Depersonalization Disorder Overview
Δε μετεφρασα το κειμενο γιατι ειναι μεγαλο και θα εχανε και καποια απο την αξια του σαν κειμενο, αλλα ειναι αρκετα ευκολο και κατανοητο αρκει καποιος να γνωριζει βασικα Αγγλικα εστω και να ξερει οτι "Depersonalization" ειναι η αποπροσωποιηση.
Depersonalization : A frightening and/or disturbing experience of not being within one's own body or of being in immediate danger of vanishing/separating from reality – often described as the sensation of living inside a dream. Although cognitive functioning remains intact, the sufferers feel disconnected from their sense of self and often interpret it “as if I am losing my mind.”
“ My hands feel like they're made of paper, or like they belong to someone else.” “My own face in a mirror seems foreign, like I have never really seen it before this moment…” “I cannot feel my body, not truly numb, but it is as if I have disappeared into myself, beyond my own flesh and blood…”
“Sometimes I literally wonder if I am already dead and existing as a ghost…it feels like my soul is trying to leave its shell and I am fighting with all my strength to hold it inside this body. I don't know if I'm dreaming or awake; I must be going insane…to feel my self wafting away…I know it is only a matter of time…”
Derealization : A state of consciousness that creates a sense of detachment from all environments, fogginess, as if a plate of glass is in between the mind and the physical world. Any concentration requires tremendous effort, and the harder the sufferer tries to focus, the more disconnected they become. Often including feelings of déjà vu or jamais vu. Familiar places look alien, bizarre, and surreal – as if they are part of a Salvador Dali painting. In fact, the more familiar the surrounding, the more foreign it seems to be.
“In a split second, the world seems to tilt. I am suddenly a stranger in my own neighborhood.” “Reality seems to vanish, or is closing in, as if the literally edge of the world is right beyond the horizon.” “Everything looks ‘off,' like it turned into a stage set or fake replica of how it should really look…” “The world looks like I'm dreaming, or like I have unwittingly taken LSD…”
Depersonalization and Derealization involve similar consciousness states, although psychiatric literature discusses them as two different symptoms. The major distinction is that the first is a distorted awareness of self, while the second is a distorted perception of the physical environment. Often patients experience both, simultaneously or alternately. These states of mind are accompanied by an obsessive need to self-monitor, to observe the self moment by moment. The sufferers describe an inability to experience their own lives while stuck in chronic self-observation (also feeling that identity is disappearing, or has already vanished).
Usually, but not exclusively, these altered states include debilitating anxiety and overwhelming preoccupation that a total loss of reality is only moments away. There may be pervasive beliefs of literally “willing oneself” to remain sane, along with a morbid fear of (and resisted wish for) total surrender to what seems to be an impending psychosis. Over time, the patients believe they are losing more of the self, and while actual reality-testing remains intact, the feeling of reality diminishes. There are increasing doubts about the actual existence of an external reality and the sufferers often harbor secret thoughts that they have only conjured up the world and their own being. Bizarre ideas may include a notion of being the only person in the world, or of existing merely as a thought without a body. Thoughts can develop about being the singular author/director/producer of one's perceived existence (as is true in a night dream). Such ideas often lead to overwhelming ruminations on the nature of being human. The result is increased withdrawal into one's own mind, which encourages social isolation and enhances the feeling of alienation.
Trying to Tell Others
Rarely are patients able (or willing) to accurately describe their symptom states. Although desperately wanting to be understood, they fear being labeled insane, and fully realize that other people would find their ideas irrational and disturbing. Even when seeking professional help, patients often call their fears and thoughts “anxiety” or “panic” or “depression” in efforts to sound less bizarre. Physicians, accustomed to hearing those symptoms, may then prescribe medication to minimize the reported anxiety or depression.
Anti-anxiety and/or anti-depressant medications often reduce the experience of unreality by reducing obsessive thinking and incapacitating fears, but may not completely eliminate depersonalization and derealization states. Further efforts by patients to describe their increasing detachment may motivate the doctor to increase medication in an effort to reduce what sounds like a rapidly growing depression.
Anxiety disorders and depressive states often co-exist with depersonalization states. Feelings of unreality may begin with a panic attack or disturbing recreational drug trip. The result may be intense self-monitoring of all thoughts, emotions and bodily sensations – soon creating anticipatory anxiety that evolves into social phobia. In time, the sufferers may feel they are living with an overwhelming and pervasive fear of fear.
Intense states of unreality also exist without any experience of anxiety or noticeable depression. These patients experience only an emotional deadness, and complain of being unable to feel their own emotions while retaining awareness of what they should, or would feel if they could only re-connect to a sense of self. They may report that they know they deeply love someone, but lack any access to their own emotional responsiveness and are unable to enjoy any experience. Reality continues to be “one step removed” from their sensory life, and in its place grows a barren terrain that is “two dimensional” or “flat” – “as if everything I experience is really happening to somebody else.”
Normal Dissociation
Feelings of unreality are also experienced in ordinary people under extraordinary and/or traumatic circumstances – both good and bad – severe car accidents, being victimized by a violent crime, or suddenly winning a million dollar lottery. When the reality of a situation seems so incongruous to the reality of the moment occurring before, the mind may create a dissociative reaction in efforts to maintain reality's status quo. Under extreme conditions, it is the result of a normal function of a human brain with at least a mild predisposition towards altered states of unconsciousness.
But to the depersonalization/derealization sufferer, it seems there was no provocation for this bizarre state of mind. In actuality, the brain is often reacting in response to thoughts that exist outside conscious awareness – thoughts that were perceived as potentially threatening to the self's status quo. In such cases, the mind dissociates as a form of protection – without any discernible trauma or shocking event as motivation. The “danger” was internal, and the potential assault was against self-identity, not the physical body.
Over time (and reinforced by obsessing over the original experience) the mind seems to develop a habit of re-invoking the symptom/neurological reaction. The patients usually become convinced that the way out of their nightmare lies in focusing more and more inward, relentlessly self-observing for any sign of returning reality. But like a child's straw finger puzzle, the harder one tries to pull free, the tighter grows the trap.
Relief
Patients must strive for experiences that allow them to re-engage as actors in the drama of their own lives rather than clutching fearfully to the role of observer. Cognitive-behavioral therapy can help sufferers to modify their conscious thinking patterns and reinstate spontaneity of feeling and thought.
Psychodyamic and analtyic-oriented therapies provide opportunities for bringing unacknowledged thoughts into conscious awareness, removing the need for defensive dissociation. But many of these sufferers have difficulty enduring any treatment that must temporarily increase anxiety and require exploration of the unknown. Frequently, depersonalization patients are terrified of experiencing anything unless they know what's coming beforehand, and their anxiety may have originated from desperate efforts at self-control and unrealistic preparedness. As such, psychoanalytic therapies may be highly challenging, but the potential for permanent change is great. Recovery is possible as patients find a way to trust themselves to handle life's experiences and their own unpredictable emotions – rather than anticipating or avoiding them. As each individual is unique, recovery from mental symptoms is a unique process. The continued pursuit of appropriate treatment will likely be rewarded.
It is important to remember that the frightening experience of being lost inside one's own mind is purely a feeling state and (once any neurological or systemic dysfunction has been ruled out) there is no reason to believe any permanent change has occurred within the brain itself. While in the midst of the illness, it seems impossible to believe that the ‘normal' self is still intact. But these are feelings as if reality does not exist – or as if the self/identity has perished. We know better – we just cannot feel what we know. Reality has not actually been lost – it is only the ability to experience it that is temporarily beyond reach. The same cognitive clarity that allows us to realize that the world itself has not actually changed is the same cognitive strength that will allow for complete recovery.
Μεσα σε αυτο το τριμηνο που εμφανιστηκαν οι κρισεις πανικου (που ευτυχως υποχωρησαν), αγχος,καταθλιψη εχω νιωσει ετσι αυτο το συναισθημα εντονα καποιες φορες. Τωρα παλι τελευταια το νιωθω παλι εδω και 3 μερες συνεχομενα (πρωτη φορα κραταει τοσο) αλλα οχι στο τοσο πολυ, δλδ. δε νιωθω σαν να τα βλεπω απο ενα πεπλο και θολουρα κτλ. Αλλα κυριως σαν σκεψη και ελαφροτερα σε συναισθημα. Νιωθω λιγοτερο ζωντανος, δε με αγγιζουν τοσο τα πραγματα και ο κοσμος γυρω μοΥ οσο πριν. Νιωθω αρκετα περιεργα που μου ειναι δυσκολο να περιγραψω να βρω ακριβως τις λεξεις (λες και αναρωτιεσαι αν ειναι αληθινα τα πραγματα γυρω σου η απλα ετσι τα αντιλαμβανεσαι, και να νιωθεις οτι μπορει να αποκοπεις απο τη πραγματικοτητα φοβος μαλλον γιαυτο λογο του πως νιωθεις) αλλα απο το κειμενο αυτο καταλαβαινω οτι σιγουρα ειναι αυτο. Οπως γραφει και το κειμενο, η αποπροσωποιηση ειναι και συμπτωμα πολλων ψυχικων διαταραχων, οπως αγχωδης διαταραχη,καταθλιψη κτλ. Επειδη ποτε δεν ενιωσα ετσι χωρις να ειναι περιοδος αγχους η με καταθλιψη, πιστευω εγω οτι ειναι λογω της καταθλιψης, γιατι απο αγχος δεν εχω τοσο πια. Οπως και να χει θα μιλησω με τον ειδικο που παω στο τηλ. τη Δευτερα και ενω εχουμε ραντεβου Παρασκευη θα του πω για πιο νωρις και θα του μιλησω τελειως ανοιχτα. Λεω τελειως ανοιχτα γιατι εκανα το λαθος που τωρα συνειδητοποιησα μεσα απο μια κουβεντα με καποιο ατομο απο εδω, οτι καλυπτα τα πιο "σοβαρα" πραγματα που ενιωθα δλδ. απλα τα παρουσιαζα σαν λιγοτερης βαρυτητας και οτι τωρα νιωθω καλυτερα ομως. Επισης κυριως ελεγα για τις μερες και ωρες που ενιωθα καλα και ετσι δημιουργουνταν η εικονα οτι λιγες φορες δε νιωθω καλα και κλαιω κτλ. Αυτο λαθος μου μεγαλο αλλα το εκανα γιατι πολλες φορες φοβομουν απο το υφος του επειδη τον βλπεω παντα σοβαρο κ ετσι μην απαληθευτει κανας φοβος μου σε κατι π φοβομουν μην εχω η και μην χρειαστει φαρμακα κυριως για τους δικους μου και πως θα το παρουν. Τελος παντων για να μη πολυλογω, θα παω και θα του τα πω οπως εχει ακριβως χωρις να τα ελαφρυνω η οτι νιωθω καλα. Οτι υπαρχουν στιγμες που νιωθω καλα υπαρχουν αλλα δεν ειναι οτι νιωθω καλα οπως πριν, αλλα καλυτερα απο τις φορες μου ηταν σκατα. Επισης εχω βρει και εναν ψυχολογο στον οποιο θα τηλ. απο Δευτερα και απλα ελπιζω οι δικοι μου να μην το ριξουν αλλου και να καταλαβουν οτι το χρειαζομαι. Γιατι πραγματικα το χρειαζομαι δε μπορω αλλο αυτη τη κατασταση και ειδικα τωρα που νιωθω ετσι τις τελευταιες 3 μερες ειναι παρα μα παρα πολυ περιεργο το αισθημα σαν να αμφισβητεις πραγματα δεδομενα στο μυαλο σου και παροτι το παλευω δεν αλλαζει να περασει αυτο... Αυτα ελπιζω να μην επρηξα πολυ κανεναν που το διαβασε και θελω γνωμες για τον αν ειναι να αλλαξω ειδικο η να παω και καπου αλλου απλα να παρω και δευτερη γνωμη. Κανεις με καταθλιψη,αγψωδη διαταραχη η οτιδηποτε αλλο, εχει νιωσει αυτο το απαισιο και ενοχλητικο αισθημα? Και αν ναι πως και για ποσο καιρο? Γιατι στον καθενα ειναι και λιγο διαφορετικα..
