Depersonalization is a detachment from a person’s thoughts, emotions, and/or physical form. It can feel like watching yourself on TV or from a great distance. It can make your reflection feel wrong, distort your body image, and can even include a loss of sensation in part of the body.
Derealization is a detachment from a person’s surroundings. For example, you may feel like you are in a dream or that a thick fog has rolled in. The world may look bland and lifeless, sounds may be distorted, and time can feel like it’s passing at a different rate than usual.
BraiDID’s Layman’s Definitions
Depersonalization: Have you been in a scenario where you are in some deep emotion – let’s say it’s deep sadness – maybe grief? You’re crying, and then you just kind of stop because you’re thinking about it. You’re contemplating why you’re crying and if you actually care about what’s happening or if you’re just supposed to, maybe? If you are just following the general structure of what you’re supposed to do at that moment which at that time is to grieve? Do you feel sad – do those feelings – that genuinely are there in your body – belong to you? Who are you, and what do you genuinely own over yourself and your emotions? That’s depersonalization
Derealization: You know the whole “we’re in a simulation” joke? Yeah… so… that. Derealization feels like you’re the only real thing in existence. Not in a narcissistic way… more in a Truman Show existential terrifying mental health collapse way. Fun stuff.
DPDR can be triggered by physical conditions such as epilepsy or brain injury, by drugs such as marijuana or hallucinogens, and by severe stress, anxiety, and depression. It can also be associated with childhood emotional abuse and neglect.
While a person feels detached, they are still aware of reality. They’re aware their experience is not normal, which can lead to more anxiety about the situation, which can make the DPDR worse, starting a feedback loop that can result in a bad panic attack. In short, it’s no fun.
The condition usually starts around age 16 and is thought to affect upwards of 2% of the population. Depending on the source, it affects men and women equally or affects women 2-4 times as often as men. Take your pick – obviously, more study is needed.
Success with treating the condition with medication is mixed, with drugs such as Clomipramine (Anafranil), Fluoxetine (Prozac), Lamotrigine (Lamictal) and opioid antagonists like Naloxone (Narcan) being tried. According to this scholarly article, however, none of those drugs showed a strong anti-dissociative effect. Medications can be used to treat co-morbid disorders such as anxiety and depression, however.
T-E-C’s Personal Experience
DID is the meal deal of dissociative disorders – you get a taste of them all. Some members of T-E-C experience intense depersonalization regularly. But, for whatever reason, we don’t have derealization nearly as often.
We’re on both Prozac and Lamictal for other reasons, but we can’t say that they do much for our DPDR symptoms. We get more relief from grounding techniques and meditation. When those fail, taking a long nap sometimes helps. Sometimes nothing works but waiting it out.