How Does dpd Affect Your Life?

DPD can interfere with so many areas of your daily functioning. Foremost, you probably feel disorganized and confused. Your concentration and ability to achieve your goals may seem directly related to how “depersonalized” you feel. DPD makes it difficult to focus and get going. Everything seems to take more time.

Notice whether you avoid doing things that make you uncomfortable. For example, do you find yourself avoiding going out shopping or to certain bars or restaurants because you find the noise level intolerable? Do you drive only short distances because things seem far away and driving feels hazardous? Are you just uncomfortable in your own skin and therefore keep checking the mirror or other reflective surfaces to get a grip on yourself? Maybe instead of looking at yourself, you pinch yourself to make sure you can feel. Is going to school or work getting more difficult? You may find that socializing takes a tremendous amount of effort.

EXERCISE: How My DPD Interferes with My Life

Take a minute to list the ways your DPD interferes with your life, and let’s see if, by the end of this book, you’ve been able to change some of those behaviors.

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When You Need Professional Help

You may be wondering whether DPD is something you can tackle on your own or whether you need someone, such as a mental health professional, to help you. This is no easy question to answer, but three rules of thumb apply to seeking treatment for just about every psychological disorder. Definitely seek treatment if you are suffering severely, have lost functioning in some important area of your life, or have had any suicidal feelings or thoughts. When in doubt, it’s best to go to a qualified therapist.

When seeking treatment, make sure to find a therapist who practices behavior therapy. In the following chapters we’ll explore the reasons why behavior therapy is the way to go for treatment of depersonalization. But for now, just remember, when you speak with prospective therapists, don’t be afraid to ask questions; for example, ask whether they have ever treated anyone with depersonalization disorder and whether they practice exposure and response prevention, as well as behavioral activation, techniques we’ll explain in chapter 8. If you do seek treatment, keep in mind that in addition to having a behavioral orientation, the best therapist for you will be someone you’ll bond with. So look for someone with a warm disposition, who has empathy for what you’re going through.

Depersonalization as a Dissociative Disorder

Depersonalization is only one of the dissociative disorders identified in the DSM-IV-TR (APA 2000). Dissociation means partial or total lack of awareness about some aspect of your experiences. In other words, it means that in some way, you don’t have access to the present moment. As we’ve explored, depersonalization involves a numbing to your internal experiences, whether this relates to your emotions, your feelings about certain people, your sensations, or your attention; some aspect of your experience is inaccessible or dulled. But depersonalization is only one of the experiences described as dissociative. Most people have heard about dissociative identity disorder (DID, which previously was commonly known as multiple- or split-personality disorder), which basically involves the development of one or more “alter egos,” or distinct personalities. People who are diagnosed with DID seem to be so significantly dissociated that they no longer have one unified consciousness. People with DID generally have no awareness that they’ve slipped from one “alter” into another, and memories of behaviors carried out by one alter are forgotten by the others. Sometimes people with DID also say they experience depersonalization, but it generally doesn’t work the other way around (people with DPD don’t usually have alter egos).

Predictors of depersonalization and dissociative identity overlap (abuse and trauma, for example). But DID is typically associated with more significant trauma. So if daydreaming, depersonalization, and DID all lie on the same continuum, then daydreaming would be normal and common; brief depersonalization would be normal but infrequent; chronic depersonalization would be abnormal, nearly constant, and a sign of psychological dysfunction; and DID would be on the far end of the continuum: abnormal, dysfunctional, and relatively more destructive. While daydreaming and brief episodes of depersonalization may not be a psychological concern, chronic depersonalization and DID are very destructive and distressing.

DID is quite rare, and some controversy surrounds this diagnosis because the prevalence of this disorder is so much greater in the United States than the rest of the world. A possible explanation is that different cultures have different overall ways of dealing with emotions. For our purposes, it’s enough to say that dissociation is real; it can come about in different ways, but it’s a common way for human beings to respond to extreme stress or trauma. Other dissociative disorders include dissociative fugue and dissociative amnesia. While we don’t have the space to elaborate further on DID, dissociative fugue, or dissociative amnesia, these conditions are fascinating, and many books (whether self-help books, information guides, or memoirs) exist concerning them. For example, The Dissociative Identity Disorder Sourcebook, by Deborah Haddock (McGraw-Hill, 2001), provides a user-friendly manual for people with DID as well as their families.