2024-01-08 16:13:15
The derealization is a term used in psychiatry and psychology to describe a feeling of disconnection with reality. We talk regarding derealization disorder and/or depersonalization because this syndrome can also cause a feeling of detachment from oneself.
Definition: what is derealization and/or depersonalization?
The derealization disorder and/or depersonalization is described by the DSM V, reference manual in psychiatrywhich ranks it among the dissociative disorders.
The 5th edition of Diagnostic and Statistical Manual of Mental Disorders characterizes this disorder by the recurrence of prolonged experiences of:
Derealization that is to say, impressions of unreality or detachment from the external world; and/or depersonalization that is to say, impressions of detachment from one’s mind or body.
“These experiences are chronic or regular. The subject has the impression of having become an external observer of his own existence,” describes Johanna Rozenblum, psychologist in Paris.
2 people out of 100 affected
Episodes of transient depersonalization and/or derealization (lasting a few hours to a few days) are common in the general population: approximately half of all adults have at least one experience of derealization and/or depersonalization during their lifetime. This is especially true since these episodes can be a symptom of an anxiety attack or the use of drugs or alcohol. However, derealization/depersonalization as a chronic disorder is rarer: only 2% of the population is affected (source 1).
What are the symptoms of derealization and/or depersonalization disorder?
“This disorder can give the impression of being in a dream or in a film. The person feels detached from those close to them and from what is happening in front of them. They are in a bubble or behind a glass wall which makes them feel spectator. She is numb and does not feel emotion (emotional anesthesia).” Johanna Rozenblum psychologist.
Sometimes, this disorder also gives the impression of being a spectator of one’s own thoughts, feelings, sensations, body or actions. Some will say that they feel “empty”, “floating” or “out of their pump”.
These symptoms are described as intrusive, uncontrollable and causing significant distress. Sometimes, they are the cause of a real alteration in socio-professional functioning.
Cause: What causes derealization and/or depersonalization disorder?
Derealization/depersonalization disorder is a trouble dissociatif in the same way as the dissociative identity disorder et dissociative amnesia. Remember that dissociation is a defense mechanism which will be triggered in the event of an “overflow” of our nervous system. It is therefore a psychological survival reflex, triggered to escape extreme stress that the psyche cannot withstand. This disorder is therefore very necessary in order to put unbearable events at bay while continuing to function:
Derealization/depersonalization disorder is usually triggered by intense stress or a traumatic event, such as physical abuse, childhood neglect, or other significant sources of stress that one experiences or witnesses (accident, attack, bereavement, rape, etc.). Johanna Rozenblum, psychologist.
Is derealization and/or depersonalization serious?
Derealization and/or depersonalization disorder causes significant suffering. However, it is not a symptom of a serious mental disorder such as psychotic disorder such as schizophrenia For example). In fact, the subject remains aware of the pathological nature of his symptoms and criticizes them. He has the impression of moving away from reality but he remains well connected to reality.
When a patient shows symptoms of derealization of which he is completely unaware (apart from a diagnosis of anxiety disorder or substance use), in this case only, it will be necessary to investigate the possible psychotic pathology. Derealization is then no longer the disorder but the symptom. Johanna Rozenblum, psychologist.
Diagnosis: how do you know if you are experiencing derealization?
The diagnosis of derealization/depersonalization disorder can be carried out by a doctorand psychiatrist or one psychologist. The latter must first eliminate differential diagnoses such as an anxiodepressive disorder or acute stress (since anxiety can trigger transient experiences of derealization) or a psychotic disorder.
The diagnosis of this disorder is confirmed by a doctor if the episodes of derealization are long or frequent, if the patient is aware of these episodes, if the symptoms are disabling in daily life and finally if they are not attributed to drug consumption. or alcohol. Johanna Rozenblum, psychologist.
Treatment: how to treat derealization?
The management of derealization depends on the diagnosis:
It is not uncommon for derealization to be transient and the consequence of an anxiety or depressive disorder: “this indicator is rather reassuring because the treatment is clear”, according to the psychologist. Psychotherapy, sometimes anxiolytics and antidepressants are among the usual solutions.
“If derealization is a side effect of drug or alcohol consumption, the addiction will need to be treated,” adds the expert.
Stopping a crisis of derealization/depersonalization
In cases of derealization/depersonalization, the symptoms must be recognized and accepted. It is also recommended to take the time to breathe (cardiac coherence), to slow down (meditation), to calm the symptoms and return to the here and now. To help us return to reality, we can carry out practical tasks: integrate the current discussion, act in full awareness in the activity we are doing, be attentive to our senses (taste, touch, smell, etc.). .). Everyone will also be able to develop personal tools that are favorable to them! – Johanna Rozenblum, psychologist.
Medium to long term support sometimes necessary
Treatment for derealization/depersonalization disorder consists of psychotherapy (cognitive behavioral therapy or CBT is effective). Medication treatment in the event of comorbid depression and/or anxiety may be suggested by the doctor/psychiatrist. EMDR can be effective if the disorder follows an identified trauma.
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