Depersonalization

Depersonalization is a psychological disorder or condition in which the sufferer perceives his body, thoughts, emotions or sensory stimuli as not his own, but rather as foreign, remote or unreal. It is a dissociative (conversion) disorder, which can manifest itself in a number of mental and physical illnesses, but in certain situations also in a healthy person.

Derealization often appears together with depersonalization, during which the individual feels alienated from the environment and perceives the surrounding world as foreign, unreal, or fake. If this condition meets certain diagnostic criteria of ICD-10, is not associated with anxiety and no internal cause has been identified, we can speak of the so-called depersonalization and derealization syndrome (Template:MKN).

Clinical picture

It is very important that this is not a qualitative disorder of perception, a person does not (or does not necessarily have) hallucinations during depersonalization, he usually has insight into his condition and in most cases considers it subjectively unpleasant. Depersonalization in itself usually does not cause an objective change in behavior (unless it is caused by intoxication with psychotropic substances), however, it is often associated with anxiety; in that case, the affected person looks confused, there is visible internal tension, or the affected person appears frightened and insecure. Depersonalization can be divided into:

1. autopsychic, when one's own psyche is experienced in a changed way (it feels like an automaton),
2. somatopsychic when the individual feels either alienated or feels changes in his own body,
3. allopsychic - derealization, external reality seems changed, unreal, distant.

Conditions that can cause depersonalization

• Intoxication (typically cannabinoids or hallucinogens)
• Abstinence syndrome
• Epilepsy
• Neurologic disorders (typically in temporal localization)
• Febrile
• Encephalitis
• Postural hypotension
• Certain endocrine disorders and related conditions (hyperthyroidism, hypoglycemia)
• Intense emotional or other stressful stimulus
• Other mental illness (panic disorder, schizophrenia...)

Treatment

If depersonalization is an accompanying phenomenon of another psychological disorder (panic disorder, schizophrenia), then it is possible that with proper treatment of the primary disorder, these feelings can disappear. If it appears separately as the mentioned depersonalization and derealization syndrome, then the prognosis is uncertain. Antidepressants (especially the SSRI group) or benzodiazepines are usually used, but the risk of addiction needs to be considered.

Links

Related articles

• Panic disorder
• Schizophrenia
• Derealization

Literature used

• Ústav zdravotnických informací a statistiky ČR. ÚZIS [online]. [cit. 2015-03-30]. <https://old.uzis.cz/cz/mkn/F40-F48.html>.

• RABOCH, Jiří, Pavel PAVLOVSKÝ and Dana JANOTOVÁ. Psychiatrie: minimum pro praxi. 5. vyd. Praha: Triton, 2012. ISBN 978-80-7387-582-4.