DPDR is characterized by the violation of the perception of the world — the person thinks they are in a virtual game, and all the surrounding objects and living beings are flat or have a surreal color.
Symptoms:
The feeling of change in mental processes – the information coming in the brain is “encountered by some kind of internal barrier”. In other words, there is a feeling of alternation of perception of information.
People explain this as “being covered with a cover”, “being placed in a glass bottle”, and “being separated from the world by an invisible wall”. This could be a feeling of violation of one or more mental functions (emotions, thoughts, activity) or even the whole mental activity which is accompanied by a feeling of “incompleteness of consciousness” and a subjective violation of the perception of one’s memories, visions that are losing their clarity and seem to be blank and unreal.
Strongly pronounced depersonalization includes the feeling of severe alteration or loss of several mental functions or even mental activity as a whole, up to the complete loss of the sense of existence.
The feeling of a changed perception of bodily sensations that are coming from sensory organs (sight, hearing, cutaneous sense, and others), which are expressed by the feeling of physical emptiness, numbness, and necrosis of some parts of the body. In severe cases, one can experience the feeling of loss of organs, body parts, and even the entire body. In especially severe cases one experiences the feeling of the loss of the entire body, however, there is always a presence of mental “I” unlike depersonalization of mental functions.
The feeling of alternation of the surroundings — colors, volume, contrast: patients complain about sounds being either muffled, distant, or deafeningly loud, everything being too bright or, conversely, faded, as if everything is a decoration for a movie fake, and artificial.
A person with Derealization-Depersonalization Disorder:
- idle; sits in one place and in one position as if they don't have anything to do
- can't tell what they like from what they don't
- no desire to be active — they don't wash their clothes, don't clean up, don't attend work or school.
Syndrome classification
Autopsychic
One withdraws into themself, is scared and confused because of all the changes: thoughts, feelings — they feel fake and damaged. This disease is characterized by the following behavior: unwillingness to communicate with friends and family, lack of external emotions, and memory loss (partial).
Allopsychic
This is the type of depersonalization doctors call derealization — the patient feels the surrounding reality as a dream or a game. It is characterized by the inability to locate one’s position in familiar places, nonchalance or complete disregard when meeting someone familiar, problems with identifying people (sometimes everyone looks the same), and inability to tell the color or shape of objects.
Somatopsychic
This form is considered to be the most peculiar because the patients make very unique complaints — it may seem to them that they have no clothes on, or maybe every part of their body exists on their own. It can be said that the somatopsychic type of DPDR is characterized by a pathological perception of one’s body.
Causes:
- neurotic disorders, violations
- shock (after a serious trauma)
- frequent stress
- schizophrenia
- manic syndrome
- depressive syndrome
About fifty percent of the total population has experienced depersonalization or derealization at least once in their lives. Nevertheless, only about two percent have ever met the criteria for the DPDR diagnosis.
Depersonalization and derealization can occur as symptoms of many other mental illnesses and somatic pathologies.
Derealization — is a morbid experience of changing the surrounding world: everything has changed, alienated, “not the same as before”, fake, unreal.
Deja vu (“already seen”) — the feeling that the currently happening situation has already been experienced.
Jamais vu (“never seen”) — the feeling that the currently happening familiar situation has never been experienced before.
Depersonalization — is a morbid feeling of self-alternation, the change of one’s own mental processes, the change of the “I”: “I am not the same as I used to be”; “I lost my feelings, emotions”, “lost my own “I”.
Main symptoms of depersonalization and derealization:
- Strong confusion and misunderstanding of what is happening.
- Isolation from other people and the world.
- Inadequate perception of the world and occurring events.
- Perception of one’s own body parts as alien.
- Decreasement in mental activity and emotional reactions.
- The feeling of abandonment and loneliness.
- Lack of appetite or inability to satiate even with large portions of food.
- Problems with a perception of real-time.
- No control over one’s own body.
- The symptoms always cause discomfort, in severe cases they are agonizing.
- This state is usually accompanied by anxiety and depression.
- Some patients are afraid of having permanent brain damage or that they are going crazy.
- Others are obsessed with the idea of whether they actually exist or are constantly checking if their feelings are real.
- Nevertheless, the patients are always aware that their feeling of derealization isn't objective and is a consequence of their unique way of perception of reality).
This kind of awareness is the difference between depersonalization/derealization and psychotic disorder in which this factor does not exist.
Patients have persistent or periodically recurring episodes of depersonalization, derealization, or both. Patients are aware that their feeling of dissociation is not objective (their perception of reality remains unchanged). Symptoms cause significant discomfort or make social or professional activities far more complicated.
Depersonalization symptoms:
- Feeling detached from one’s own body, mind, feelings, and/or sensations.
- Patients feel like outside observers of their own lives.
- Many patients also claim that they experience some kind of “unreality” of their own existence or feel like they are a robot (no control over what they are saying or doing).
- They can feel emotional or physical numbness or detachment with only a hint of emotions.
- Some patients can’t even recognize or describe their own emotions (alexithymia).
- They also feel detachment from their own memory and their memories are blurry.
Derealization symptoms:
- The feeling of detachment from their surroundings (people, objects, everything in general) feels unreal.
- Patients may feel like they are dreaming or have a foggy brain, or even a glass wall or a curtain separates them from reality.
- The world feels dull, lifeless, and fake.
- Subjective distortion of the world is quite popular.
- Objects may appear blurry or strangely clear and may feel flatter or bigger/smaller than they actually are.
- Sounds may feel louder or quieter than they are in reality, it may feel like time is going too fast or too slow.