What Is Depersonalization? What Is dpd?

Most people have unknowingly felt depersonalized at some point in their lives. We have all, at times, felt detached from ourselves, as if we were watching our lives as spectators. Maybe after a loved one passed away, you felt that all that used to be familiar was now foreign to you. The person accepting condolences from others, muttering appreciation and shaking hands, was some robotic, empty creature performing actions on your behalf, while you pondered the reason for existence. Or perhaps the events of September 11, 2001, rocked you to your core, causing you to feel disconnected from others, as if you were living in a nightmare. Feelings like this are common after tragedies such as natural disasters or a death in the family, and, for most people, go away as naturally as they came.

Yet it’s likely that you’ve started reading this book not because you experience fleeting depersonalization during tragedy but, rather, because these experiences have spilled over into your every waking moment. You may wake up every day to an alarm clock, eat your breakfast, go to work, and interact with your family without an ounce of emotion, ambition, or true mental involvement. Maybe you have to pinch the skin on your leg to make sure that it does, in fact, belong to your body. Words that you hear every day may seem unfamiliar, common objects foreign, and your own children distant. Your world may feel unreal and dreamlike, as if your body were performing actions without your volition.

What Is Depersonalization?

Because 50 to 70 percent of people would say they have experienced depersonalization at some point in their lives, experiencing depersonalization doesn’t necessarily mean you have a psychological disorder (Dixon 1963). However, depersonalization disorder (DPD), a chronic experience of this common human phenomenon, is estimated to occur in only about 2 percent of the population (Sierra 2008). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (APA 2000) (the reference mental health providers use to diagnose mental disorders), the following experiences define depersonalization disorder:

You have persistent or recurrent feelings of being detached from your mental processes or body, as if you were merely an observer.

Your experience of depersonalization causes significant distress and impairment in your social, work, or other functioning.

To be diagnosed with DPD, reality testing must be intact; that is, if you are experiencing depersonalization, you are aware that your experiences are unusual. In other words, you aren’t hallucinating; you are aware of everything that’s going on around you. Reality testing merely means that you have awareness and haven’t lost touch with reality. Are you aware of the numbness, the lack of connectedness, the way your body feels, and how you think? If so, though you may not like what you are experiencing, you do have awareness. Also, for a diagnosis of DPD, depersonalization can’t be the result of another disorder, substance use, or a general medical condition. Based on these criteria, if you believe you might have DPD, it’s important to get confirmation from a mental health professional. Also, because psychological disorders can sometimes come in pairs, trios, or even quartets, diagnosis is best left to the professionals. An experienced mental health professional can help you figure out exactly what’s going on, considering the whole picture.

Depersonalization may feel like being encapsulated in a bubble, as if you can’t experience what’s around you. You may feel as if you’re on autopilot, or as if some unknown force has taken control of your body and it now acts independently of you. Depersonalization numbs you mentally and emotionally: you may feel that you go about your daily life without any true emotional connection, even regarding your spouse and children. You may not care about your actions or behaviors, while still having an understanding that you should care about such things. Naturally, a low mood, depression, anxiety, and increased worry can sometimes follow in the footsteps of depersonalization. It’s quite distressing to feel so isolated from yourself and the world.

Depersonalization affects your mental processing. You may find it difficult to concentrate, feeling as if your mind has gone blank. On the other hand, your thoughts may be jumbled and confused, and you might have trouble retaining new information. Memories from your past may not seem like your own but someone else’s, or they may simply seem very distant. You may also have trouble remembering everyday things.

The descriptions just mentioned are only a few of the many experiences of someone with depersonalization disorder. Later, we’ll go into depth about these and other symptoms.

What Is Derealization?

Akin to depersonalization is derealization. Whereas depersonalization refers to an altered perception of yourself, derealization, a term coined in 1935 by Irish psychiatrist Edward Mapother (Mathew et al. 1999), refers to perceiving your environment in an altered way, and it’s often a manifestation of DPD. People experiencing derealization describe it as seeing the external world as strange or unreal. For example, your vision may be distorted so that objects appear larger or smaller than they really are. A familiar scene may seem foreign or somehow perverted. Objects in the environment may seem as if they’re somehow not the same as you know them to be, as though they’re not the right size or shape, or as if they’re alien in some other way.

Throughout this book, we’ll refer to four people with DPD whom the authors have worked with. Emily, a young woman with depersonalization disorder, always acknowledged being overwhelmed by her environment. She said she couldn’t read because she couldn’t focus on the individual words but, instead, became distracted by the whole picture. John, who also has DPD, said that when he closed his eyes, he had the sensation that the chair he was sitting in was way too small for him, that the bed he was lying in was engulfing him, or that the room he was in was caving in on him. He knew intellectually that the environment wasn’t really changing; therefore, what he was experiencing was derealization rather than hallucination. Both Emily and John were experiencing symptoms of derealization associated with DPD.

Derealization may also cause you to question the purpose of things in your everyday environment. For example, you might feel that cars on the street move without purpose. The people with whom you interact on a regular basis may seem unfamiliar to you or mechanical. Because the world around you appears unreal or artificial, you might experience unusual physical and perceptual sensations and have sensations of weightlessness or loss of basic senses (such as smell, touch, or taste). You may experience feelings of being slowed down or sped up. Objects may seem two-dimensional or less colorful. Dizziness is also common. Your own voice may even sound distant or unfamiliar to you. Basically, your experience of everything you can observe (including your own internal sensations) may be distorted.

Quiz: Do You Have Symptoms of Depersonalization?

Do you feel hollow inside?

Do you feel as if you’ve lost your sense of self?

Do you feel as if you are observing yourself from the outside, looking inside?

Do you feel like a robot?

Are you numb, unable to feel emotions, although you know what you are supposed to feel?

Would you describe your experience as the life of the “living dead”?

Does the world around you seem strange, as if you don’t perceive it as others do?

Do your body and mind seem disconnected?

Does everything around you seem foggy or unreal?

Are you living in a dream world where everything’s surreal?

Are you an actor onstage, knowing your part but not feeling it?

Do you spend a lot of time thinking about philosophical or religious issues (such as why we exist, whether we actually exist, who’s really talking, and what time and space really are)?

Does your thinking seem separate from your body?

Are you paying a lot ofattention to your bodily sensations, your thoughts, or both?

Do you fear that you’re not controlling your own actions?

Are you overly aware of noise?

Do objects look different than before?

Do you feel as if there’s an inner voice that’s yours but that simultaneously converses with you and interrupts your other thoughts?

Do you feel detached from things and people around you?

Do you feel as if you are in a constant state of detachment?

If you identify with even half of these questions, it’s possible that you have depersonalization disorder. Yet, to know for sure, it’s important that you consult a mental health professional who has some experience working with DPD and other dissociative disorders.

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