Generally DP comes from trauma. In tantra peaceful deity practices allay the
inner samsaras associated with indifference. Ganesha also very good.
----- Original Message -----
From: "suziezuzie" <[EMAIL PROTECTED]>
To: <FairfieldLife@yahoogroups.com>
Sent: Sunday, January 14, 2007 12:26 AM
Subject: [FairfieldLife] The Cure for Depersonalization is TM
Note that the cure is underlined towards the end of the article. Mark
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Depersonalization disorder forumEncyclopedia of Mental Disorders ::
Del-Fi
Depersonalization disorder
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Definition
Depersonalization is a state in which the individual ceases to
perceive the reality of the self or the environment. The patient
feels that his or her body is unreal, is changing, or is dissolving;
or that he or she is outside of the body.
Depersonalization disorder is classified by the Diagnostic and
Statistical Manual of Mental Disorders, 4th Edition, text Revision,
also known as the DSM-IV-TR as one of the dissociative disorders.
These are mental disorders in which the normally well-integrated
functions of memory, identity, perception, and consciousness are
separated (dissociated). The dissociative disorders are usually
associated with trauma in the recent or distant past, or with an
intense internal conflict that forces the mind to separate
incompatible or unacceptable knowledge, information, or feelings. In
depersonalization disorder, the patient's self-perception is
disrupted. Patients feel as if they are external observers of their
own lives, or that they are detached from their own bodies.
Depersonalization disorder is sometimes called "depersonalization
neurosis."
Depersonalization as a symptom may occur in panic disorder,
borderline personality disorder, post-traumatic stress disorder
(PTSD), acute stress disorder, or another dissociative disorder. The
patient is not given the diagnosis of depersonalization disorder if
the episodes of depersonalization occur only during panic attacks or
following a traumatic stressor.
The symptom of depersonalization can also occur in normal individuals
under such circumstances as sleep deprivation, the use of certain
anesthetics, experimental conditions in a laboratory (experiments
involving weightlessness, for example), and emotionally stressful
situations (such as taking an important academic examination or being
in a traffic accident). One such example involves some of the rescue
personnel from the September 11, 2001 terrorist attacks on the World
Trade Center and the Pentagon. These individuals experienced episodes
of depersonalization after a day and a half without sleep. A more
commonplace example is the use of nitrous oxide, or "laughing gas" as
an anesthetic during oral surgery. Many dental patients report a
sense of unreality or feeling of being outside their bodies during
nitrous oxide administration.
To further complicate the matter, depersonalization may be
experienced in different ways by different individuals. Common
descriptions include a feeling of being outside one's body; "floating
on the ceiling looking down at myself" feeling as if one's body is
dissolving or changing; feeling as if one is a machine or
robot; "unreal" feeling that one is in a dream or that one"is on
automatic pilot." Most patients report a sense of emotional
detachment or uninvolvement, or a sense of emotional numbing.
Depersonalization differs from "derealization," which is a
dissociative symptom in which people perceive the external world as
unreal, dreamlike, or changing. The various ways that people
experience depersonalization are related to their bodies or their
sense of self.
Depersonalization is a common experience in the general adult
population. However, when a patient's symptoms of depersonalization
are severe enough to cause significant emotional distress, or
interfere with normal functioning, the criteria of the DSM-IV-TR
for "depersonalization disorder" are met.
Description
A person suffering from depersonalization disorder experiences
subjective symptoms of unreality that make him or her uneasy and
anxious. "Subjective" is a word that refers to the thoughts and
perceptions inside an individual's mind, as distinct from the objects
of those thoughts and perceptions outside the mind. Because
depersonalization is a subjective experience, many people who have
chronic or recurrent episodes of depersonalization are afraid others
will not understand if they try to describe what they are feeling, or
will think they are "crazy." As a result, depersonalization disorder
may be underdiagnosed because the symptom of depersonalization is
underreported.
Causes and symptoms
Causes
Depersonalization disorder, like the dissociative disorders in
general, has been regarded as the result of severe abuse in
childhood. This can be of a physical, emotional, and/or sexual nature.
Findings in 2002 indicate that emotional abuse in particular is a
strong predictor of depersonalization disorder in adult life, as well
as of depersonalization as a symptom in other mental disorders.
Analysis of one study of 49 patients diagnosed with depersonalization
disorder indicated much higher scores than the control subjects for
the total amount of emotional abuse endured and for the maximum
severity of this type of abuse. The researchers concluded that
emotional abuse has been relatively neglected by psychiatrists
compared to other forms of childhood trauma.
It is thought that abuse in childhood or trauma in adult life may
account for the distinctive cognitive (knowledge-related) profile of
patients with depersonalization disorder. These patients have
significant difficulties focusing their attention, with spatial
reasoning, and with short-term visual and verbal memory. However,
they have intact reality testing. (Reality testing refers to a
person's ability to distinguish between their internal experiences
and the objective reality of persons and objects in the outside
world.) Otherwise stated, a patient with depersonalization disorder
may experience his/her body as unreal, but knows that "feelings
aren't facts." The DSM-IV-TR specifies intact reality testing as a
diagnostic criterion for depersonalization disorder.
The causes of depersonalization disorder are not completely
understood. Recent advances in brain imaging and other forms of
neurological testing, however, have confirmed that depersonalization
disorder is a distinct diagnostic entity and should not be considered
a subtype of PTSD.
No specific genes have been associated with susceptibility to
depersonalization disorder as of early 2002. It is possible that a
genetic factor will be identified in the future.
NEUROBIOLOGICAL. In the past few years, several features of
depersonalization disorder have been traced to differences in brain
functioning. A group of British researchers found that the emotional
detachment that characterizes depersonalization is associated with a
lower level of nerve cell responses in regions of the brain that are
responsible for emotional feeling; an increased level of nerve cell
responses was found in regions of the brain related to emotional
regulation.
A group of American researchers concluded that patients with
depersonalization disorder had different patterns of response to
tests of the hypothalamic-pituitary-adrenal axis (HPA, the part of
the brain involved in the "fight-or-flight" reaction to stress) than
did patients with PTSD. Other tests by the same research team showed
that patients with depersonalization disorder can be clearly
distinguished from patients with major depression by tests of the
functioning of the HPA axis.
Other neurobiological studies involving positron emission tomography
(PET) measurements of glucose (sugar) metabolism in different areas
of the brain found that patients with depersonalization disorder
appear to have abnormal functioning of the sensory cortex. The
sensory cortex is the part of the brain that governs the senses of
sight, hearing, and perceptions of the location of one's body in
space. These studies indicate that depersonalization is a symptom
that involves differences in sensory perception and subjective
experiences.
HISTORICAL. Depersonalization disorder may be a reflection of changes
in people's sense of self or personal identity within Western
cultures since the eighteenth century. Historians of psychiatry have
noted that whereas some mental disorders, such as depression, have
been reported since the beginnings of Western medicine, no instances
of the dissociative disorders were recorded before the 1780s. It
seems that changes in social institutions and the structure of the
family since the mid-eighteenth century may have produced a
psychological structure in Westerners that makes individuals
increasingly vulnerable to self disorders-as they are now called.
Experiences of the unreality of one's body or one's self, such as
those that characterize depersonalization disorder, presuppose a
certain notion of how the self is presumed to feel. The emphasis on
individualism and detachment from one's family is a mark of adult
maturity in contemporary Western societies that appears to be a
contributing factor to the frequency of dissociative symptoms and
disorders.
Symptoms
The symptoms of depersonalization disorder have been described
earlier. Although DSM-IV-TR does not specify a list of primary
symptoms of depersonalization, British clinicians generally consider
the triad of emotional numbing, changes in visual perception, and
altered experience of one's body to be important core symptoms of
depersonalization disorder.
DSM-IV-TR notes that patients with depersonalization disorder
frequently score high on measurements of hypnotizability.
Demographics
The lifetime prevalence of depersonalization disorder in the general
population is unknown, possibly because many people are made anxious
by episodes of depersonalization and afraid to discuss them with a
primary care physician. One survey done by the National Institutes of
Mental Health (NIMH) indicates that about half of the adults in the
U.S. have had one or two brief episodes of depersonalization in their
lifetimes, usually resulting from severe stress. About a third of
people exposed to life-threatening dangers develop brief periods of
depersonalization, as do 40% of psychiatric inpatients.
Depersonalization disorder is diagnosed about twice as often in women
as in men. It is not known, however, whether this sex ratio indicates
that women are at greater risk for the disorder or if they are more
likely to seek help for its symptoms, or both. Little information is
available about the incidence of the disorder in different racial or
ethnic groups.
Diagnosis
The diagnosis of depersonalization disorder is usually a diagnosis of
exclusion. The doctor will take a detailed medical history, give the
patient a physical examination, and order blood and urine tests in
order to rule out depersonalization resulting from epilepsy,
substance abuse, medication side effects, or recent periods of sleep
deprivation.
There are several standard diagnostic questionnaires that may be
given to evaluate the presence of a dissociative disorder. The
Dissociative Experiences Scale, or DES, is a frequently administered
self-report screener for dissociation. The Structured Clinical
Interview for DSM-IV Dissociative Disorders, or SCID-D, can be used
to make the diagnosis of depersonalization disorder distinct from the
other dissociative disorders defined by DSM-IV. The SCID-D is a semi-
structured interview, which means that the examiner's questions are
open-ended and allow the patient to describe experiences of
depersonalization in some detail-distinct from simple "yes" or "no"
answers.
In addition to these instruments, a six-item Depersonalization
Severity Scale, or DSS, has been developed to discriminate between
depersonalization disorder and other dissociative or post-traumatic
disorders, and to measure the effects of treatment in patients.
Treatments
Depersonalization disorder sometimes resolves on its own without
treatment. Specialized treatment is recommended only if the symptoms
are persistent, recurrent, or upsetting to the patient. Insight-
oriented psychodynamic psychotherapy, cognitive-behavioral therapy,
and hypnosis have been demonstrated to be effective with some
patients. There is, however, no single form of psychotherapy that is
effective in treating all patients diagnosed with depersonalization
disorder.
Medications that have been helpful to patients with depersonalization
disorder include the benzodiazepine tranquilizers, such as lorazepam
(Ativan), clorazepate (Tranxene), and alprazolam (Xanax), and the
tricyclic antidepressants, such as amitriptyline (Elavil), doxepin
(Sinequan), and desipramine (Norpramin). As of 1999, newer, promising
medications called selective serotonin reuptake inhibitors (SSRIs)
became available. Some SSRIs include fluoxetine (Prozac), sertraline
(Zoloft), and paroxetine (Paxil). SSRIs act on brain chemicals that
nerve cells use to send messages to each another. These chemical
messengers (neurotransmitters) are released by one nerve cell and
taken up by others. Those that are not taken up by other cells are
taken up by the ones that released them. This is called "reuptake."
SSRIs work by preventing the reuptake of serotonin-an action which
allows more serotonin to be taken up by nerve cells.
Unfortunately, there have been very few well-designed studies
comparing different medications for depersonalization disorder.
Because depersonalization disorder is frequently associated with
trauma, effective treatment must include other stress-related
symptoms, as well.
(Take note of this: Mark)
Relaxation techniques have been reported to be a beneficial
------------------------------------------------------------
adjunctive treatment for persons diagnosed with depersonalization
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disorder, particularly for those who are worried about their sanity.
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Prognosis
The prognosis for recovery from depersonalization disorder is good.
Most patients recover completely, particularly those who developed
the disorder in connection with traumas that can be explored and
resolved in treatment. A few patients develop a chronic form of the
disorder; this is characterized by periodic episodes of
depersonalization in connection with stressful events in their lives.
Prevention
Some clinicians think that depersonalization disorder has an
undetected onset in childhood, even though most patients first appear
for treatment as adolescents or young adults. Preventive strategies
could include the development of screening techniques for identifying
children at risk, as well as further research into the effects of
emotional abuse on children. It is also hopeful that further
neurobiological research will lead to the development of medications
or other treatment modalities for preventing, as well as treating,
depersonalization.
Resources
BOOKS
American Psychiatric Association. Diagnostic and Statistical Manual
of Mental Disorders. 4th edition, text revised. Washington, DC:
American Psychiatric Association, 2000.
"Depersonalization Disorder." Section 15, Chapter 188, in The Merck
Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and
Robert Berkow, MD. Whitehouse Station, NJ: Merck Research
Laboratories, 2001.
Ellenberger, Henri. The Discovery of the Unconscious. New York: Basic
Books, Inc., 1970.
Herman, Judith, MD. Trauma and Recovery. 2nd ed., revised. New York:
Basic Books, 1997.
Medical Economics staff. Physicians' Desk Reference. 56th ed.
Montvale, NJ: Medical Economics Company, 2002.
Stout, Martha, PhD. The Myth of Sanity: Tales of Multiple Personality
in Everyday Life. New York: Penguin Books, 2001.
PERIODICALS
Berrios, G. E., and M. Sierra. "Depersonalization: A Conceptual
History." Historical Psychiatry 8 (June 1997): 213-229.
Guralnik, O., J. Schmeidler, and D. Simeon. "Feeling Unreal:
Cognitive Processes in Depersonalization." American Journal of
Psychiatry 157 (January 2000): 103-109.
Lambert, M. V., C. Senior, M. L. Phillips, and others. "Visual
Imagery and Depersonalisation." Psychopathology 34 (September-October
2001): 259-264.
Phillips, M. L., N. Medford, C. Senior, and
others. "Depersonalization Disorder: Thinking Without Feeling."
Psychiatry Research 108 (December 30, 2001): 145-160.
Sierra, M., and others. "Lamotrigine in the Treatment of
Depersonalization Disorder." Journal of Clinical Psychiatry 62
(October 2001): 826-827.
Sierra, M., and G. E. Berrios. "The Phenomenological Stability of
Depersonalization: Comparing the Old with the New." Journal of
Nervous and Mental Disorders 189 (September 2001): 629-636.
Simeon, D., and others. "Personality Factors Associated with
Dissociation: Temperament, Defenses, and Cognitive Schemata."
American Journal of Psychiatry 159 (March 2002): 489-491.
Simeon, D., O. Guralnik, E. A. Hazlett, and others. "Feeling Unreal:
A PET Study of Depersonalization Disorder." American Journal of
Psychiatry 157 (November 2000): 1782-1788.
Simeon, D., O. Guralnik, M. Knutelska, and others. "Hypothalamic-
Pituitary-Adrenal Axis Dysregulation in Depersonalization Disorder."
Neuropsychopharmacology 25 (November 2001): 793-795.
Simeon, D., O. Guralnik, and J. Schmeidler. "Development of a
Depersonalization Severity Scale." Journal of Traumatic Stress 14
(April 2001): 341-349.
Simeon, D., O. Guralnik, J. Schmeidler, and others. "The Role of
Childhood Interpersonal Trauma in Depersonalization Disorder."
American Journal of Psychiatry 158 (July 2001): 1027-1033.
Simeon, D., D. J. Stein, and E. Hollander. "Treatment of
Depersonalization Disorder with Clomipramine." Biological Psychiatry
44 (August 15, 1998): 302-303.
Stanton, B. R., A. S. David, A. J. Cleare, and others. "Basal
Activity of the Hypothalamic-Pituitary-Adrenal Axis in Patients with
Depersonalization Disorder." Psychiatry Research 104 (October 2001):
85-89.
Zanarini, M. C., and others. "The Dissociative Experiences of
Borderline Patients." Comparative Psychiatry 41 (May-June 2000): 223-
227.
ORGANIZATIONS
International Society for the Study of Dissociation (ISSD). 60 Revere
Drive, Suite 500, Northbrook, IL 60062. (847) 480-0899. Fax: (847)
480-9282. <www.issd.org>.
National Institute of Mental Health. 6001 Executive Boulevard, Room
8184, MSC 9663, Bethesda, MD 20892-9663. (301) 443-4513.
<www.nimh.nih.gov>.
National Organization for Rare Disorders, Inc. P. O. Box 8923, New
Fairfield, CT 06812-8923. (203) 746-6518. <www.rarediseases.org>.
Society for Traumatic Stress Studies. 60 Revere Dr., Ste. 500,
Northbrook, IL 60062. (708) 480-9080.
Rebecca J. Frey, Ph.D.
User Contributions:
The following comments are not guaranteed to be that of a trained
medical professional. Please consult your physician for advice.
1Bridgette RodersNov 19, 2006 @ 8:20 pm
Does anyoneout there have any information of depersonalization due
to either the drug interferon, or the drug ribavrin? If so please e-
mail me.Questions would be like how long does it last after treaments
are stopped? Is it completely reversible.Hoe do you attempt to deal
with it,esecially since my combinatin treatment of interferon with
ribavirin is going to go on for about six more oths?
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