Depersonalization: Difference between revisions

<onlyinclude>'''Depersonalization''' or '''depersonalisation''' (sometimes abbreviated as '''DP''') is medically recognized as the experience of feeling detached from, and as if one is an outside observer of, one's thoughts, body, or actions.<ref name="DSM5Glossary">{{cite journal|title=Glossary of Technical Terms|journal=Diagnostic and statistical manual of mental disorders (5th ed.)|year=2013|pages=818-20|doi=10.1176/appi.books.9780890425596.GlossaryofTechnicalTerms}}</ref><ref name="ICD-11-depersonalization-derealization-disorder">{{cite journal|title=Depersonalization-derealization disorder|journal=International statistical classification of diseases and related health problems (11th ed.)|year=2022|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/253124068 | access-date=20 May 2022}}</ref><ref name=":1">{{cite journal | vauthors=((Kolev, O. I.)), ((Georgieva-Zhostova, S. O.)), ((Berthoz, A.)) | journal=Behavioural Neurology | title=Anxiety Changes Depersonalization and Derealization Symptoms in Vestibular Patients | volume=2014 | pages=e847054 | date=28 January 2014 | url=https://www.hindawi.com/journals/bn/2014/847054/ | issn=0953-4180 | doi=10.1155/2014/847054}}</ref><ref name=":4">{{cite journal | vauthors=((Sierra, M.)), ((Senior, C.)), ((Dalton, J.)), ((McDonough, M.)), ((Bond, A.)), ((Phillips, M. L.)), ((O’Dwyer, A. M.)), ((David, A. S.)) | journal=Archives of General Psychiatry | title=Autonomic Response in Depersonalization Disorder | volume=59 | issue=9 | pages=833 | date=1 September 2002 | url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.59.9.833 | issn=0003-990X | doi=10.1001/archpsyc.59.9.833}}</ref> During this state, the affected person may feel like they are "[[physical autonomy|on autopilot]]" and that the world is lacking in significance.<ref name=":4" /><ref name=":2">{{cite journal | vauthors=((Radovic, F.)), ((Radovic, S.)) | journal=Philosophy, Psychiatry, &amp; Psychology | title=Feelings of Unreality: A Conceptual and Phenomenological Analysis of the Language of Depersonalization | volume=9 | issue=3 | pages=271–279 | date= 2002 | url=http://muse.jhu.edu/content/crossref/journals/philosophy_psychiatry_and_psychology/v009/9.3radovic01.html | issn=1086-3303 | doi=10.1353/ppp.2003.0048}}</ref> Individuals who experience depersonalization feel detached from aspects of the self, including feelings (e.g., "I know I have feelings but I don't feel them"),<ref name=":3">{{cite journal | vauthors=((Phillips, M. L.)), ((Medford, N.)), ((Senior, C.)), ((Bullmore, E. T.)), ((Suckling, J.)), ((Brammer, M. J.)), ((Andrew, C.)), ((Sierra, M.)), ((Williams, S. C. R.)), ((David, A. S.)) | journal=Psychiatry Research: Neuroimaging | title=Depersonalization disorder: thinking without feeling | volume=108 | issue=3 | pages=145–160 | date= December 2001 | url=https://linkinghub.elsevier.com/retrieve/pii/S0925492701001196 | issn=09254927 | doi=10.1016/S0925-4927(01)00119-6}}</ref> thoughts (e.g., "My thoughts don't feel like my own")<ref name=":5">{{cite journal | vauthors=((Melges, F. T.)) | journal=Archives of General Psychiatry | title=Temporal Disintegration and Depersonalization During Marihuana Intoxication | volume=23 | issue=3 | pages=204 | date=1 September 1970 | url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1970.01750030012003 | issn=0003-990X | doi=10.1001/archpsyc.1970.01750030012003}}</ref>, and sensations (e.g., touch, hunger, thirst, libido).<ref name=":1" /><ref name=":0">{{cite book | title=Dissociative Disorders|journal=Diagnostic and statistical manual of mental disorders (5th ed.) | date=22 May 2013 | publisher=American Psychiatric Association | edition=Fifth Edition | url=https://doi.org/10.1176/appi.books.9780890425596.dsm08 | doi=10.1176/appi.books.9780890425596.dsm08 | isbn=9780890425558}}</ref><ref name=":6">{{cite journal | vauthors=((Sierra, M.)), ((Baker, D.)), ((Medford, N.)), ((David, A. S.)) | journal=Psychological Medicine | title=Unpacking the depersonalization syndrome: an exploratory factor analysis on the Cambridge Depersonalization Scale | volume=35 | issue=10 | pages=1523–1532 | date= October 2005 | url=https://www.cambridge.org/core/product/identifier/S0033291705005325/type/journal_article | issn=0033-2917 | doi=10.1017/S0033291705005325}}</ref> This can be distressing to the user, who may become disoriented by the loss of a sense that their self is the origin of their thoughts and actions.  

It is perfectly normal for people to slip into this state temporarily,<ref name=":8">{{cite journal | vauthors=((Stein, D. J.)), ((Simeon, D.)) | journal=CNS Spectrums | title=Cognitive-Affective Neuroscience of Depersonalization | volume=14 | issue=9 | pages=467–471 | date= September 2009 | url=https://www.cambridge.org/core/product/identifier/S109285290002352X/type/journal_article | issn=1092-8529 | doi=10.1017/S109285290002352X}}</ref> often without even realizing it. For example, many people often note that they enter a detached state of autopilot during stressful situations or when performing monotonous routine tasks such as driving.

It is worth noting that this state of mind is also commonly associated with and occurs alongside [[derealization]]. While depersonalization is the subjective experience of unreality in one's sense of self, derealization is the perception of unreality in the outside world.<ref name="ICD-11-depersonalization-derealization-disorder"/><ref name=":1" /><ref name=":2" /><ref name=":0" /><ref name=":6" />

Depersonalization is often accompanied by other coinciding effects such as [[anxiety]],<ref name=":1" /><ref name=":3" /> [[depression]],<ref name=":3" /> [[time distortion]],<ref name=":5" /> and [[derealization]].<ref name=":0" /><ref name=":7">{{cite journal | vauthors=((Mathew, R. J.)), ((Wilson, W. H.)), ((Humphreys, D.)), ((Lowe, J. V.)), ((Weithe, K. E.)) | journal=Biological Psychiatry | title=Depersonalization after marijuana smoking | volume=33 | issue=6 | pages=431–441 | date= March 1993 | url=https://linkinghub.elsevier.com/retrieve/pii/0006322393901719 | issn=00063223 | doi=10.1016/0006-3223(93)90171-9}}</ref>  It is most commonly induced under the influence of [[dosage#common|moderate]] [[dosage|dosages]] of [[dissociative]] compounds, such as [[ketamine]],<ref name=":8" /> [[PCP]],<ref>{{cite journal | vauthors=((Erard, R.)), ((Luisada, P. V.)), ((Peele, R.)) | journal=Journal of Psychedelic Drugs | title=The PCP Psychosis: Prolonged Intoxication or Drug-Precipitated Functional Illness? | volume=12 | issue=3–4 | pages=235–251 | date= July 1980 | url=https://www.tandfonline.com/doi/full/10.1080/02791072.1980.10471432 | issn=0022-393X | doi=10.1080/02791072.1980.10471432}}</ref><ref>{{cite journal | vauthors=((Pradhan, S. N.)) | journal=Neuroscience & Biobehavioral Reviews | title=Phencyclidine (PCP): Some human studies | volume=8 | issue=4 | pages=493–501 | date= December 1984 | url=https://linkinghub.elsevier.com/retrieve/pii/014976348490006X | issn=01497634 | doi=10.1016/0149-7634(84)90006-X}}</ref> and [[DXM]]. However, it can also occur under the influence of [[cannabis]],<ref name=":8" /><ref name=":7" /><ref>{{cite journal | vauthors=((Mathew, R. J.)), ((Wilson, W. H.)), ((Chiu, N. Y.)), ((Turkington, T. G.)), ((Degrado, T. R.)), ((Coleman, R. E.)) | journal=Acta Psychiatrica Scandinavica | title=Regional cerebral blood flow and depersonalization after tetrahydrocannabinol adrninistration | volume=100 | issue=1 | pages=67–75 | date= July 1999 | url=https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.1999.tb10916.x | issn=0001-690X | doi=10.1111/j.1600-0447.1999.tb10916.x}}</ref> [[psychedelics]],<ref name=":8" /> and to a lesser extent during the [[withdrawal]] symptoms of [[depressant|depressants]]<ref>{{cite journal | vauthors=((Roy-Byrne, P. P.)), ((Hommer, D.)) | journal=The American Journal of Medicine | title=Benzodiazepine withdrawal: Overview and implications for the treatment of anxiety | volume=84 | issue=6 | pages=1041–1052 | date= June 1988 | url=https://linkinghub.elsevier.com/retrieve/pii/0002934388903099 | issn=00029343 | doi=10.1016/0002-9343(88)90309-9}}</ref><ref>{{cite journal | vauthors=((Duncan, J.)) | journal=Human Psychopharmacology: Clinical and Experimental | title=Neuropsychiatric aspects of sedative drug withdrawal | volume=3 | issue=3 | pages=171–180 | date= September 1988 | url=https://onlinelibrary.wiley.com/doi/10.1002/hup.470030304 | issn=0885-6222 | doi=10.1002/hup.470030304}}</ref> and [[SSRI|SSRI's]]<ref name=":8" />.</onlyinclude>

In psychiatry, chronic depersonalization that arises during sobriety is identified as "Depersonalization/Derealization Disorder" and is classified by both the DSM5 and ICD-11 as a single dissociative disorder.<ref name="ICD-11-depersonalization-derealization-disorder"/><ref name=":0" />

Temporary depersonalization/derealization symptoms lasting hours to days are common in the general population. Approximately one-half of all adults have experienced at least one episode of this effect within their lifetime, and the gender ratio for the disorder is 1:1.<ref name=":0" /> Chronic depersonalization is more common within individuals who have experienced severe trauma or prolonged stress and anxiety. The symptoms of both chronic derealization and depersonalization are common within the general population, with a lifetime prevalence of up to 26-74% and 31–66% at the time of a traumatic event.<ref>{{cite journal | vauthors=((Hunter, E. C. M.)), ((Sierra, M.)), ((David, A. S.)) | journal=Social Psychiatry and Psychiatric Epidemiology | title=The epidemiology ofdepersonalisation and derealisation | volume=39 | issue=1 | pages=9–18 | date=1 January 2004 | url=https://doi.org/10.1007/s00127-004-0701-4 | issn=1433-9285 | doi=10.1007/s00127-004-0701-4}}</ref>

Within the context of [[identity alteration|identity-altering]] effects, depersonalization can be considered as being at the opposite end of the identity spectrum relative to states of [[unity and interconnectedness]]. This is because, during depersonalization, a person senses and attributes their identity to nothing, giving a sense of having no self. However, during a state of unity and interconnectedness, one senses and attributes their identity to everything, giving a sense that the entirety of existence is their self.