Have you ever felt like this? It's like you're outside your body and looking at you. Or the things around you don't feel real, like they're a dream. These experiences are a bit strange, maybe even scary, aren't they? Today we're talking about the mental state that occurs when you have these experiences over and over again.
What is this feeling of separation from oneself and the environment?
Simply put, in this condition called ``Depersonalization-Derealization Disorder'', you may feel detached from yourself (called ``Depersonalization'') and detached from your surroundings and environment (called ``Derealization'').
Imagine you are going to a store to buy something. But you feel like it's not you, but someone else is sitting inside your body, pushing the trolley, choosing the goods, paying for them. It's as if you are watching from the side. Maybe if you see your image in a store window, you feel so alienated that you can't even recognize it. This is what we call ``(Depersonalization)`` or feeling detached from yourself . This is when you feel like your thoughts, feelings, even your body don't belong to you.
The other side is `(Derealization)`. That is, your surroundings, your environment, feel like they are not real to you . It can feel like you are looking at the world through a foggy window, or like you are watching a black and white film. Sometimes the shape and size of things can appear to change. You can even feel like they are changing as you look at them. Imagine that when you are walking on the street, all the houses and trees look like they are made of cardboard, like toys. That is the state called `(Derealization)`.
A person with Depersonalization-Derealization Disorder may experience both of these experiences, or only one. The important thing is that you realize that these things are not real . You have not lost your mind. But knowing that these experiences are not real and not being able to escape them can cause a lot of stress and anxiety.
Doctors classify this condition as a ``Dissociative Disorder'' in the ``DSM-V'' classification of mental illnesses. Conditions such as ``Dissociative Identity Disorder'' (which is the condition in which a person has multiple personalities) and ``Dissociative Amnesia'' (which is a condition in which memory is lost) also belong to this category.
How common is this condition?
In fact, we all experience a feeling of being apart from the world at some point in our lives. It's normal. It's called ``transient depersonalization''. That means it's a temporary feeling . But the ``Depersonalization-Derealization Disorder'' we're talking about is not like that. It's a long-term condition, or a recurring one . This condition usually affects one or two out of every hundred (1%-2%). However, it is more common among young people and children who are entering puberty .
What are the symptoms of this?
People with this condition have a hard time putting their feelings into words. Some people have the words to say, but others may not understand or think they don't care. However, the main symptom of Depersonalization-Derealization Disorder is this feeling of detachment and disconnection . You may experience things like:
- Depersonalization is feeling as if you are separated from your thoughts, feelings, and body.
- Derealization is the feeling of being detached from your surroundings and environment.
- Feeling like a robot, or that the people around you are robots.
- Feeling emotionally numb, like you've lost all feeling.
- It feels like you're stepping out of your body and looking at yourself.
- It feels like living in a dream world.
- Feelings like sadness and anxiety.
These symptoms can cause you a lot of stress and anxiety. You may start to wonder, 'Have I done something wrong?' You may be tempted to ruminate on these symptoms and try to control them. This can increase your anxiety and fear, and make your symptoms worse .
Why is this happening? What are the reasons?
Doctors still don't know the exact cause of Depersonalization-Derealization Disorder, but it is often linked to stress or a traumatic event . For example:
- Being physically abused.
- Domestic violence (experienced or witnessed).
- Facing accidents or natural disasters.
- Dangerous events that pose a threat to life.
- Sudden death of a loved one.
- Growing up with a parent who suffers from a severe mental illness.
Imagine, some people experience a traumatic event in their childhood. Some believe that this sense of separation can also arise as a way for the mind to escape the unbearable psychological stress that occurs at that time, to protect itself. That is, the mind tries to remain 'separate' from that traumatic experience.
Who is most at risk for this condition?
Some people may be at higher risk of developing a dissociative disorder, or a state of separation. There are several factors that contribute to this:
- Lack of awareness of one's own emotions (i.e., inability to understand exactly what one is feeling).
- Having other personality disorders or other mental health conditions.
- Having physical conditions such as seizure disorders.
How do you recognize this?
If you have these symptoms, it's best to see a mental health professional , such as a psychiatrist or psychologist. He or she will ask you a few questions about your symptoms. They will also look for other mental health conditions that could be causing these symptoms. For example:
- Depression
- Anxiety
- Obsessive-Compulsive Disorder (OCD)
- Post-Traumatic Stress Disorder (PTSD)
- Personality Disorders
If you don't have any other medical conditions like this, if these symptoms don't appear after you stop taking any medication, and if these things aren't caused by drug or alcohol use, your doctor may diagnose you as having Depersonalization-Derealization Disorder.
If you ask what tests are being done to diagnose this, your doctor will ask you questions to find out what your symptoms are, how often they occur, and how much they affect your daily life. You may also be given some assessments to write down or do on a computer. It can be difficult to put into words how you feel, but it is important to be as clear as possible about your experience . This will make it easier for your doctor to help you.
What are the treatments for this?
In fact, researchers are still trying to figure out the best treatment for Depersonalization-Derealization Disorder. Before you start treatment, your doctor will talk to you about your medical history, symptoms, and what you expect from treatment. Often, a combination of medication and psychotherapy may be recommended. These may include cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR).
Think about it, `(CBT)` therapy teaches you how to deal with these strange thoughts and feelings of yours, how to face them. When you feel like ``I am not me'', you are taught to challenge that thought, to see it in a different way. `(EMDR)` therapy can be very useful, especially if this condition is related to traumatic events.
Medications
Talk therapy is considered the best treatment for this. However, your psychiatrist may also recommend one or more medications as part of your treatment. For example:
- `(Selective Serotonin Reuptake Inhibitors - SSRIs)` (These are a type of medication given for depression and anxiety).
- Anti-anxiety medications.
- Mood-stabilizing medications.
- Antipsychotic medications are medications given for certain mental illnesses.
These medications are given to help control symptoms, but it is important to remember that these medications alone cannot completely cure the condition.
Are there any side effects of the medication?
Since different medications are used for Depersonalization-Derealization Disorder, the side effects can vary. However, here are some of the most common side effects:
- Constipation.
- Dizziness.
- Drowsiness.
- Dry mouth.
- Increased appetite.
- The possibility of adverse reactions with other medications, drugs, or alcohol you are taking.
- Difficulty urinating (Urinary retention).
- Weight gain.
Therefore, it is very important to inform your doctor if you experience any side effects . The doctor can then change the dosage or prescribe a different medication if necessary.
How long will this situation last?
There is not much research data on this either. However, if left untreated, Depersonalization-Derealization Disorder can last for years . Sometimes it can even go away on its own. However, it can still have a negative impact on your relationships and work. The best part is that with treatment, symptoms usually start to improve within a few months .
How do you take care of yourself?
If you continue to have symptoms of Depersonalization-Derealization Disorder, your first priority should be to seek treatment from a mental health counselor . You may need to see a few people at first, then have regular meetings with a psychologist and occasional meetings with a psychiatrist. The psychologist can help you find the right treatment for you and help you manage the side effects of medication. The counselor can teach you how to deal with your symptoms through talk therapy and identify triggers.
In the meantime, take your prescribed medications on time . Be kind to yourself. It's okay if you can't put into words exactly how you feel. It's normal to feel anxious about your health, but don't dwell on it. You can reduce your anxiety by doing things like paced breathing or meditation .
Are there any things that are not good to eat or drink?
If you have Depersonalization-Derealization Disorder, it's best to avoid using drugs and alcohol . Drugs and alcohol can cause symptoms of depersonalization and derealization. They can also interact negatively with medications you take. If you're using drugs or alcohol, be honest with your mental health team about it . They can then give you the support you need to get over it safely.
When do you need to see a doctor?
Your doctors will schedule regular follow-up appointments to check on your well-being, symptoms, and side effects of your treatment. However, sometimes you may have a problem or need support, but you may miss an appointment. If your symptoms get worse, don't hesitate to contact your doctor . If you feel that you are going to harm yourself or someone else, get help right away . In Sri Lanka, go to the emergency room of your nearest hospital, or call 1926 (the National Mental Health Helpline). (In the US, you can call 988 for suicide and crisis help or 911 for emergency help, but in Sri Lanka, we use the services available in our country.)
What questions should you ask your doctor?
Don't be afraid or nervous to ask your doctor questions. It's your right. Sometimes when the doctor asks, "Do you have any questions?", we can't immediately think of anything. Therefore, it's a good idea to write down a list of questions you have to ask . You can ask questions like these:
- How long will it take for me to feel like myself again?
- What side effects should I expect from the treatment?
- How long will I have to take medication and/or go to talk therapy?
- If I have questions or concerns, how should I contact you?
- What should I do if my symptoms get worse? What if they get better after work or on the weekend?
It's easy to feel isolated when you have Depersonalization-Derealization Disorder. You may feel detached from yourself or the world around you. Or you may feel like you're living in a dream, or you may feel like you're looking at life through a thick, foggy glass. These feelings can make you feel isolated. But remember, your mental health team is there to help you . And your family, your friends... even though they may have a hard time understanding your reality, they love you. They're not going to stop helping you because they can't understand you. Tell them what you need from them . Then they'll know how to help you.
Finally, the most important thing
So, simply put, Depersonalization-Derealization Disorder is a mental condition that causes you to have strange, unrealistic feelings about yourself and your surroundings. This is not your fault, and it is not a weakness . This is a treatable condition. You are not alone . If you have these symptoms, please seek medical advice. With proper treatment, you can live your life normally again. Be kind to yourself, be patient, and don't be afraid to ask for help .
` Detachment from self, detachment from environment, Depersonalization-Derealization Disorder, mental health, dissociative disorder, anxiety, stress
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