Feeling ‘Unreal’

(Feeling ‘Unreal’ or ‘Not There’)

During depersonalisation, people will experience changes in self-awareness,
which might include feeling as if their thoughts and actions are not their
own, perhaps as far as experiencing the sensation as watching themselves
from the outside.  Derealisation occurs when people feel dissociated
from their environment.  The experience might include perceiving objects
as unsolid, diminished in size or two-dimensional; and the self as perhaps
being inside some glass-like container or peering at the world through a
fog, with the world unreachable and meaningless.

These feelings are quite common.  Some research suggests that up
to 50% of ‘normal’ adults experience one or both of these problems
occasionally and that, as a psychiatric condition it might affect up to 3%
of the general population.  In the situation where the effect is occasional
and mild the process might last for seconds or a few minutes and, rarely,
several hours.  The problem will tend to start and stop fairly abruptly
and sometimes, when mild, can be hard to distinguish from anxiety symptoms
such as floating, dizziness or ‘cotton wool’ in the head.

However, there is other research that suggests that either of these situations
can be the precursor to a panic attack or an aspect of the anxiety peak reached
in a panic attack.  Early research on this subject suggested that depersonalisation
and derealisation could be the body’s way to ‘cut off’
from severe anxiety feelings; also that some sufferers did not report excessive
anxiety before an attack.  It was also speculated that a great deal
of introspection – much involvement with how this person was feeling
all the time –  laid the ground for the problem. As involvement
of all the senses in some other activity seems to reduce dp problems, this
seems to be a reasonable suggestion.

Research also reports that, when severe, a main psychiatric condition,
these periods of unreality may last for weeks or months, causing much distress;
and that when depersonalisation occurs at a disorder level, sufferers have
been known to self-mutilate.  However there is an interesting observation
in one article that, at disorder level, depersonalisation can occur in response
to severe trauma or self-mutilation.  Obviously a lot more research
needs to be done.

On this subject, the iop site suggests that self-mutilation might be in
response to sensory problems such as numbness where the sufferer may be experiencing
a lack of tactile responses and, presumably, self-mutilates as an extreme
way to be able to feel his or her body.   This site also states that
depersonalisation sufferers may experience ringing in the ears or the sensation
that the volume has increased in every day activity around them.

Anecdotal evidence within the charity suggests that many people, during
periods of heightened anxiety find ‘normal’ light and sound too
much for them, so it would be interesting to know if this is a specific aspect
of dp or simply another symptom of severe anxiety from which dp might develop.

With the situation of weeks suffering as described above, it is very likely
that a person would become anxious or depressed, so it might not always be
possible to ascertain which came first – the depersonalisation or the
anxiety/depression.

Depersonalisation Disorder can be the main psychiatric condition or can
occur as part of another mental disorder such as panic disorder, depression
and OCD or a neurological problem such as epilepsy.  It has also been
suggested that it can occur in healthy individuals who have taken drugs such
as cannabis and Ecstasy and/or excessive alcohol.  Anecdotal evidence
around the charity suggests that the latter is probably correct.

When it is the prime condition, it is possible that the disorder can
become chronic in up to 50% of cases and may not respond well to treatment.
It seems to affect twice as many men as women and rarely occurs in people
over forty years of age.

Treatment options seem unclear but will probably involve some form of
psychotherapy when this is the prime disorder.  It is suggested that
when this is not the prime disorder, the depersonalisation problems ease
as the main problem is dealt with.  One article seen suggests that depersonalisation
and derealisation are the result of a serotonin imbalance, but does not go
into the efficacy of current serotonin reuptake inhibitors (SRI’s)
as a possible treatment.   Ecstasy seems also to work on serotonin levels,
bringing on an almost opposite effect to depersonalisation, but has, as mentioned,
been flagged up as a possible cause of the condition, besides its more commonly
known dangers. It would seem that much more needs to be understood about
pharmacological treatments and abuses.

Years ago, depersonalisers were recommended to carry a ‘dp kit’
around with them.  This was to include several small items that had
strong links with this person’s life, like a baby’s shoe or a
photograph.  Heavily textured items like sandpaper or fur were also
recommended as the theory was that any strong tactile sensation focuses the
mind and draws the person back as in: ‘this is here, therefore so am
I’.  Manipulating objects such as plastic or metal balls, rings
or keys also had its adherents as did having a very familiar person nearby
who could be touched or hugged.

The Institute of Psychiatry, Denmark Hill, South London, England has
a Depersonalisation Research Unit, set up in 1998, and is reported to distribute
information to doctors and sufferers.

Their website is: 
http://www.iop.kcl.ac.uk/IoP/Departments/PsychMed/index.stm


Source material:

British Psychological Society, ‘Depersonalisation’

www.bps.org.uk/publications/thepsychologistdet.cfm?ID=186


The Institute of Psychiatry website

I.M. Marks, ‘Fears, Phobias and Rituals, Oxford University Press inc.
1987

University of Tasmania, ‘Depersonalisation Disorder’

www.healthsci.utas.edu.au/psychiatry/disper_dis.htm

Unreal, ‘Depersonalisation and Derealisation’,

www.kbk73.dial.pipex.com/depder.htm