*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/?
