How real do you feel?
Have you ever felt as though your body is not your own? As if you are an observer of yourself, from outside your body?
Have you felt your perception of your environment altered, appearing automated or somehow, not quite real?
You may have experienced “depersonalisation” or “derealisation”.
While many people may experience this state once or twice, or even several times throughout their lives, for some it is a chronic and debilitating condition.
It happened to me:
I first experienced depersonalisation and derealisation some time around my mid teens. Nowadays, it occurs from time to time, and more often when I am stressed and overworked, lacking in sleep and irregular exercise. When I experience it, I am aware of a change in the brightness and intensity of colour in things around me. My environment takes on a hazy sheen that I seem partly removed from, but the brightness can be kind of overstimulating, like someone just turned the lights up real high. I have this sensation of being aware of myself from outside of myself. I find this somewhat fascinating, and mildly unsettling.
What’s going on?
Depersonalisation is a dissociative disorder defined in the DSM-IV as ‘alteration in the perception or experience of the self so that one feels detached from and as if one is an outside observer of one’s mental processes or body’. Derealisation is defined as an ‘alteration in perception or experience of the world so that it seems unreal’.
They can be experienced exclusively or both together, and often occur in the context of another illness or condition. It’s commonly associated with depression, panic and anxiety disorders, and to a lesser extent, various neurological conditions, obsessive-compulsive disorder, illicit drug use, near death experiences, post traumatic stress disorder or head injury. Occurring as a primary condition, the disturbing changes in perception are often expressed as the precursor to anxiety and are the primary cause for complaint to the therapist.
Research suggests the average age of onset is 22.8 years, with initial onset as young as 16. Prevalence in the population is between 2% and 20% of the population. That could be as high as one in every five people you meet. Some research even suggests that depersonalisation might be the third most common psychiatric disorder after anxiety and low mood.
Don’t freak out. It’s normal:
Like many illnesses and disorders, they occur on a dimensional continuum, and occasional experiences of these perceptual states are considered ‘normal’ (if indeed there is such as thing). So if you are like me when I first heard about this, you have just convinced yourself that you have the full blown disorder and that you are indeed a crazy nutter. But hey, be careful, don’t freak out. Consider this: Number 1: I repeat, it’s completely normal to experience this on occasion; and 2: if you do experience it a lot, now you know you are not alone. Please, seek professional help.
Where to from here? Treatment and Public Awareness:
Considering the startling statistics, I find it concerning that there is not more public awareness of this disorder. To date, there is no set prescribed treatment, however cognitive behavioural therapy (CBT) and psychoanalytic therapy have shown to be helpful in some cases. Patients can express significant levels of relief after diagnosis as they find out it is described and defined in the psychiatric literature, and they feel less isolated, baffled and confused. Building public awareness could be helpful in providing insight for those undiagnosed or non-clinical cases, and in attracting more funding for research into effective management and treatment.