2. Myth: Depersonalization can turn into schizophrenia. Fact: Depersonalization-derealization disorder and schizophrenia are two distinct illnesses, and one does not turn into the other. Not everyone who experiences a depersonalization or derealization episode has depersonalization-derealization disorder.
Introduction: The phenomena of depersonalisation/derealisation have classically been associated with the initial phases of psychosis, and it is assumed that they would precede (even by years) the onset of clinical psychosis, being much more common in the prodromal and acute phases of the illness.
Depersonalization-derealization disorder occurs when you persistently or repeatedly have the feeling that you're observing yourself from outside your body or you have a sense that things around you aren't real, or both.
Derealization involves feeling detached from your surroundings. You may feel disconnected from external objects in your immediate environment, including other people. Even your closest family members or friends may seem like strangers. Often people describe derealization as feeling spaced out or foggy.
Already in 1998, Sierra and Berrios proposed that symptoms of depersonalization may be associated with a “disconnection” of a cortico-limbic brain system, involving the amygdala, anterior cingulate cortex (ACC), and prefrontal structures.
Dissociation likely plays a key role in schizophrenia and borderline personality disorder (BPD), although empirical studies that compare specific manifestations of these symptoms in schizophrenia and BPD are rare.
A diagnosis is made when the dissociation is persistent and interferes with the social or occupational functions of daily life. While depersonalization-derealization disorder was once considered rare, lifetime experiences with it occur in about 1–2% of the general population.
Summarizing the current state of information we consider depersonalization with the experience of being in a dream or being dead as a heuristic reaction to brain damage. Similar models have already been discussed in neuropsychological disorders as for instance reduplicative paramnesias, neglect, and anosognosia.
A greater number of depersonalization experiences were associated with higher levels of paranoia and worry. The positive association of worry and paranoia became nonsignificant when controlling for depersonalization.
Dissociation, especially depersonalization, has been routinely linked to post-traumatic auditory hallucinations. As a phenomenon, depersonalization may transform mental activity into strange and foreign experiences that manifest as auditory hallucinations.
You're likely to start by first seeing your primary care doctor, but you may be referred to a doctor who specializes in brain and nervous system disorders (neurologist) or a doctor who specializes in diagnosing and treating mental health disorders (psychiatrist).
Tumors in this area can result in auditory hallucinations (hearing things), an inability to understand speech (receptive aphasia), and vision changes. Symptoms such as deja vu experiences, depersonalization, and perceiving things as either larger or smaller than they really are may also occur.
3. Myth: Depersonalization is a permanent condition. Fact: Many people recover from depersonalization-derealization disorder, often without treatment. Some mental illnesses are considered lifelong conditions, but this is not the case with depersonalization-derealization.
Derealization can last for as long as the panic attack lasts, which can range in length from a few minutes to 20 or 30 minutes. In some cases, however, these sensations can persist for hours and even days or weeks.
Some people experience mild, short-lived symptoms. Others have chronic (ongoing) symptoms that may last for years. The symptoms may interfere with your ability to function. They may even lead to a disability.
The difference between the two is that, while dissociation causes a disconnection from reality (i.e., loss of memory and sense of identity), psychosis causes some kind of additional experience (i.e. seeing and hearing things that don't exist).
Drastic changes in behaviour may occur, and the person can become upset, anxious, confused, angry or suspicious of those around them. They may not think they need help, and it can be hard to persuade them to visit a doctor. Read more about understanding psychotic experiences.
Many people experience dissociation, or a lack of connection between their thoughts, memory, and sense of identity, during or after a traumatic experience. A specific type of dissociation—persistent derealization—may put individuals exposed to trauma at greater risk for mental illnesses and functional impairment.
Causes of Depersonalization-Derealization
The exact cause of this disorder has not been identified but current research points to an imbalance of neurotransmitters (chemicals in the brain) that make the brain vulnerable to heightened responses when exposed to severe stress.
Dissociative symptoms include derealization/depersonalization, absorption, and amnesia. These experiences can cause a loss of control over mental processes, including memory and attention.
Depersonalization disorder is marked by periods of feeling disconnected or detached from one's body and thoughts (depersonalization). The disorder is sometimes described as feeling like you are observing yourself from outside your body or like being in a dream.
There is no cure for depersonalization derealization disorder, but treatment can reduce distressing symptoms and even lead to full remission of the disorder. Depersonalization-derealization disorder is a dissociative disorder that was once only vaguely understood.