Depersonalization Disorder

This condition is characterized by chronic feelings of detachment from one’s self . The diagnostic criteria for Depersonalization Disorder includes:

• Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).

• During the depersonalization experience, reality testing remains intact.

• The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

• The depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

Often individuals with Depersonalization Disorder may have difficulty describing their symptoms and may fear that these experiences signify that they are "crazy." Derealization may also be present and is experienced as the sense that the external world is strange or unreal. The individual may perceive an uncanny alteration in the size or shape of objects (macropsia or micropsia), and people may seem unfamiliar or mechanical.

Course

Individuals with Depersonalization Disorder usually present for treatment in adolescence or adulthood, although the disorder may have an undetected onset in childhood. The mean age at onset has been reported to be around age 16. Because depersonalization is rarely the presenting complaint, individuals with recurrent depersonalization often present with another symptom such as anxiety, panic, or depression. Duration of episodes of depersonalization can vary from very brief (seconds) to persistent (years).

Depersonalization subsequent to life-threatening situations (e.g., military combat, traumatic accidents, being a victim of violent crime) usually develops suddenly on exposure to the trauma, and trauma histories are often associated with this disorder. The course is usually chronic and may wax and wane in intensity but is also sometimes episodic. Most often the exacerbations occur in association with actual or perceived stressful events.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.