Depersonalization and sensitivity to fluorescent lighting: Have other trans people experienced this?

As a teenager, I was often profoundly uncomfortable with the fluorescent lights used in schools, businesses, and other settings. From age 13 onward, it was impossible for me not to notice the unnerving light and color they cast onto everything, making it all seem strange and distant. Classrooms were bathed in unnatural white light, and it was almost like they kept me in a kind of muted trance the entire time I was there – it seemed impossible to concentrate. The Wal-Mart was oddly dim and pale, yet somehow suffused with this light, and being in the store felt like being in a kind of dream. And the somewhat more subtle lighting at Target just made it seem as though it was full of uncomfortably large open spaces.

For a long time, I assumed this was just some weird personal hangup or quirk: many people seem to dislike fluorescent lighting, and I figured I happened to be at the extreme end of that. But it turns out that these particularly noticeable and unpleasant feelings of everything being distant and unreal – more than just a mere distaste for certain lights – are part of a known phenomenon.

Fluorescent lighting has long been known as an environmental trigger that can quickly produce a worsening of depersonalization symptoms in sufferers of depersonalization/derealization disorder, a condition of chronic feelings of unreality and separation from your sense of self, your emotions, and the world. I experienced chronic depersonalization throughout my life, and by far my worst and most intense symptoms began during the first signs of puberty around age 13; depersonalization disorder most often appears or worsens in adolescence (Medford, 2012). Similarly, my teenage years featured the clearest instances of these attacks of depersonalization and derealization in settings with fluorescent lights.

Simeon & Abugel (2006) provided an example of how these feelings of unreality may be experienced:

It’s all just there and it’s all strange somehow. I see everything through a fog. Fluorescent lights intensify the horrible sensation and cast a deep veil over everything. I’m sealed in plastic wrap, closed off, almost deaf in the muted silence. It is as if the world were made of cellophane or glass.

The authors go on to explore the role that fluorescent lighting can play in triggering depersonalization attacks, and its potential connections to general sensory and perceptual sensitivities in sufferers:

Why does fluorescent lighting exacerbate depersonalization? The short answer is that we do not know, yet this effect is terribly common for those with DPD. We discussed lighting above when talking about the sleep-wake cycle in depersonalization. Alternatively, depersonalized individuals are known to be unusually sensitive to all kinds of perceptual overstimulation (noise, crowds, busy streets, computer screens overloaded with information, new and unfamiliar environments, and even perceptually challenging cognitive tests), and the vulnerability to fluorescent lights could have something to do with this kind of perceptual overstimulation. A PET imaging study has documented that people with DPD have changes in brain activity in the sensory association areas of the temporal, occipital, and parietal cortex, which are responsible for processing and integrating incoming sensory stimuli.

Similarly, the DSM-5 description of depersonalization/derealization disorder makes note of environmental factors which can worsen these symptoms, including lighting conditions (American Psychiatric Association, 2013):

Internal and external factors that affect symptom intensity vary between individuals, yet some typical patterns are reported. Exacerbations can be triggered by stress, worsening mood or anxiety symptoms, novel or overstimulating settings, and physical factors such as lighting or lack of sleep.

Simeon et al. (1997), Abugel (2011), and Hunter (2013) also mention fluorescent lighting or “bright or artificial lights” as a potential trigger for attacks of these symptoms in individuals with chronic depersonalization. In a study of 204 people with depersonalization, Baker et al. (2003) found that many reported fluorescent lights as one of several “factors known to worsen” the condition. And in another study of 117 sufferers (Simeon et al., 2003), “bright/fluorescent lights” were commonly listed as an exacerbating factor, while “bright light/sunshine” was reported to be an alleviating factor.

For me, the frequency of these light-triggered symptoms diminished somewhat in my late teens, and once I started transitioning with HRT at 23, my broader depersonalization abated almost entirely – this condition is notably much more common in trans people, and is often relieved after transition. There are still occasional instances where I’ll notice I’m feeling a bit off in a place with fluorescent lights, like a near-deserted Wal-Mart at 4 in the morning with tinny repetitive music playing over the speakers. But it’s much less common now, and much more easy to tolerate.

So: Have other trans people with depersonalization symptoms experienced noticeable attacks in settings with fluorescent lights? Just how common is this among us? I’d like to hear about how these symptoms manifested in others who’ve had these particular reactions to this trigger. Let’s gather some reports. ■