psychiatric disorders
Depersonalization Derealization Disorder
Symptoms and Signs of Depersonalization Derealization Disorder
Symptoms of depersonalization/derealization disorder are usually episodic and wax and wane in intensity. Episodes may last for only hours or days or for weeks, months, or sometimes years. But in some patients, symptoms are constantly present at a constant intensity for years or decades. Depersonalization symptomsinclude Feeling detached from one's body, mind, feelings, and/or sensations Patients feel like an outside observer of their life. Many patients also say they feel unreal or like a robot or automaton (having no control over what they do or say). They may feel emotionally and physically numb or feel detached, with little emotion. Some patients cannot recognize or describe their emotions (alexithymia). They often feel disconnected from their memories and are unable to remember them clearly. Derealization symptomsinclude Feeling detached from their surroundings (eg, people, objects, everything), which seem unreal Patients may feel as if they are in a dream or a fog or as if a glass wall or veil separates them from their surroundings. The world seems lifeless, colorless, or artificial. Subjective distortion of the world is common. For example, objects may appear blurry or unusually clear; they may seem flat or smaller or larger than they are. Sounds may seem louder or softer than they are; time may seem to be going too slow or too fast. Symptoms are almost always distressing and, when severe, profoundly intolerable. Anxiety and depression are common. Some patients fear that they have irreversible brain damage or that they are psychotic. Others obsess about whether they really exist or repeatedly check to determine whether their perceptions are real. However, patients always retain the knowledge that their unreal experiences are not real but rather are just the way that they feel (ie, they have intact reality testing). This awareness differentiates depersonalization/derealization disorder from a psychotic disorder, in which such insight is always lacking. 