Do You Feel Like a Stranger to Yourself?

I am often asked, even by colleagues in the mental health field, "What is Depersonalization Disorder?" For doctors and patients alike, Depersonalization Disorder, or DPD, is somewhat mysterious and difficult to define. And yet, some researchers consider it to be the third most common mental disorder, after depression and anxiety. Several research studies indicate that more than half of college students have experienced elements of depersonalization at one time or another. And many creative people, such as Poe or Sartre, have suffered from it. Deuce Bigelow director Harris Goldberg explored his experiences of depersonalization in the movie Numb.

Depersonalization may happen when you first wake up, or while flying on an airplane. You may link it to acute trauma or years of chronic stress, or to nothing at all. Sometimes it happens after smoking marijuana or using "club drugs."

The first signs are often felt as a "mental break." Suddenly, inexplicably, something changes --- common objects and familiar situations seem strange or foreign, as if you've found yourself in an unfamiliar world. And at the same time you feel unreal, "not yourself." You close your eyes and turn inward, but the very thoughts running through your head seem different. Patients feel as if they have no self that formerly enabled them to deal with the world around them, and with their inner world.

The most clinically true and psychologically sharp descriptions of depersonalization are those given by people with DPD. In his excellent book, Stranger to Myself, medical journalist and DPD survivor Jeffrey Abugel summarizes eight symptoms a person with DPD may experience:

Feeling panic. When a person first experiences DPD, he often feels as if he is going mad. Patients report feeling panic stricken, trapped "inside oneself" or thrown into an unfamiliar world they can't escape.

Lack of emotion. People with DPD describe feeling inhuman, like a robot or a rock. They experience a loss of spirit, "absence" of emotions, and no mood changes.

Feeling detached. People with DPD feel distant from others and themselves. Many describe the feeling of watching themselves, as if from above. Once-familiar objects seem strange.

Fixation/obsession. People with DPD repeatedly check their sanity. They sometimes fixate on the strangeness or foreignness of a single thought or object.

Abstract ruminating. People with DPD often dwell on the ideas of eternity and infinity. They think over and over about the nature of existence or the void and the dark mysteries of life.

Lifestyle changes. People with DPD are sometimes afraid to leave their houses or engage in activities that might trigger panic attacks. They stop traveling, talking to others, watching TV, even going to doctors.

Feeling possessed. People with DPD in some cases report feeling as if an evil entity has taken up residence inside their head, watching them and making negative comments.

Acting "as if." People with DPD suffer from not feeling that they are acting, but instead they have a strange feeling of "as-if acting." They feel that they "imitate" moods and expressions, as if trying to "act normal" around others. But they continue to feel like outsiders who aren't part of ordinary life.

Like many psychopathological signs, depersonalization can linger for years, go away, and then return. Some people with depersonalization sometimes suffer devastating consequences in their personal and professional lives, while others can continue to function fairly well while they seek treatment.

If you think you may have depersonalization, it is crucial to seek out a physician you feel attuned to, preferably one who has experience treating depersonalization, and in whom you have confidence. There are also good informational sites on the web where you can share your stories and get support from other DPD survivors