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  • Writer's pictureDr Heather Dyson

When I am not here, not me, and not real

When I am not here, not me, and not real: Differentiating Dissociation, Depersonalisation, and Derealisation.

The human mind is an intricate and complicated entity, capable of experiencing a myriad of emotions and perceptions. However, at times, it can also undergo unique psychological experiences that deviate from the usual flow of consciousness. Three such phenomena are dissociation, depersonalisation, and derealisation. Often mistaken for one another, these experiences possess distinct characteristics and impacts on an individual's mental well-being. In this blog post, we will delve into the depths of dissociation, depersonalisation, and derealisation, seeking to understand their differences, causes, and effects.

Dissociation (I’m not here) Dissociation refers to a psychological state in which an individual detaches or disconnects from their surroundings, thoughts, feelings, or memories. It can manifest as a coping mechanism in response to overwhelming stress, trauma, or psychological distress. In some cases, it serves as a protective shield for the mind, enabling it to distance itself from distressing situations.

Dissociation may present itself in various forms, such as dissociative amnesia, dissociative identity disorder (formerly known as multiple personality disorder), and dissociative fugue. The severity of dissociative experiences can vary significantly, from mild episodes of zoning out to more profound, dissociative states.

Dissociation is not uncommon and can happen to people from all walks of life. However, when dissociative experiences become chronic, severe, or interfere with daily functioning, it is crucial to seek professional help. Mental health professionals, such as psychologists and psychiatrists, can provide accurate diagnosis, support, and appropriate treatment for individuals experiencing dissociation. Therapies like cognitive-behavioural therapy (CBT) and dialectical behaviour therapy (DBT) have shown effectiveness in helping individuals manage dissociative symptoms and improve overall mental well-being. Depersonalisation (I’m not me) Depersonalisation is a specific type of dissociative experience characterised by a sense of detachment or estrangement from oneself. Individuals experiencing depersonalisation often feel as though they are observing themselves from an external perspective, leading to a disconnection between their thoughts, emotions, and physical sensations.

The sensation of "unreality" in depersonalisation can be distressing and may lead to heightened anxiety. Sufferers might question their identity, sense of self, and even reality itself. Depersonalisation is commonly associated with anxiety disorders, trauma, and substance abuse.

Some common features of depersonalisation include:

1. Emotional Numbness: Individuals experiencing depersonalisation may feel emotionally detached or numb, as if their emotions are muted or distant.

2. Self-Perception Changes: They may have a distorted or altered perception of themselves, their identity, or their body, sometimes feeling like they are living in a dream or in a fog.

3. Distorted Time Perception: Time may seem to pass slowly or quickly, contributing to the feeling of disconnection from reality.

4. Sensory Changes: People with depersonalisation may experience changes in sensory perception, such as feeling like the world is colourless or lacking in detail.

Depersonalisation can be a distressing experience, and individuals may worry that they are losing touch with reality. It is important to note that depersonalisation is a symptom rather than a disorder in itself. It can occur in various mental health conditions, such as anxiety disorders, post-traumatic stress disorder (PTSD), depression, and dissociative disorders. Common triggers for depersonalisation include stress, trauma, substance abuse, and anxiety. In some cases, it may be the mind's way of coping with overwhelming emotions or traumatic events.

Although depersonalisation can be temporary and resolve on its own, when it becomes chronic or significantly impairs daily functioning, seeking professional help is crucial. Mental health professionals can assess the underlying causes and provide appropriate treatment, such as therapy (e.g., cognitive-behavioural therapy) and support tailored to the individual's needs. With proper intervention, many people can learn to manage depersonalisation and improve their overall well-being.

Derealisation (I’m not real) Unlike depersonalisation, derealisation involves a sense of detachment from the external world. Those experiencing derealisation may perceive their surroundings as unfamiliar, dreamlike, or artificial. Colours may appear more vivid or faded, and the environment may seem distorted or distorted in some way.

Individuals undergoing derealisation often struggle to connect emotionally with their environment, leading to a feeling of disconnection from reality. Like depersonalisation, derealisation can also stem from traumatic experiences, anxiety, or certain medical conditions.

Some common features of derealisation include:

1. Altered Perception: Objects, people, or the environment may appear distorted, surreal, or unfamiliar, as if they are part of a movie or a dream.

2. Emotional Numbness: Similar to depersonalisation, individuals with derealisation may also feel emotionally detached or numb, with their surroundings lacking emotional significance.

3. Time Distortion: Time may seem to pass slowly or quickly, contributing to the sense of unreality.

4. Disconnected from Surroundings: People with derealisation may struggle to emotionally connect with their environment, leading to a feeling of isolation.

Derealisation can be distressing and can lead to heightened anxiety, as individuals may question the authenticity of their experiences and surroundings. Like depersonalisation, derealisation is a symptom and can occur in various mental health conditions, such as anxiety disorders, trauma-related disorders, depression, and dissociative disorders. Derealisation can be triggered by stress, anxiety, trauma, sleep deprivation, or substance use, among other factors. It may also occur as a coping mechanism in response to overwhelming situations or emotional distress.

As with depersonalisation, derealisation may be transient and resolve on its own. However, if derealisation becomes chronic or significantly impairs a person's daily functioning, seeking professional help is essential. Mental health professionals can assess the underlying causes and provide appropriate treatment, such as therapy and support tailored to the individual's needs. Managing derealisation often involves addressing the underlying mental health condition and developing coping strategies to reduce stress and anxiety. With the right support and intervention, many individuals can learn to manage derealisation and improve their overall well-being. The Overlap and Comorbidity: While dissociation, depersonalisation, and derealisation are distinct psychological experiences, they can often overlap and coexist. Many individuals who encounter one of these phenomena may also experience the others to varying degrees. These overlapping symptoms can make it challenging to pinpoint the specific type of dissociative experience, necessitating careful evaluation by mental health professionals.

Causes and Triggers: The origins of dissociation, depersonalisation, and derealisation are rooted in a combination of psychological, environmental, and biological factors. Some common triggers include:

  1. Trauma: Experiencing or witnessing traumatic events can overwhelm the mind's ability to process emotions, leading to dissociative responses as a way to cope with distress.

  2. Anxiety and Stress: Prolonged periods of stress or anxiety can contribute to dissociative experiences, especially depersonalisation and derealisation.

  3. Substance Abuse: Certain drugs and substances can induce dissociative states, leading to short-term or even long-term effects on an individual's mental state.

  4. Personality Disorders: Dissociation is frequently associated with certain personality disorders, such as borderline personality disorder and dissociative identity disorder.

Psychological Impact: Dissociation, depersonalisation, and derealisation can have significant effects on an individual's mental health and well-being. Some of the potential psychological impacts include:

  1. Increased Anxiety and Depression: The feelings of detachment and disconnection can exacerbate existing anxiety and depression, making it challenging to engage with everyday life.

  2. Impaired Memory and Concentration: Dissociative experiences might interfere with an individual's ability to concentrate and recall information, affecting work or academic performance.

  3. Identity Confusion: Depersonalisation can lead to a profound questioning of one's identity and self-concept, causing distress and confusion.

  4. Social Isolation: Struggling with dissociation may lead to social withdrawal as individuals may feel disconnected or alienated from others.

Seeking Help and Treatment: If you or someone you know is experiencing dissociation, depersonalisation, or derealisation, seeking professional help is important. A mental health professional, such as a psychologist or psychiatrist, can provide an accurate diagnosis and recommend appropriate treatment. Therapy, particularly cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), has shown promising results in helping individuals cope with dissociative experiences. Additionally, mindfulness-based practices and stress reduction techniques can also aid in managing dissociative symptoms.

Managing symptoms of dissociation, derealisation, and depersonalisation can be a challenging but essential aspect of improving one's mental well-being. While seeking professional help from a mental health expert is important, here are five effective ways to cope with these symptoms:

Grounding Techniques:

Grounding techniques help individuals stay connected to the present moment and their surroundings, reducing feelings of detachment and disconnection. There are several grounding exercises that can be practiced, such as:

  • 5-4-3-2-1 Technique: Name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste.

  • Mindfulness Meditation: Engage in mindful breathing exercises to bring your focus back to the present moment, acknowledging your thoughts and sensations without judgment.

  • Physical Movement: Engage in physical activities like walking, stretching, or yoga to become more aware of your body and its sensations.

Self-Care and Stress Reduction:

Practicing self-care is beneficial for managing dissociative symptoms. Engage in activities that promote relaxation and reduce stress, such as:

  • Establishing a Routine: Creating a daily routine can provide structure and stability, helping to reduce feelings of chaos and disconnection.

  • Restful Sleep: Prioritise getting enough sleep, as fatigue can exacerbate dissociative experiences.

  • Relaxation Techniques: Explore relaxation techniques like deep breathing, progressive muscle relaxation, or guided imagery to alleviate stress.

Cognitive-Behavioural Techniques:

Cognitive-behavioural techniques can help challenge negative thought patterns and reframe perceptions related to dissociation, depersonalisation, and derealisation:

  • Thought Record: Keep a thought journal to identify patterns in your thoughts and feelings. Challenge distorted thoughts and replace them with more rational and balanced ones.

  • Coping Statements: Develop positive coping statements to remind yourself that the feelings of detachment are temporary and will pass.

Support Network:

Building a strong support network is essential in managing dissociative symptoms. Reach out to trusted friends, family members, or support groups who can provide understanding and empathy:

  • Express Your Feelings: Openly communicate with your support network about your experiences, helping them understand your challenges better.

  • Limit Isolation: Avoid isolating yourself, as social connections can help ground you in reality and reduce feelings of detachment.

Professional Therapy:

Seeking guidance from a mental health professional with experience in dissociative disorders is vital for effective management:

  • Cognitive-Behavioural Therapy (CBT): CBT can help identify triggers, modify negative thought patterns, and develop coping strategies.

  • Dialectical Behaviour Therapy (DBT): DBT emphasises mindfulness and emotion regulation techniques to manage distressing experiences.

  • Eye Movement Desensitisation and Reprocessing (EMDR): EMDR is useful for individuals with trauma-related dissociation.

Dissociation, depersonalisation, and derealisation are intricate psychological phenomena that warrant careful examination and understanding. By distinguishing their differences, recognising their potential causes, and acknowledging their impacts, we can foster empathy and compassion for those who experience these unique mental states. Furthermore, by advocating for mental health awareness and accessible support, we can contribute to creating a more inclusive and understanding society for everyone's well-being.

Each person's experience with dissociation, derealisation, and depersonalisation is unique, and finding the right combination of coping strategies may take time. Be patient with yourself and celebrate small victories along the way. If you, or someone you know is struggling with any of these symptoms and wants to know more, or access therapy, feel free to contact me at #dissociation #depersonalisation #derealisation #trauma #traumaresponse #treatment #therapy #psychologist #specialist #traumapsychologist #counsellingpsychologist #ptsd #cptsd #anxiety #depression

Photo by Nick Linnen on Unsplash

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