Depersonalization and Derealization

In just the last few days I’ve had moments that I can only describe with the above terms. These mind states for me right now are not severe and not terribly frightening as they are reported by some people. For many people suffering from the full-blown disorder there is a fear of going crazy.

When it’s experience as a full-blown disorder people have been mistakenly diagnosed with psychosis. Well, I have been crazy–floridly psychotic–and I know this is something else. I’m not fearful of going mad.

Apparently people withdrawing from drugs have the experience of depersonalization and derealization. This I’ve learned in my withdrawal groups and I haven’t been able to find documentation of it pertaining specifically to psychiatric drug withdrawal from other sources on the internet. It is just commonly spoken about in the forums. It is not a permanent disorder, can be fleeting, last for hours or days, or become a constant state for the course of withdrawal resolving once the withdrawal period is over.

For me, it feels like I am coming on to a hallucinogenic drug trip. The feeling is very familiar as I’ve taken hallucinogenics several times some 20 years ago. I’ve now currently only experienced it twice…once the other day, lasting just a matter of hours and now today to a lesser degree. I imagine the popular concept of LSD “flashbacks” may be the experience of this phenomena.

I’m having a difficult time writing, but I want to update my blog and this seems a reasonable topic to deal with as I’m experiencing it now and it is intimately related to the scope of this blog.

In addition, and in general, I’ve become mildly agoraphobic which is part of the phenomena as well. My “agoraphobia” is manifested not to the extent that I can’t go out, but I intensely don’t want to go out. This has been going on for a couple of weeks. I also have lost all interest in socializing, in spite of ordinarily being extremely outgoing. This is not associated with any depression.

A description of the depersonalization in general is described below:

It may happen when you first wake up, or while flying on an airplane or driving in your car. Suddenly, inexplicably, something changes. Common objects and familiar situations seem strange, foreign. Like you’ve just arrived on the planet, but don’t know from where. It may pass quickly, or it may linger. You close your eyes and turn inward, but the very thoughts running through your head seem different. The act of thinking itself, the stream of invisible words running through the hollow chamber of your mind, seems strange and unreal. It’s as if you have no self, no ego, no remnant of that inner strength which quietly and automatically enabled you to deal with the world around you, and the world inside you. It may settle over time, into a feeling of “nothingness”, as if you were without emotions, dead. Or the fear of it may blossom into a full-blown panic attack. But when it hits for the first time, you’re convinced that you’re going insane, and wait in a cold sweat to see when and if you finally do go over the edge.According to DSM-IV, Depersonalization Disorder, in part, constitutes the following:

… a feeling of detachment or estrangement from one’s self . The individual may feel like an automaton or as if he or she is living in a dream or a movie. There may be a sensation of being an outside observer of one’s metal processes, one’s body, or parts of one’s body.

… Various types of sensory anesthesia, lack of affective response, and a sensation of lacking control of one’s actions, including speech, are often present. The individual with Depersonalization Disorder maintains intact reality testing (e.g., awareness that it is only a feeling and that he or she is not really an automaton) . Depersonalization is a common experience, and this diagnosis should be made only if the symptoms are sufficiently severe to cause marked distress or impairment in functioning).

In addition to DSM-IV, another vital diagnostic tool, Merck’s Manual, describes depersonalization clearly:

Persistent or recurrent feelings of being detached from one’s body or mental processes and usually a feeling of being an outside observer of one’s life.
Depersonalization is the third most common psychiatric symptom and frequently occurs in life-threatening danger, such as accidents, assaults, and serious illnesses and injuries; it can occur as a symptom in many other psychiatric disorders and in seizure disorders. As a separate disorder, depersonalization has not been studied widely, and its incidence and cause are unknown.2

This one young person’s account is typical of the feelings of unreality laced with intermittent panic that often besets sufferers in the earliest stages whether drug-induced or not:

… three times after I’ve smoked pot I’ve had a disabling depersonalization from it. Again, it’s the same numbness, then far away, unable to control my body, time feels like it’s flashing like movie stills, cannot tell what is happening, even what I am thinking, sound is far away, cannot speak. Think it is near death as one could get. Also one time it happened to me after half a beer (didn’t feel at all intoxicated) and the ambulance came and got me. Some lady was sitting over me saying something about Jesus, which only made the fear stronger.

The terror is inexplicable. In between attacks I experience feelings of unreality, sometimes lasting days. I deal with agoraphobia and panic, dread of dying. Sometimes just feel it is hard to move around. Like I will become disoriented and fall over (which really happens during my serious attacks). I avoid people, since they make me feel strange, especially if they are too close. Being in a store can make me feel strange too.

As I’ve said, I am only mildly experiencing some of this. I suppose one might say I shouldn’t diagnose myself, but I’m doing so based on reports on my withdrawal boards and lists. My experience of it is very much like that of the people describing it during the withdrawal process. I would post some peoples’ experience of it as described on these boards, but I wish to keep the confidentiality of the authors. I will at some future time ask people if I can publish some of their posts.

In any case, for today, I’ve cancelled my neurofeedback appointment and asked a friend I was meeting in town to come to my house as I don’t feel comfortable going out. I actually don’t really want to be social at all, but also, wish not to be anti-social, so I asked my friend to come here, which she graciously agreed to do. (I live in a remote area far from the town she lives in…I was supposed to meet her in town for lunch)

I am now exhausted and spaced-out. I know this post is lacking in clarity. I’m certainly not as clear-headed as usual and what is the norm for me now is considerably blunted by drugs as compared to my pre-drugged years in any case. I continue to hope for improved cognitive ability as I continue to withdraw from my drugs. As I’ve said before, the fact that I am writing anything coherent at all is amazing.

I started this blog in 2004. You might wonder why the posts begin this year. I kept the blog on a private setting and wrote for months at a time, repeatedly deleting everything I wrote. It was pure gibberish. I finally feel, and hope it’s true, that I can write clearly enough to be interesting and helpful to people.

More on DP/DR

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters

10 Responses

  1. michael

    My recommendation is “don’t sweat the depersonalisation”.

    I’ve been diagnosed as bipolar too and often experience long periods that match clinical descriptions of D&D.

    I’m also a long time vipassana meditator and find myself entering subjectively identical states during meditation. I suspect D&D is actually one of the jhanas.

    Sometimes I can (and do) even deliberately trigger such states at times when I’m feeling overwhelmed by despair in public places and just need to hold tight for a while instead of running home and locking myself in my bedroom.

    Of course I can’t know how other people experience such states and whether my own are really a match for what is pathologised as depersonalisation and derealisation, but if it is its not something I’m particularly eager to be cured of. For me its both a coping mechanism and an insight gaining form of detachment from my own mental/emotional states.

    BTW, I thought I’d share this piece of diagnostic logic from Like

  2. Gianna

    Michael,
    Thanks for your comment. It was very interesting. Did you read my next post where I specifically mention meditation? I too have had these states while meditating and have found them to be very pleasant. I suggest it’s a matter of context and interpretation that determines how one experience of these states.

    I also speak of these states being “defense mechanisms” but we don’t need to clinicalize or pathologize them just because they can be “defense mechanisms.” They may be, indeed, helpful and legitimate states of consciouness. I intent is not to pass judgement on them.

    What I think is important is that people do also find them to be traumatic and troubling. I think this is when they are interpreted with fear. Also they can and do get in the way of functioning normally.

    In your final quote taken from that website it suggests they are always anxiety states. I don’t agree with this. I’m not sure if you were agreeing or not.

    I certainly currently experience them with anxiety, but I suspect that is because of how I am interpreting them, rather than because they are by nature caused by an underlying anxiety.

    I include clinical documentation of them because that is where they are most clearly discussed. Not because I think they need to be interpreted this way.

    I think I will look into the phenomena of jhana. I’ve been introduced to that term, but don’t remember what it means at this point. Here is something I found by doing a cursory search on google:

    http://www.angelfire.com/electronic/awakening101/absorption.html

    D. JHANA OR DHYANA WITHOUT FORM (arupa jhana): absorption without form, leading to increasing rarefaction or incorporeality (similar to Patanjali’s asamprajnata samadhi. Asamprajnata-samadhi is sometimes known in Vedanta circles as nirvikalpa-samadhi). Asamprajnata-samadhi is generally considered to incorporate the following four Jhanas within its scope:

    8) Eighth Jhana: jhana beyond perception and nonperception (nevasannanasanna) Saijojo.
    7) Seventh Jhana: jhana of pure emptiness (akinci, lit. “nothingness”) Ken-Chu-Shi.
    6) Sixth Jhana: jhana of pure expansive consciousness (vinnana).
    5) Fifth Jhana: jhana of boundless space (anantakasa).

    See also: Amrita–Nadi

    C. JHANA OR DHYANA WITH FORM (rupa): absorption in supporting content (similar to Patanjali’s samprajnata samadhi). Samprajnata-samadhi is generally considered to incorporate the following four Jhanas within its scope:

    4) Fourth Jhana: delete sense of well-being, leaving absorbed equanimity.
    3) Third Jhana: delete joy, leaving equanimity and sense of well-being.
    2) Second Jhana: delete mental activity, leaving joy and sense of well-being.
    1) First Jhana: mental activity, joy, and sense of well-being.

    I don’t argue that these states may indeed be akin to DP/DR, simply interpreted positively.
    thanks again for your thoughts.

    Like

  3. michael

    I read your later post, but only after already making my comment to the earlier one.

    Agree that any inner state that is perceived as troubling or threatening is a problem to the person experiencing it, regardless of whether a some belief systems consider it virtuous.

    I’m reminded of Joseph Campbell’s comments on the difference between mysticism and mental illness. Whether you ‘swim’ or ‘drown’ in the ‘inner ocean’ basically depends on whether you fear it and how much control you feel you have over your immersion.

    My intent in drawing attention to the commercial website was to point out the circular logic in their diagnostic criteria (i.e. D&D is always a symptom of an anxiety disorder even when its the only sign of an anxiety disorder). Wonder if the fact that they make their money treating anxiety disorders has influenced their view of D&D.

    My understanding of the jhanas comes from the Therevadan Buddhist tradition.

    The first jhana is generally described as a blissful state free of anger, desire, anxiety, directed thought or the internal monologue of subvocalised thought. That fits pretty well with a state I can usually reach during vipassana practice and it feels subjectively identical to a coping mechanism I can sometimes use in public during stressful situations (assuming I get the chance to focus on my breathing for a while and don’t have to keep responding to external events).

    Like

  4. Tonya

    Hi Gianna, This is Tonya from WandR group. I’m going through this same experience right now.
    Only I’m not coming off drugs (have been off for over 3 years). I think, in my case, this is due
    to the heavy cortisol levels I was experiencing the last few months because of the adrenal collapse.
    I’m going through many of the old withdrawal symptoms actually. It’s quite unnerving. The one thing
    that keeps me going is the fact that I made it through derealization before and felt quite normal
    for a while. I’m hoping I can get back to normal quickly this time.
    Just wanted to let you know you’re not alone right now.
    Be well.

    Like

  5. aliciaarol

    People who feel real can never (in a million years) understand what it is like to not feel real. If you tell people you do not feel real you sound crazy. I know that I am real, and I know that the world is real, but everything has always seemed like some sort of endless dream to me. My mother became schizophrenic when I was eleven. My mother’s illness forced me to move in with my father and his girlfriend when I was 14. My father (who was supposed to take care of me and take away all the hurt and pain) turned out to be an emotional abuser of the worst degree. I do not remember ever feeling real, but I accept it-what else can I do? Deep down, I have never wanted to exist (which does not mean that I want to die now). I guess, when life was so painful, my brain decided to deny what was happening, and this created the chronic “derealization” I’ve experienced ever since. (I’m also Borderline, but that is a whole other issue).

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  6. kava

    I have had d/p and or d/r for over fifteen yrs. Its often worse when I am undergoing my ocassional existential angts and the subsequent fears that goes with that. I have noticed however that my fears holds my anxieties and my anxieties hold my d/p. I find that when I completely surrender all fears this altered state of seeing things becomes very insighfull and uplifting and often wanes or not there. Everything is pure absolute consciousness. when your fear decreases or abates from worries of having this condition you will realize that you are not diminished in any manner, but rather expanded. I still have my fears, but I am now seeing it as a valuable lesson that I must learn to inspire total surrender to absolute beingness.

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