Anxiety and Depersonalization: Facts & Feelings

"Dissociation" by Joe Z via Flickr

Any of the quotations I use in this post will be from the book I did the majority of my research with. It has the very succinct and completely easy to remember title: "Overcoming depersonalization & feelings of unreality - A self-help guide using Cognitive Behavioural Techniques."

The Facts

Depersonalization, derealisation or dissociation are all terms for a similar phenomenon that can be triggered by intense stress or fear, and is also a symptom of many mental illnesses like depression, OCD, anxiety disorders, agoraphobia, or bipolar disorder to name a few. This is not the same as a complete loss of reality, as someone with a form of psychosis would experience, but a feeling of being separate from reality, floating above it or standing to the side of it. It is also not the same as full-blown delusions or hallucination, because the person afflicted is still aware of the fact that these happenings are abnormal. It's not something that can normally be observed from the outside, as no physical symptoms are ever really displayed.

The definition from the American handbook of Psychiatric conditions (version iv 1994) is as follows:

"An alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of one's mental processes or body (e.g. Feeling like one is in a dream)"

The idea of depersonalization has been appearing in medical books and articles since around the nineteenth century, and in fact a lot of the work done on understanding depersonalization has been done in the Maudsley Hospital in my very own London.

Extensive research has helped to debunk some misconceptions about the disorder, for example it was once thought that depersonalisation was a precursor to psychosis. However, this is not the case and while there are rare cases there is no proven correlation between the two.

It has also helped to identify some high-stress situations that would lead to something like depersonalization or a feeling of unreality, but are not necessarily indicative of other mental health problems. Bereavement, neurological conditions like migraines or epilepsy, severe stress, and even jet lag can all trigger depersonalization in some people.

How does it feel?

"To the depersonalized individual the world appears strange, peculiar, foreign, dream-like. Objects appear at times strangely diminished in size, at times flat. Sounds appear to come from a distance. The tactile characteristics of objects likewise seem strangely altered ... Patients complain that they are capable of experiencing neither pain nor pleasure; love and hate have perished with them...the climax is reached with their complaints that they have become strangers to themselves. It is as though they were dead, lifeless, automatons..."

"The world looks perfectly still like a postcard. It is standing still; there is no point in it. A bus moves along without purpose. It does not feel real. Everything in vision is dead; branches of trees are swaying without purpose."

It does not effect all people in the same way or with the same severity, and there is no one type of person that experiences depersonalization either. According to "Overcoming depersonalization..." it is experienced in equal numbers of men and women, and for most it is often first experienced in late teens or mid-twenties but can happen at any age. Some of the ways people can experience depersonalization are:
  • Robotic actions/feeling as though you're moving on autopilot
  • Feeling as though you are a spectator to your own activities
    • An "out of body" experience
  • One's own voice sounding unfamiliar
  • Inability to feel emotion
  • Intense absorption in the feeling of unreality
  • Numbness
  • One's body feeling different/wrong

I have been experiencing depersonalization in varying levels of severity for most of my life. As a child I had no idea what it was, only that sometimes I would look at a cupboard, look at a ball, or look at my own hand and couldn't remember what it was called, or what year it was, or what I even looked like, so I started to grab hold of tables and walls and anything around me that felt solid and real.
As a teen it would sometimes hurt, almost like a headache, and would crop up when I had been dealing with stresses from school/home/friendship drama all piling on top of each other. I vividly remember being in an English class at around fifteen or sixteen and doing silent work, maybe a quiz. All of a sudden my heart started racing, my chest started to hurt, I couldn't breathe, tears were pricking the corners of my eyes and everything in the room blurred. I was having a panic attack, out of nowhere, and I didn't know how to breathe through it at the time so I just stayed scared and angry until eventually I fell into this even space of depressive nothingness. I felt as though I was floating aside from my body. I looked at my hand like I had never seen it before, and it scared me.

If you have experienced anything like what I've mentioned in this post, you may be suffering from Depersonalization. It's a frightening, disorienting side-effect of really intense emotional experiences and mental illness that can be managed once you learn what it is and how to do so. In Part 2 I will address the techniques that I learned and taught myself in order to cope.

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