Understanding and treating depersonalisation disorder

Abstract

Depersonalisation disorder involves an unpleasant, chronic and disabling alteration in the experience of self and environment. In addition to these classic features of depersonalisation and derealisation, symptoms may also encompass alterations in bodily sensation and a loss of emotional reactivity. Primary depersonalisation disorder is probably more common than previously thought, and here we discuss the diagnosis, assessment and treatment of the condition, with particular reference to our experiences in a specialist depersonalisation clinic. We also consider psychological and biological aspects of the condition. Although there is as yet no recognised treatment for this disorder, various pharmacological interventions, particularly a combination of lamotrigine and a selective serotonin reuptake inhibitor, have shown promise. We discuss these drug treatments, together with psychological approaches, in particular a recent cognitive–behavioural conceptualisation and treatment approach.

Postpartum Onset Depersonalization- a Rare Case Report

“…He advocated treatment aimed at psycho-education. 2 Similarly, our patient managed by self psycho-educating on neuro-psycho-pathological basis that her symptoms are body reactions to child birth which is itself a traumatic experience (stress) along with practice of Yoga 'pranayama' -'Om' chanting and 'Brahmri' and with 3 to 4weeks there was complete resolution of the symptoms. Although, this is a single rare case report but it definitely paves way for identification of primary depersonalization in post partum period.…”

“…1 It has been emphasized as a persistent, pervasive phenomenon, causing subjective distress and functional impairment. 2 Some literature points out women are more commonly affected as compared to men whereas others have mentioned it affects both gender equally. 2,3 Proportion of individual in which depersonalization occurs primarily or in isolated form is minimal.…”

“…2 Some literature points out women are more commonly affected as compared to men whereas others have mentioned it affects both gender equally. 2,3 Proportion of individual in which depersonalization occurs primarily or in isolated form is minimal. 2 Further, studies have demonstrated inconsistent evidence for efficacy of both psychotropic and psychological intervention in management of depersonalization disorder.…”

“…2,3 Proportion of individual in which depersonalization occurs primarily or in isolated form is minimal. 2 Further, studies have demonstrated inconsistent evidence for efficacy of both psychotropic and psychological intervention in management of depersonalization disorder. 3 It seems this postpartum case with primary depersonalization which was effectively managed with psycho-education and Yoga is first to be reported.…”

Dissociative Experience and Cultural Neuroscience: Narrative, Metaphor and Mechanism

“…However, depersonalization has been found to be among the top three most common psychiatric symptoms in clinical populations and Depersonalization Disorder has become an increasingly common diagnosis in recent years. Depersonalization has also been the focus of a number of neurobiological studies (Baker et al 2003;Medford et al 2005;Simeon et al 2000Simeon et al , 2004. These studies have lent support to a 'cortico-limbic' model (Sierra and Berrios 1998) in which inhibitory activity in the prefrontal cortex disrupts the "emotional tagging" of perceptual and cognitive material by the amygdala and related structures.…”