Feeling Unreal
June 22, 2023
Daphne Simeon, Jeffrey Abugel
Depersonalization is the third most common psychiatric symptom, yet remains poorly understood by clinicians and the public. It can accompany other mental illnesses but is also a distinct disorder recognized by major diagnostic manuals. This chapter describes the symptoms of depersonalization/derealization disorder through historical documentation and personal stories. Core symptoms include detachment from one's whole self or aspects of the self (feelings, thoughts, body, agency) and detachment from the outside world. The origins of the term "depersonalization" are discussed, and historical and current descriptions are illustrated with personal quotes and stories, supporting depersonalization/derealization as an independent syndrome rather than merely a symptom of other disorders.
June 22, 2023
Daphne Simeon, Jeffrey Abugel
Depersonalization/derealization disorder is comprehensively examined, covering its history, diagnosis, and treatment. The book describes the dissociative state of feeling unreal through personal vignettes and explores both psychological and biological perspectives. Treatment options discussed include medications, transcranial magnetic stimulation, and various psychotherapies such as cognitive-behavioral, acceptance, mindfulness, and psychodynamic approaches. Literary and philosophical reflections enrich the understanding, and contemporary societal factors like chronic internet use and virtual reality are explored for their impact on detachment.
The Journal of clinical psychiatry
October 1, 2009
Daphne Simeon, David S Kozin, Karina Segal et al.
Chronic depersonalization/derealization triggered by drugs presents a uniform syndrome indistinguishable from non-drug-triggered cases, except that drug-triggered cases show more improvement over time. An internet survey of 394 adults with chronic depersonalization compared those whose onset was initiated by drugs (196 participants) versus those whose onset was not (198 participants). Cannabis, hallucinogens, and ecstasy were the most common precipitating drugs. Both groups reported similar illness course, impairment, suicidality, and limited treatment response. The drug-initiated group showed significantly greater improvement over time, but the groups did not differ in overall depersonalization severity or in reported effectiveness of psychotherapy or pharmacotherapy.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
Psychotherapy can successfully treat depersonalization disorder (DPD) for some patients, leading to important symptom improvement and better life adaptation, though it may not work fully for everyone. The chapter reviews traditional approaches, some outdated and others still useful, alongside state-of-the-art therapies that have proven most effective. Therapeutic approaches are tailored to patients' psychological makeup and specific symptoms, and accumulated success stories have formed a body of suggested approaches worth considering.
Feeling Nureal
April 20, 2006
Daphne Simeon, Jeffrey Abugel
Depersonalization disorder (DPD) is frequently misdiagnosed or underdiagnosed in psychiatry. Patients often present with accompanying anxiety or depression, but they distinguish their core experience—feelings of unreality, deadness, or having no self—from those conditions. Clinicians may misattribute these symptoms to anxiety or depression due to their training and comfort with those domains, leading to inappropriate treatment.