Categories
Dissociative Disorders

A Break from the Oneself (and Maybe the World): Examining Depersonalization-Derealization Disorder

*Top image is part of a comic drawn by a community member, with the account name as Planetmclulu, on Bored Panda. The individual’s name is Lulu, and they drew this comic to display what it is like to have depersonalization/derealization disorder. They are cited in the reference section; however, one may go on their account to view more of their illustrations.*

 

Dissociative disorders are characterized by an absence of connectivity between one’s perceptions, emotions, and understanding of self. The dissociation, defined by these types of disorders, usually results from prior experiences with trauma, and is thought to allow the individual to cope with their reality that is a result of situations associated with a painful or sorrowful memory or sentiment (Mayo Clinic, 2017). Depersonalization/derealization disorder (DPDR) is one type of dissociative disorder categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Within DPDR, one may experience significant aspects of depersonalization and/or derealization that are strongly likely to interfere with the routine functioning of daily life (Mayo Clinic, 2017). 

The depersonalization element of DPDR is defined by detachment from one’s self in terms of mind and body (2017). With this, an individual can feel that they are viewing themselves from a third-person perspective. Alexithymia may arise as a symptom in which one cannot identify or properly explain their emotions. Additionally, one may experience a physical loss of sensation or ability to control movement which can be further exacerbated by an idea that one’s limbs are disfigured (Fritscher, 2020). The derealization element of DPDR is defined by detachment from one’s environment and other people within one’s surroundings (2020). With this type of dissociation, an individual can feel separate and isolated from their surroundings to the point where they may feel objects and people near them are fabricated (2020). Hence, one’s senses of vision and hearing, which make up memory, may be warped (2020). A person experiencing derealization may have symptoms of hyper-awareness of their environment and visualizing objects in the nearby vicinity to be manipulated into two-dimensional, colorless, or cartoonish configurations (Fritscher, 2020).  

Whether an individual experiences both depersonalization and derealization aspects or just one, it is apparent that this disorder has strong potential to severely impact one’s behavior and capacity in daily function. An individual with DPDR is likely to experience initial symptoms and episodes of the disorder in their mid-teenage years to young adulthood (American Psychiatric Association, 2018). Although most episodes are not chronic, the respective episodes can persist over hours, days, weeks, and even months. The symptoms can also periodically return over several years (Fritscher, 2020). To be diagnosed as an individual with DPDR, along with identifying the presence of the depersonalization/derealization symptoms, it is also important to identify if the disorder is causing social or personal disturbance to the individual and if the individual recognizes that the dissociation they experience is not real (2020). To recognize that one’s reality is not the dissociation experience is a crucial criterion for a DPDR diagnosis, as it rules out other psychotic disorders (Fritscher, 2020).  

While there is no distinct cause for DPDR, it is possible for certain situations or predispositions, such as genetic or environmental causes, to pose a higher risk for individuals to be more susceptible to the disorder. Most often, individuals with DPDR have experienced or witnessed a past trauma such as emotional, physical, or sexual childhood abuse. In early years, a child is more readily able to learn how to view traumatic events from a third-person perspective as personal identity is still under development. Thus, it is possible for dissociation to unknowingly be a coping mechanism for later years of life (Fritscher, 2020). For treatment purposes, it is usually most effective for individuals with DPDR to undergo psychotherapy, such as cognitive-behavioral therapy (CBT). CBT serves to help an individual to reconnect with their emotions, mind, and body, so they may block out false perceptions of themselves and their surroundings. The second form of therapy, eye movement desensitization and reprocessing (EDMR), may also be used, in which an individual is trained to shift their negative thoughts and memories with a series of bilateral (side-to-side) eye movements (Fritscher, 2020). Through this therapy, it is hoped for the individual to focus on a specific memory or thought until it does not cause distress to the individual (Gotter & Raypole, 2022). 

 

References

American Psychiatric Association. (2018, August). What are dissociative disorders? https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders

Fritscher, L. (2020, December 4). What Is Depersonalization/Derealization Disorder (DPDR)? Verywell Mind. https://www.verywellmind.com/derealization-2671582

Gotter, A., & Raypole, C. (2022, January 11). Considering EMDR Therapy? What to Expect. Healthline. https://www.healthline.com/health/emdr-therapy

Mayo Clinic. (2017, November 17). Dissociative disorders. https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/symptoms-causes/syc-20355215#:~:text=Dissociative%20disorders%20are%20mental%20disorders,with%20functioning%20in%20everyday%20life

Planetmclulu. (2019). I’ve been suffering from DPDR for over 3 years now, and I want people to know what it’s like (10 comics) [Illustration]. Bored Panda. https://www.boredpanda.com/comics-life-with-depersonalization-derealisation-disorder-planetmclulu/?

Categories
Dissociative Disorders

Personality Disorders and Cinema: Misconceptions about Mental Health

From tales as old as time, cinema has captured the public’s attention through thriller, action, and romance packed movies. Famous movies such as Split (2016), Psycho (1960), and Fight Club (1999) have allowed the public to develop a perception of mental illness. These movies share a similarity that the main characters show behaviors typically displayed in dissociative identity disorder (DID), previously known as multiple personality disorder. 

Film portrayals have led to the creation of stigma and unfavorable opinions about mental illness (Sampson, 2020). One of the strongest abilities cinema holds is being able to influence what and how people think about mental illness. Hollywood loves to dramatize and produce certain portrayals of characters that may bring mental illness to light, but not in the most positive way. 

A well-known mental illness portrayed in films is DID. Dissociative identity disorder can be described as an individual having at least two different personality states. The switch between one personality state to another is most often seen as an involuntary escape from reality. The jump from reality to reality tends to stem from a disconnect in thoughts, identity, consciousness, and memory. People are still researching and finding more information about, but the most conclusive trigger to DID is a history of trauma or abuse experienced in the individual’s lifetime. 

For most individuals with DID, dissociation can be seen as a coping mechanism that an individual may use to disconnect from a stressful or traumatic experience, or even try to separate those traumatic experiences from normal awareness (Cleveland Clinic, 2016). This leads an individual to disconnect from the present moment and the outside world. This type of defense mechanism comes into play when there is a probable situation where physical or emotional pain can potentially occur. However, there is still a lot that we don’t know about DID yet in terms of other plausible triggers to the disorder. 

So what does this mean for the film industry? The media’s portrayal of mental illness tends to be gravely inaccurate. Most often, films who have characters portraying the symptoms of a mental illness are aggressive and violent. It is not uncommon to find these characters being posed as criminals or living in a homeless area. From negative depictions of DID and stereotypes, it is apparent that most people will have a convoluted idea of what mental illness is. These misinformed films are one of the primary reasons there has been great stigma against those who actually suffer and live with a mental illness or condition.

Not only has the film industry negatively framed the information about mental illness, but it has also led to the confusion and mix up between other mental disorders. Particularly, in the film Fight Club, when the main character who displays DID and his alternate identity called Tyler had stated what he felt was almost a hallucination. Dissociative identity disorder and schizophrenia are often seen together collectively, despite both disorders being very different from each other. Because of such media portrayals, the public eye becomes misled to what actually is the truth behind these disorders. 

One of the biggest issues the media tends to display more often than not is the dialogue and language used against characters who are portraying a mental illness. Vulgar and offensive terms such as “unstable,” “crazy,” “nutjob,” “psycho,” and “freak” are just a few words out of many that are common in films. The use of offensive language in film addressing mental health can influence the public to think it is normal or okay to call someone these terms without seeing the impact and long lasting effect they have on an individual. It is never okay to say any of these words to any individual, especially those who suffer from mental illness. Offensive language should not be normalized in films portraying mental health, and filmmakers should consider the sensitivities of the audience.

How can you change the conception of mental health in the film industry? One probable solution to this problem is for the public audience to be better informed about mental health. It is not enough for the public to see a two hour film and to have the correct perception of a mental disorder like DID, which has been used so many times in cinema. We should start normalizing open conversations about mental health so the public could have a more positive and informative view.  

 

References

Dissociative Disorders | NAMI: National Alliance on Mental Illness. (2020). National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders

Multiple Personality Disorder: Causes, Symptoms, Diagnosis, Treatment. (2016). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9792-dissociative-identity-disorder-multiple-personality-disorder

Sampson, V. (2020). The Portrayal of Dissociative Identity Disorder in Films. The Portrayal of Dissociative Identity Disorder in Films, 11(2), 79–88. https://www.elon.edu/u/academics/communications/journal/wp-content/uploads/sites/153/2020/12/08-Sampson_ejfinal.pdf