Depersonalization Disorder is “characterized by reoccurring episodes, of depersonalization, derealization, or both. Depersonalization is defined as feelings of “unreality of detachment from, or unfamiliarity with one’s whole self or from aspects of the self.”(Psychology 577). This disorder is very fascinating as it seems like something that can happen to all of us. Similar characteristics and notions are explored in philosophy and religion such as Friedrich Nietzsche’s Nihilism, even Buddhism with the idea of the non-self.
Thus, the main purposes of this paper is to see what makes the disorder the disorder, how it is similar and or different to Nihilism, and also the potential treatments, and lastly what we can learn from and build upon. Little Background on The Disorder and Some Backdrop to Author’s Connections and Rationale: Depersonalization is also known as derealization. This is a very interesting thing and many times it can be glossed over as one having a bad day, or just some sort of philosophical mode, as opposed to an actual psychological disorder. For example, John Lennon, in the song, Strawberry Fields Forever, uses the phrase “Nothing Is Real”, this is interesting as it shows the pop-cultural elements of breaking away from reality and some sort of detachment but not actually suffering from a disorder. This is what makes the disorder so interesting to further explore.
Psychology Today describes this as “normal to feel this way briefly and occasionally— due to side effects of medication, recreational drugs, or some other physical or mental health condition—depersonalization disorder is usually diagnosed only if such feelings of detachment frequently reoccur, cause anguish, and interfere with you quality of life.” (1). It also places this type of feeling into an episode and kind of surreal cinema type experience. This is really interesting and this is what I think is what separates form the philosophical/ religious concepts of nothingness. Definitions: Nihilism: For this paper, I am going to use the basic understanding of Friedrich Nietzsche and metaphysics that I have while elementary and more political science esque. I will define Nihilism as the state of nothing is real, and the idea that life is this dark road to an abyss, and the ultimate principle of nothingness which when embraced can encourage and lead to great things such as the Will to Power among a plethora of other notions.
Depersonalization-Derealization Disorder: There are multiple definitions, however, I believe in order to have a good since of the disorder, one must take a cohesive look and explore a few of the definitions from professionals. According to WebMD, “Depersonalization disorder is one of a group conditions called a dissociative disorder. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, consciousness, awareness, identity, and or perception. When one or more of these functions is disrupted, symptoms can result….” (1). To me this seems to be the main separating factor of this between Nihilism and a disorder as Nihilism is a controlled state in which one is consciously aware that language and other apparatuses of society are mere artificial constructs of reality. In contrast, this disorder seems to lack a conscious path to getting there. I will explore this more throughout the paper. According to the British Medical Journal, “Depersonalization is a strange, complex, and essentially private experience, one characteristic of which is the individuals’ difficulty in communicating a comprehensible account of it. A prominent feature of the experience is a feeling of change involving either or both the inner and outer worlds and carrying with it a vague but uncomfortable sense of unfamiliarity….”(378).
This article also associates other terms and definitions such as “Derealization” [which] is employed to describe the changes the environment seems to have undergone…Desomitzation describes changes in the experience of the body, individual parts which may seem enormous, tiny, telescoping, detached, hollow, without sensation, or oddly deformed. De-actualization has been used to describe a sense of loss of the capacity to feel emotion, so that a person seems unable to cry, worry, love, or hate….”(378). Lastly, another important distinction this article notes is, “But diagnosis is easier than the definition in this condition and for clinical purposes, it is sufficient to use the general term depersonalization to cover all of these phenomena which occur intermittently, always have the quality of unfamiliarity and discomfort and are recognized as changes in experience rather than in reality in itself.” (378). This is crucial to understand this disorder to see how many complex layer and different types of symptoms in encompassing.
This also is core in our understanding of why Nihilism does not qualify as a disorder, but rather a state of being and that is in my opinion the mere idea that consciousness and true reality is not questioned and also I don’t believe any physical changes occur to the body or the lack of ability to feel emotion of pleasure, hate, fear, etc., but rather diminishing the need for it. History and Discovery: This disorder was named in 1898. Eqsquiorial, Zeller, Billod, and Gissinger reported it. “The new disorder had since been explained as resulting from pathological changes in the sensory system, memory, affect, body image and self-experience.” Evolutionary psychologist Mayer- Gross expanded and contributed heavily to the disorder. (Berrios et al 1).
Evolutionary Psychology uses and draws inspiration from Charles Darwin’s Theory of Evolution to make a hypothesis about specific and certain things that may cause species to evolve, or what may tell us something about particular disorders or traits. This started with the finches in the Galapagos having different sized beaks than other finches among other geographical things. This approach helped with the disorders as one’s society and personal environmental factors can indeed serve as triggers of this disorder. What Causes the Disorder: Depersonalization and Derealization are often broken up into two categories. For the contexts of this paper, I will keep them as similar names for the disorder. “The exact cause of dissociation is unclear, but it often affects people who have experienced a life-threatening event or traumatic event, such as extreme violence, war, a kidnapping, or childhood abuse.” (Medical News Today). Some also say is an imbalance of brain chemicals.”(1). This here is similar to other psychological disorders. It can also be triggered by drugs and other substances which will be explored later. It can also be a symptom of another condition. WebMD, argues that this disorder as a standalone disorder is rare. They also state that is can be a byproduct of other disorders. (Web MD 1).
Outside Substances: Medical News Today, discusses “the use of ketamine cannabis, alcohol, and other hallucinogens as drugs that can trigger feelings of depersonalization.”(1). Ketamine: Ketamine is “categorized as a dissociative anesthetic….It can be injected, consumed in drinks, snorted, or added to joints or cigarettes.”(Drugfreeworld.org). This is also a prescription drug for certain types of depression. This drug is also marketed as a way for people to have an “out of body experience, or a K-Hole effect…Due to the detached dreamlike state it creates, where the user finds it difficult to move,…”(Drugfreeworld.org). This was interesting as it demonstrates how a prescription drug can be used to help something can also create symptoms in one that either mimic or could lead to a person actually suffering from a psychological disorder. It seems like the research is not clear on how many episodes one must have in order to be a suffer of the disorder versus just some sort of other dream-like state or feeling.
I think this will be explored in further study. Also, because the disorder by itself, only chronically exists by itself as a rare condition it will receive less notoriety and resources than other more commonly known psychological disorders. Cannabis: There are cases of symptoms of depersonalization arising from cannabis usage. In the research, by Sean P. Madden and Patrick M. Einhorn, it may help in the treatment and knowing the effects of cannabis on psychological disorders. (3-6). However, for the purposes of this research, I did not have the time to go into detail or further explore multiple studies on cannabis use. Cannabis has also traditionally been falsely blamed for many of societal ills, therefore thorough research and a different research question would be necessary in order to fully draw a conclusion as well as additional research on the subject matter. Hallucinogens: Hallucinogens are a type of drug. According to the National Institute on Drug Abuse, hallucinogens are “a diverse group of drugs that alter perception (awareness of surrounding objects and conditions), thoughts, and feeling. They cause hallucinations or sensations and images that seem real though they are not.”(1).
The Oxford Treatment Center notes, that “Numerous drugs [including hallucinogens, probably more specifically, hallucinogens], can produce sensations or feelings that one is outside of their body, being detached from oneself, being unreal, etc., which are symptoms of depersonalization; however, a dissociative disorder that is based on feelings of depersonalization cannot be diagnosed when some is under the influence of drugs or alcohol.”(1). It also notes that the American Psychological Association does not consider them to “causal in nature”, “despite them exacerbating symptoms of a dissociative disorder.”(Oxford Treatment Center 2). This was really interesting to read as drugs do not seem to be the main cause of such, but do in some ways enable one to experience these types of feelings. Other sources as mentioned in the Ketamine section of this paper have treated drugs as a leader or a vehicle to this state of being that could lead to the disorder in conjunction with other factors. Another interesting thing to explore would be the idea that the disorder could also drive people to these types of drugs. It would be interesting to see the correlation between the two.
Genetics: Genetics does not appear to play a large role in dissociative personality disorder. Prevalence: The disorder is most prevalent in people who have faced severe trauma or abuse. Mayo Clinic, also mentions other causes such as “Certain Personality traits that make you want to avoid or deny difficult situations or make it hard to adapt to difficult situations. Depression or anxiety, and recreational drug use.”(1). This makes sense as we have discussed that is a rare stand-alone disorder and therefore, it can also be symptoms of other psychological disorders. Depression and anxiety would also drive one to these feelings and consistent dwelling would lead one to an altered state of non-belonging, and a shift in consciousness induced by the depression or anxiety.
Treatment: Different sources and different professionals list similar but different methods of treatment. The Cleveland Clinic lists” Psychotherapy, cognitive-behavioral therapy, Eye movement desensitization and reprocessing, dialectic-behavior therapy, family therapy, creative therapy, meditation and relaxation, clinical hypnosis as possible treatments.”(1). For the purposes of this project, I am going to focus on Psychodynamic psychotherapy, behavior therapy, cognitive therapy, and humanistic therapy as illustrated in the textbook. Psychodynamic psychotherapy was a type of “talk therapy based on belief that the unconscious and childhood conflicts impact behavior.” (609). This therapy would make since as there are thoughts repressed and many believe that this disorder has origins in childhood and based on the experience of trauma by talking one can learn more about that and proscribe different methods in dealing with that to help one psyche. Behavior therapy deals with lifestyle changes and how behavior influences consciousness and the mind.
Cognitive-behavioral therapy deals with one’s perceptions and ideas to help one improve their thoughts and to explore some of the causes of these problems. These are all type of therapy type, positive psychological approaches for treating such as there is no one particular clear-cut cookie-cutter type disorder or treatment to prescribe. Cognitive Behavioral Therapy, for instance, “teaches people how to practice and engage in more positive and healthy approaches to daily situations. In total, hundreds of studies have shown the effectiveness of treating psychological disorders.”(615). This is very important to see evidence of these different treatment methods working and also would be interesting to further explore each of them and their direct correlation with depersonalization disorder. However one also has to remember that this disorder is very rare, in its standalone manner, and therefore they may not be enough data to further correlate such. Thus, this serves as a preliminary analysis of the various treatment methods available and would indeed warrant further research and future consideration.
Medication: Medication is controversial in relation to this disorder. MedicalNewsToday, stated in a 2013 Review, that “ doctors may prescribe a combination of medications specifically lamotrigine (Lamitical), selective serotonin reuptake inhibitors (SSRIs) and other drugs.”(1). According to the Cleveland Clinic, “There is no medication to treat dissociative disorder themselves. However, people with dissociative disorders especially those associated with depression and/or anxiety may benefit from treatment with antidepressant or anti-anxiety medications. (1). Conclusion/ Further Considerations: Thus, the disorder is really interesting as it really connects to the meaning of the self. It was interesting to me to see the fine line between a positive philosophical/ religious experience to a psychological disorder. One really interesting thing to me was, “Dr. Elena Bezzubba, a Russian psychoanalyst who treats people with depersonalization in California, call it a painful absence of feeling. “A mother comes to me and says ‘My son is in prison, I received a letter from him. I do not care, but it bothers me. Please prescribe me something to cry.”( Lofthouse 2). This was really fascinating to me and demonstrates how the disorder takes over and some of the importance of studying. Throughout this project I have learned so much about what this disorder is, how much we still do not know, the different types of treatment, the effects of drugs on the human body, and the interesting paradox of the disorder itself that being how some seek similar characteristics of such, but the scientific community is unsure what exact effect it has on the likelihood of one suffering from the disorder.
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