Persistent or recurrent episodes of detachment characterize depersonalization disorder. During these episodes, self-awareness is temporarily altered or lost; the patient often perceives this alteration in consciousness as a barrier between himself and the outside world. The sense of depersonalization may be restricted to a single body part such as a limb, or it may encompass the whole self.
Although the patient seldom loses touch with reality completely, the episodes of depersonalization may cause him severe distress.
Depersonalization disorder usually has a sudden onset in adolescence or early in adult life. It follows a chronic course, with periodic exacerbations and remissions, and resolves gradually.
Depersonalization disorder typically stems from severe stress, including war experiences, accidents, and natural disasters.
The primary symptom of depersonalization disorder is a distorted perception of the body. The person might feel like he or she is a robot or in a dream. Some people might fear they are going crazy and might become depressed, anxious, or panicky. For some people, the symptoms are mild and last for just 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.
Psychotherapy aims to establish a trusting therapeutic relationship in which the patient can come to recognize the traumatic event and the anxiety it evoked. The therapist subsequently teaches the patient to use reality-based coping strategies rather than to detach himself from the situation. A person in treatment for a dissociative disorder might benefit from antidepressants or anti-anxiety medication.
Some clinicians think that depersonalization disorder has an undetected onset in childhood, even though most patients first appear for treatment as adolescents or young adults. Preventive strategies could include the development of screening techniques for identifying children at risk, as well as further research into the effects of emotional abuse on children. It is also hopeful that further neurobiological research will lead to the development of medications or other treatment modalities for preventing, as well as treating, depersonalization.
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