Depersonalization Disorder: Lost Inside The Self Issue 1, May, 2014 - Page 17

How do people go into this intoxicated state and never come out of it?

After the triggering experience, many find themselves waking up the next morning with the intoxicated feeling still present, and this feeling does not ease up, leaving them stuck with it for months and years. In the case of marijuana, it is known to be excreted over several weeks after use, the presence of symptoms spanning months or years following drug use begs for an explanation.

Psychological triggers

The onset of depersonalization is often reported more with no relation to drug experiences. Severe stress is commonly reported as a trigger of DPD.

Recent extensive research has highlighted how childhood adversity plays a major role in how individuals handle and cope with stress and traumatic events.

It has been fairly well established that in the face of life-threatening situations people often experience depersonalization. This suggests the increase in anxiety during such events can act as a powerful trigger.

For example in a study of the San Francisco Bay area earthquake, it was found that 25% of a sample of normal students admitted marked depersonalization during and immediately after the earthquake, and 40% described derealization. (Cardena and Spiegal, 1993). These findings would seem to suggest that dissociation disables rather than enables the adaption to traumatic situations.

Depersonalization and other psychiatric disorders

The association between depersonalization and chronic anxiety disorders has been known since Krishaber’s (1873) early descriptions of depersonalization.

In Marlene Steinberg’s The Stranger in the Mirror (2001), Steinberg discusses DP/DR under the grouped dissociation spectrum, describing DP/DR as symptoms rather than a disorder in its own right. Although Steinberg does not discuss DPD as a disorder in its own right, she does highlight how feeling detached from one’s self can manifest itself in many forms:

• An out –of – body episode

• Loss of feeling in parts of your body

• Distorted perceptions of your body

• Feeling of being invisible

• Inability to recognize yourself in the mirror

• Sense of detachment from your emotions

• Impression of watching a movie of yourself

• Feeling of being unreal or a robot

• Sense of being split into an observer and a participant

• Interactive dialogues with an imaginary person

Steinberg describes the feelings of derealization:

• A feeling of detachment from the world

• A feeling that your home, work place or other customary environment is unknown or unfamiliar

• A sense that what is happening is not real

• A sense that your friends or relatives are strange, unfamiliar or unreal

• Changes in your visual perception of the environment- the sense that buildings, furniture, or other objects are changing in size or shape or that colours are becoming more or less intense.

16

S.Khan