The depersonalization / derealization disorder is a form of the stand from prolonged or repeated experience, outside of the body or to be separated from one’s own thoughts of dissociative disorder, is. Most with the feeling of watching one’s life from the outside. The disorder is often triggered by severe stress. Diagnosis is based on symptoms for other potential causes. The treatment consists of psychotherapy plus drug therapy for each comorbid depression and / or anxiety.
About 50% of the population have made at least a passing experience of depersonalization or derealization in their lives. However, only about 2% of people who meet the criteria for a depersonalization / derealization disorder. Meet
The depersonalization / derealization disorder is a form of the stand from prolonged or repeated experience, outside of the body or to be separated from one’s own thoughts of dissociative disorder, is. Most with the feeling of watching one’s life from the outside. The disorder is often triggered by severe stress. Diagnosis is based on symptoms for other potential causes. The treatment consists of psychotherapy plus drug therapy for each comorbid depression and / or anxiety. About 50% of the population have made at least a passing experience of depersonalization or derealization in their lives. However, only about 2% of people who meet the criteria for a depersonalization / derealization disorder. Meet Depersonalization or derealization can also occur as a symptom of many other mental disorders and even with physical diseases such as seizure disorders (iktal or postictal). Occurs depersonalization or derealization independently of any other mental or psychological disorder on, she is persistent or recurring and affect the function, then there is a depersonalization disorder. Depersonalization / derealization disorder occurs equally in men and women. the average age of onset is 16 years. The disorder may begin in the early or middle childhood; only 5% of cases begins after the age of 25, and the disease often begins after age 40. Etiology people with depersonalization / derealization disorder often have experienced severe stress, especially emotional abuse or neglect in childhood. To the other stressors include physical abuse, experience of domestic violence, a greatly impaired or mentally ill parent and the unexpected death of a family member or a close friend. Episodes can be triggered by interpersonal, financial or professional stress; Depression; Anxiety or the use of illegal drugs, especially marijuana, ketamine or hallucinogens. Symptoms and signs The symptoms of depersonalization / derealization disorder are episodic in general and wane in intensity. Episodes can last a few hours or days or weeks, months or sometimes years. But in some patients the symptoms remain constant presence with a steady intensity for years or decades. Depersonalisationssymptome include yourself detached from her body, her mind, feel their feelings or sensations. Patients feel like an observer of their lives from the outside. Many patients also say they felt unreal or like an automaton (without control over what they say or do). You can feel emotionally and physically numb and have a flattened affect; some call themselves “walking dead.” Some patients can not recognize their emotions or describe (alexithymia). You feel removed from their memories and are not able to clearly remember this. Derealization symptoms include the feeling from the environment (eg., Humans, objects, everything) that seems unreal to be detached Patients feel as if they are surrounded in a dream or fog, or as if they have a glass wall or a veil separates from its surroundings. The world seems lifeless, colorless, or artificial. A subjective distortion of the world is common. For example, objects can appear blurry or unusually clear; they may appear flat or smaller or larger than they are. Sounds may seem louder or quieter than they are; Time seems to pass too slow or too fast. The symptoms are almost always stressful and if they are heavy, deeply unbearable. Anxiety and depression are common. Some patients fear that they will have irreversible brain damage or that they are crazy. Others think obsessively about it, repeatedly if they really exist or check to see if their perceptions are real. Patients, however, always retain the knowledge that their unreal experiences do not reflect reality, but only a momentary feeling state (z. B. possess intact reality assessment). This awareness distinguishes the depersonalization of a psychotic disorder in which such knowledge is always missing. Diagnosis Clinical criteria The diagnosis of Depersonalization / derealization disorder is clinical based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The patients have persistent or recurrent episodes of depersonalization, derealization, or both. Patients have the knowledge that their unreal experiences inconsistent with reality (that is, they have an intact sense of reality) symptoms cause significant distress or impair significantly the social or occupational functioning. Also, the symptoms can not be better accounted for by another disorder (eg. As seizures, ongoing substance abuse, panic disorder, major depressive disorder, another dissociative disorder). MRI and EEG are performed to rule out physical causes, especially if the symptoms or progression are atypical (for example, if symptoms occur after the age of 40 started). Toxicological urine tests may also be displayed. Helpful are psychological tests and special structured interviews and questionnaires. Frequently, patients prognosis without intervention of improvement. In many patients, restitution is possible, especially if the symptoms resulting from treatable or temporary loads or do not exist for long. In other cases, depersonalization and derealization chronic and refractory to treatment is. Also, persistent or recurrent Depersonalization or derealization symptoms cause any minimal adverse effects if patients manage to distract himself from the subjective feeling of themselves by hiring their minds and focus on other thoughts or activities. Other patients can again be hampered by the chronic sense of alienation and / or the accompanying anxiety or depression. Treatment Psychotherapy In therapy, a Depersonalization / derealization disorder have not only all the charges are addressed, which are related to the onset of the disorder, but also previous stress situations (eg. As abuse or neglect in childhood) that the patient for a later onset depersonalization may have predisposed. In different patients different forms of psychotherapy can be successful (eg psychodynamic oriented psychotherapy, cognitive behavioral therapy.): Cognitive processes can help to block compulsive thinking of the unreal state of being. Verahltensorientierte method can help the patient to deal with tasks that distract them from the depersonalization and derealization. Grounding techniques use the five senses (eg., By playing loud music or placing an ice cube in his hand) and help patients to feel connected with yourself and the world and real at the moment. Psychodynamic therapy helps patients with negative feelings, make conflicts or experiences underlying certain emotions for self unbearable and are therefore separated, deal with it. to follow a moment after the other and designate affect and dissociation in the therapy sessions, works well in some patients. Several drugs have been used, but none has a clearly demonstrable effectiveness. However, some patients of SSRIs, lamotrigine, opioid antagonist, anxiolytics and stimulants appear to benefit. However, these drugs could affect a large extent by directed against other mental disorders (eg. as anxiety, depression) that are often associated with depersonalization and derealization or extended solve them.