Concept of Depersonalization – This book covers the entire syllabus of “Psychiatric Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics. This book is an examination-friendly setup according to the teachers’ lectures and examination questions.
At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.
Concept of Depersonalization
Alteration in the perception or experience of oneself, so that the self is felt to be unreal, sufferers will have persistent or recurring feeling of being detached from reality or one’s body or world or mental processes and by a feeling of being an outside observer of one’s life.
Depersonalization is most often described as a symptom of emotions. For example, fear, panic, DSM-IV categorizes depersonalization as a dissociative disorder’. Depersonalization and ‘derealization’ are the two terms used interchangeably, however derealization means, ‘nothing is real’. It may be an indicative of neurological disorder.
Causes:
Depersonalization can happen to anyone, but theyare most prominent in people suffering from:
1. Psychological trauma
2. Panic disorders
3. Clinical depression
4. Bipolar disorder
5. Symptoms of borderline personality disorders
6. Some epileptic conditions, e.g. temporal lobe epilepsy
7. Side effect of certain drugs, e.g. hallucinogens
8. Overdose of stimulants, e.g. caffeine, nicotine, alcoholic beverages etc. can induce depersonalization effect
9. Post-traumatic stress disorder
10. Withdrawal symptom from many drugs
11. Hypochondriasis
12. Neurological diseases, e.g. Alzheimer’s disease, multiple sclerosis, lyme disease (neuro borreliosis)
13. Early schizophrenia
14. Occurs after life threatening dangers, e.g. accident, assault, serious illness or injury
Symptoms
1 . Feels isolated both from their own body and external world
2. Sufferers feels like a movie or things seen ‘unreal’ or ‘hazy’
3. Recognitions of self-breaks down
4. Feel as though, life is a dream or an illusion
5. Increases the feelings of ‘fakeness’, ‘feedback loop’ that amplifies itself or feeling like a ‘ghost’
6. Clients may have difficulty fully comprehending what they hear and see
7. Feeling a sense of vertigo or detachment, anxiety, depression, lack of meaning, lack of joy and general apathy
8. Distorted perception of their identity, body and life that makes them uncomfortable
9. History-special interview will be conducted on basis of symptoms
10. Physical examination to rule out any physical disorder
11. Carryout psychological tests (to assess intellectual levels and emotional status of ar individual).
Treatment
Depersonalization will often disappear without treatment. If disease persists, recurs or cause; distress then treatment will be planned.
1. Based on underlying causes treatment will be given on individual basis.
2. Drug therapy-based on manifestation the following drugs will be prescribed. Antianxiety drugs (benzodiazepine-xanex; antidepressants (SSRI and TCA, MAOI); antipsychotics (gabapentin or olanzapine or risperidal); sedative
3. Psychodynamic psychotherapy
4. Behaviour therapy
5. Hypnosis
6. Drug therapy-sedatives and antidepressants may help some people
7. Any stress associated with onset of depersonalization, is treated promptly
[Ref: KP Neeraja/1/Vol-2/427-28/]
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