleep deprivation, stress, and anxiety; it is a symptom of anxiety disorders, such as panic disorder.[11]
A study of undergraduate students found that individuals high on the depersonalization/derealization subscale of the Dissociative Experiences Scale exhibited a more pronounced cortisol response. Individuals high on the absorption subscale, which measures experiences of concentration to the exclusion of awareness of other events going on around them, showed weaker cortisol responses.[12]
Treatment is dependent on the underlying cause.
If depersonalization is a symptom of neurological disease, then diagnosis and treatment of the specific disease is the first approach. Depersonalization can be a cognitive symptom of such diseases as amyotrophic lateral sclerosis, Alzheimer's, multiple sclerosis (MS), neuroborreliosis (Lyme disease), or any other neurological disease affecting the brain.
If depersonalization is a psychological symptom, then treatment may be dependent on the diagnosis. Depersonalization is often a symptom of borderline personality disorder, which can be treated in the long term with proper psychotherapy and psychopharmacology.[13]
Treatment of chronic depersonalization is considered in depersonalization disorder.