Definition of depersonalization and derealization disorder – The Modern York Times

Barrie Miskin was newly pregnant when she noticed her appearance was changing. Shadowy spots appeared on her skin like watercolor ink. A “thickness” of hair had grown on her upper lip and chin.

The outside world was changing, too: in her Astoria neighborhood in Queens, glowing lights haloed objects, blurring her vision. Co-workers and even her doctors began to seem like “alien stand-ins” for themselves, Ms. Miskin, 46, said.

“I felt like I was looking at the world through a sheet of sullied glass,” she added. However, Mrs. Miskin knew it was all an illusion, so she sought support.

Consultations with mental health professionals continued for over a year before Ms. Miskin finally found an explanation for her symptoms: she was diagnosed with dissociative state called depersonalization/derealization disorder, or DDD. Before her pregnancy, Ms. Miskin stopped taking antidepressants. Her novel psychiatrist concluded that her symptoms may have been caused by the months of untreated depression that followed.

Although Mrs. Miskin felt alone in her mysterious illness, she was not. Dozens thousands With posts ON social media reference depersonalization or derealizationsome compare this state to “living in a movie or a dream” or “observing the world through a fog.”

People who experience depersonalization may feel as if they are disconnected from their mind and body. Derealization, on the other hand, refers to a feeling of detachment from one’s surroundings, as if people and things in the world were unreal.

People suffering from DDD are “painfully aware” that something is wrong, says Elena Bezzubova, a psychoanalyst who specializes in treating the condition. It’s like seeing an apple and feeling that it’s so strange that it doesn’t seem real, even though you know it is, she added.

This disorder is believed to occur in approx 1 to 2 percent population, but it is possible experience anyone transient symptoms.

Mental health professionals have sometimes dismissed DDD as a separate diagnosis not only because of a lack of knowledge about the disorder, but also because its symptoms overlap with conditions such as depression, anxiety, or panic disorder.

As novel research has emerged, it has become more widely recognized and discussed. The second edition of “Feeling Unreal,” a DDD textbook originally published in 2006, was released in 2023. Last June, Ms. Miskin published a memoir on the subject titled “Hell Gate Bridge.” In the same month, the novel “Please Stop Trying to Leave Me” was published, in which the main character is DDD. Author Alana Saab knows this disorder well: she was diagnosed several years ago.

“I imagine this is what a drug journey would be like,” she said of her experience with the disorder. “But it’s two in the afternoon and I’m completely sober.”

The Cambridge Depersonalization Scale is widely considered the most reliable measure of the disorder. Patients are asked to rate how often and for how long 29 different experiences occur. Examples include feeling like a “robot”, losing bodily sensations such as hunger or thirst, and seeing a world that now looks “flat” or “lifeless” like a painting.

People with DDD may feel disconnected from themselves and their surroundings for months or even years. Less commonly, they may also experience auditory distortions – such as sounds that become muffled or louder.

DDD is often associated with: a history of emotional abuse or neglect. Symptoms can be caused by anxiety, depression, re-emergence of early trauma, major stressors, cannabis and hallucinogenic drugs such as LSD, according to Dr. Daphne Simeon, an expert in the disorder and co-author of the book “Feeling Unreal.”

For some people, there may be multiple triggers, especially if there is an underlying tendency to dissociate.

“You might meet someone whose first episode was triggered by panic, then it happened again when they became depressed, and then the third time was when they went through a terrible divorce,” Dr. Simeon says.

Researchers have hypothesized that depersonalization/derealization may be part of the mind’s defense system.

“Your body and mind are telling you something,” Dr. Simeon added. “Basically, you have an unbearable experience that you need to distance yourself from.”

Jeffrey Abugel, co-author of Dr. Simeon’s “Feeling Unreal,” struggled with DDD for over a decade before he was finally diagnosed. He knows exactly where it came from: “Pot, plain and basic,” he said. The drug pushed him “over the edge,” he added, causing a “massive panic attack.”

Mr. Abugel, a health and wellness coach, finally found support. Currently offering private consultations and virtual support groups for people with this disorder.

Ms Miskin’s symptoms improved with a combination of psychotherapy and medication. She restarted her antidepressant and started taking lamotrigine, or Lamictal, a drug best known for treating seizures and bipolar disorder.

Recovery was a painful process.

“You have to learn to live in the world again,” she said, even though “you just want to lie in bed, pull the covers over your head and never come out.”