Understanding depersonalization disorder

How does DPAFU manifest itself?

Up until the mid-1990s our understanding of this condition had changed little since 1950, but over the past fifteen years there have been major advances in research and treatment; for the first time, doctors are beginning to understand the mechanisms in the brain that are involved in the disorder and studies have shown that far from being rare, DPAFU may be as common as other well-known psychiatric conditions such as schizophrenia.

DPAFU symptoms can affect people on five levels:

1) Emotional

How you feel, your moods, numbness

  • People with DPAFU experience an alteration in their perception or experience of the self.  Sufferers often report that their actions feel 'robotic', and as if they are an outside observer of their own body and mental processes. Their voice may sound unfamiliar and their thoughts, speech and actions no longer feel spontaneous.
  • Another major factor sufferers describe is an inability to feel emotion, even towards those close to them.  
  • There can be an additional feeling of being cut off from the world, and even one's self; for example, some sufferers feel detached from their own reflection when looking in the mirror.  This can lead to doubts and confusion about one's own identity.
  • Many sufferers also report significant levels of anxiety, which can manifest itself as panic attacks, a fear of going out alone, intense anxiety in social situations, or a tendency to worry too much.

2) Cognitive

Thoughts, beliefs, meanings, images, attention and memory

  • It is common for sufferers to spend excessive amounts of time worrying about abstract, existential, metaphysical or hypochondriacal issues, such as the meanings of words, how other people experience the world, the meaning of life and concepts of space and time.
  • Some sufferers may be quite introverted or preoccupied, as they spend a lot of time dwelling on their thoughts, and may appear wrapped up in their own world.
  • Many sufferers have difficulty with attention and memory; they may have problems remembering everyday things, struggle to take in new information and experience thoughts that are speeded up and confused.

3) Physical

Bodily changes, sleep patterns, numbness

  • Many feel as though bodily changes have taken place; their head may feel strange, for example large or numb, the body may feel weightless, hollow or lifeless and some may lose their sense of touch, taste or smell.  In some people this experience is so intense that they touch, punch or prick themselves to try to feel 'normal' again.
  • People's experience of their surroundings can become odd or unusual - occasionally people complain of visual distortion involving the size of objects, their three-dimensionality, or the sharpness of colours.

4) Behavioural

What you do more or less of, things you avoid

  • When we feel discomfort or stress, it is natural to try to find behaviours, thoughts, situations or substances to take away those unpleasant feelings.  For example, sufferers may stop drinking alcohol or try to improve diet and exercise regimes.  Any action that is used to take away distress or discomfort in this way is called a safety-seeking behaviour.
  • Sufferers may also employ avoidance tactics, for example going to great lengths to avoid looking in the mirror, being with people, or even leaving the house.
  • Both these behaviours can appear useful in the short-term, but tend not to last and can actually make the situation worse over time, perpetuating the negative cycles that maintain the problems associated with DPAFU. 

5) Environmental

Situations, relationships, work, home

  • The emotional, cognitive, physical and behavioural effects of DPAFU described above can have a negative impact on the sufferer's environmental experience; symptoms such as loss of concentration and emotional numbness can make work difficult to handle and personal relationships may suffer.

 

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