The nature and impact of depersonalization
Depersonalization is a dissociative symptom that encompasses certain feelings and experiences of oneself or the world as “unreal”. While the perception of reality remains intact, it is subjectively felt to take on a distinct character of flatness or lifelessness. The world is experienced as having a “dreamlike” quality, blunted and drained of vividness, and separated from oneself as if by a skin, veil, glass, or fog (symptoms collectively known as derealization). A sense of distance from one’s emotions is a core feature of depersonalization: sufferers are aware of their feelings, but may not experience them as “real” (emotional numbing – “I know I have feelings but I don’t feel them”). They may describe themselves as emotionally “dead” or feeling like a “zombie”, and perceive themselves as having a lack of agency in their own lives. There is a feeling of existing as a detached observer of one’s own thoughts, emotions, and actions, with a sense of “going through the motions” of life (detachment from self). For some, this is perceived as a kind of disembodiment, such as a feeling of seeing oneself externally in a kind of “out-of-body” experience (anomalous body experience) (American Psychiatric Association, 2013; Steinberg, Cicchetti, Buchanan, Hall, & Rounsaville, 1993; Sierra & David, 2011).
These feelings and sensations are noted to be particularly difficult to describe or convey to others; this fundamental alteration in the “texture” of conscious experience can generally be explained only by metaphors or “as if” statements. Some may not necessarily realize that they are experiencing a distinct and genuine symptom, believing that this is simply the normal feeling of life. For many, they’ve never experienced anything else.
This is not an innocuous condition. Sufferers find depersonalization to be highly distressing, not in spite of their alienation from their emotions, but because of their alienation from their emotions: “the distress is described as arising from the unpleasantness of the depersonalization experience itself” (Medford, 2012). The pervasive sense of disengagement from one’s life can result in what might be expected from perpetually feeling that life has little purpose. Those who experience depersonalization have elevated rates of depression, anxiety, and social and occupational impairment: they may feel that there is no point to career or academic pursuits. They are more likely to be unemployed, more often single, and more likely to live with their parents (Michal et al., 2016). Students with depersonalization show greater rates of academic underachievement and unhealthy avoidant coping strategies (Michal et al., 2015). Most worryingly, sufferers of depersonalization show a highly increased rate of suicidal ideation, active suicidal desire, suicide planning, and previous suicide attempts (Michal et al., 2010; Tosić-Golubović, Žikić, Slavković, Nikolić, & Simonović, 2017).
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By Heather McNamara
