Feeling Unreal
June 22, 2023
Daphne Simeon, Jeffrey Abugel
Depersonalization is the third most common psychiatric symptom, yet remains poorly understood by clinicians and the public. It can accompany other mental illnesses but is also a distinct disorder recognized by major diagnostic manuals. This chapter describes the symptoms of depersonalization/derealization disorder through historical documentation and personal stories. Core symptoms include detachment from one's whole self or aspects of the self (feelings, thoughts, body, agency) and detachment from the outside world. The origins of the term "depersonalization" are discussed, and historical and current descriptions are illustrated with personal quotes and stories, supporting depersonalization/derealization as an independent syndrome rather than merely a symptom of other disorders.
Feeling Unreal
June 22, 2023
Daphne Simeon, Jeffrey Abugel
This chapter reviews biological factors potentially involved in depersonalization/derealization (dpdr) and depersonalization/derealization disorder (DDD). It discusses sensory association cortical areas and corticocortical dysconnectivity models in relation to perceptual alterations, the limbic system and cortico-limbic disconnection hypothesis regarding hypoemotionality, and findings on the autonomic system and hypothalamic-pituitary-adrenal (HPA) axis. The putative roles of the serotonergic and endogenous opioid systems are examined, along with brain rhythm findings related to dissociation and the neuroscience of selfhood.
June 22, 2023
Daphne Simeon, Jeffrey Abugel
Depersonalization/derealization disorder is comprehensively examined, covering its history, diagnosis, and treatment. The book describes the dissociative state of feeling unreal through personal vignettes and explores both psychological and biological perspectives. Treatment options discussed include medications, transcranial magnetic stimulation, and various psychotherapies such as cognitive-behavioral, acceptance, mindfulness, and psychodynamic approaches. Literary and philosophical reflections enrich the understanding, and contemporary societal factors like chronic internet use and virtual reality are explored for their impact on detachment.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
The article discusses how depersonalization, a disruption in one's sense of self, can fundamentally alter a person's reality, echoing the ancient Buddhist idea that reality is constructed from our own thoughts. It describes how individuals with depersonalization may feel their beliefs need reconstruction, experience an altered sense of self or a sensation of having no self, and may respond to this change through spiritual awakening, anxiety, rumination, or artistic creation.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
The author argues that popular analogies comparing the human brain to a computer, or explaining mental disorders as simple chemical imbalances, fail to capture the brain's true complexity. The text first reviews basic brain anatomy and function, then examines brain regions that may be dysfunctional in depersonalization disorder.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
Depersonalization disorder (DPD) is frequently misdiagnosed or underdiagnosed in psychiatry. Patients often present with accompanying anxiety or depression, but they distinguish their core experience—feelings of unreality, deadness, or having no self—from those conditions. Clinicians may misattribute these symptoms to anxiety or depression due to their training and comfort with those domains, leading to inappropriate treatment.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
Psychotherapy can successfully treat depersonalization disorder (DPD) for some patients, leading to important symptom improvement and better life adaptation, though it may not work fully for everyone. The chapter reviews traditional approaches, some outdated and others still useful, alongside state-of-the-art therapies that have proven most effective. Therapeutic approaches are tailored to patients' psychological makeup and specific symptoms, and accumulated success stories have formed a body of suggested approaches worth considering.