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Depersonalization disorder is characterized by a persistent or recurring feeling of being detached from one's body or mental processes (depersonalization) and by a feeling of being an outside observer of one's life. The symptom of depersonalization is the third most common psychologic symptom (after feelings of anxiety and feelings of depression) and often occurs after a person experiences life-threatening danger, such as an accident, assault, or serious illness or injury. Depersonalization disorder has not been studied widely, and its cause and occurrence in the population are unknown. Symptoms and Diagnosis People with depersonalization disorder have a distorted perception of their identity, body, and life that makes them uncomfortable. Symptoms may be temporary or persist or recur for many years. People with the disorder often have a great deal of difficulty describing their symptoms and may fear or believe that they are going crazy. Depersonalization disorder can be a minor, passing disturbance with little noticeable effect on behavior. Some people can adjust to it or even block its impact. Others are continually plagued with anxiety over their state of mind, worrying that they are going crazy or ruminating over the distorted perceptions of their body and their sense of estrangement from themselves and others. Mental anguish may disable them. The diagnosis of depersonalization disorder is made on the basis of symptoms. A doctor evaluates the person to rule out physical disorders (such as a seizure disorder), drug abuse, and other mental health disorders. Psychologic tests and special interview procedures may help the doctor recognize the problem. Treatment and Prognosis Depersonalization disorder often disappears without treatment. Treatment is warranted only if the disorder persists, recurs, or causes distress. Psychodynamic psychotherapy, behavior therapy, and hypnosis have been effective for some people. Sedatives and antidepressants help some people with the disorder. Depersonalization disorder is often associated with or triggered (precipitated) by other mental health disorders, which require treatment. Any stresses associated with the beginning (onset) of the depersonalization disorder must also be addressed. Some degree of relief is usually achieved with treatment. Complete recovery is possible for many people, especially those whose symptoms occur in connection with stresses that can be addressed during treatment. Other people with depersonalization disorder do not respond well to treatment, although they may gradually improve on their own. A few remain unresponsive to all treatments.
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