Depersonalisation disorder – sometimes called derealisation disorder, DPD or DPDR – is a difficult condition that’s often misunderstood.
Studies show that DPD could affect one person in every 50 in the UK, though many people struggle to get a diagnosis. With little understanding of DPD in modern psychiatry, treatments are few and far between – in fact, there are no approved treatments for the condition in the UK.
Depersonalization/ derealization is a dissociative disorder, defined in the DSM-IV as “persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body.
‘feeling like one is in a dream’
Thus it is the experience of feeling a detachment from their sense of selves and their reality (depersonalization), or their perception of the world (derealization). It is characterised by emotional numbness and a disruption in self-awareness.
Symptoms of DPD can include:
• Feeling as though the world around you is unreal
• Feeling as though you are watching your life in a film
• Feeling disconnected from parts of your body or your emotions
• Seeing objects distorting or changing in appearance
Symptoms of depersonalization disorder are initially episodic but become more frequent and severe over time, with symptoms fluctuating, but never being entirely absent.
Symptoms can affect people on five levels:
Whilst the cause of depersonalization disorder is still not known, there are a number of factors thought to increase the risk of it developing, including:
• Severe trauma
• Severe stress
• Depression or anxiety
• Recreational drug use
Depersonalisation disorder is notoriously difficult to diagnose, as the symptoms can often be mistaken as other conditions. Each sufferer will experience different symptoms, which can often leave you feeling like you're sleepwalking through life.
DPD can co-occur with a range of other mental and physical disorders. However, it is when the symptoms are experienced persistently and recurrently, independently of other mental (schizophrenia, panic disorder) or physical disorders (epilepsy) that it is considered a disorder.
• Onset is usually over the age of 30
• Patients typically exhibit nihilistic delusions
• Perceptual anomalies may be present
People suffering with depersonalization disorder will experience symptoms of depersonalisation, derealisation or both.
Depersonalization: feeling detached from one’s body, feelings, thoughts, sensations. E.g. being unable to recognise oneself in a mirror, or feeling as though it is not them. Patients may feel like an outside observer to their life or feel disconnected for their memories and emotions.
- “A feeling of being fundamentally wrong in your own body”
- “Separate from myself”
- “Like a robot”
- “It feels like my limbs do not belong to me”
- “I do not feel an emotional connection”
Derealization: feeling detached from their surroundings, a sense that things are unreal. Patients may feel as though they are in a dream or a fog, or like there is glass wall between them and the world. Derealization is often experienced in conjunction with blurred vision or perceptual distortions.
- “Everything appears flat or in 2D”
- “My head feels full of cotton wool”
- “Everything is wavy”
Other typical symptoms of derealisation include:
- Difficulty in concentrating
- Loss of emotional reactivity
- Fear of going ‘crazy’
- Emotional numbness
Treating depersonalization disorder is not straightforward, as it is a complex issue. Traditional treatment options are:
• Medication – There are currently no recognised pharmacological treatments for depersonalization disorder. In some cases antidepressants, specifically SSRI’s may relieve some symptoms
• CBT (Cognitive Behaviour Therapy) - This counselling/talking approach with a psychologist or therapist addresses the patterns of thinking that are associated with one’s behaviour and offers a range of techniques and strategies to change these negative thought processes. The therapy involves reducing avoidances, safety behaviours and symptom monitoring. Research for CBT as a treatment for depersonalization has shown some positive, though limited results.
Repetitive Transcranial Magnetic Stimulation – rTMS offers an alternative, medication-free treatment.
How does TMS treatment work for DPD?
Research has shown that Transcranial Magnetic Stimulation (TMS) may reduce the symptoms of DPD.
TMS is a non-invasive therapy that uses a repetitive magnetic pulse to stimulate the area of the brain that controls your emotional reactions and regulates mood. With no anaesthetic, no medication, no need for hospitalisation and no recovery time, this non-invasive treatment uses a repetitive magnetic pulse to stimulate the parts of the brain that cause depersonalisation and derealisation symptoms.
A course of TMS treatments for DPD involves up to 30 sessions, split into courses of 10 sessions, which take place over a period of three to six weeks. Each treatment lasts 30 minutes, and some patients are able to have more than one session a day.
ADVANTAGES OF TMS TREATMENT for DPD
No unpleasant side-effects or reliance on long-term drug therapy
Enduring treatment results. Top up sessions available as required
TMS treatment has shown positive results and evidence
Expert TMS Team
Our practitioners are trained in depersonalisation disorder treatment
What our patients say
As DPD is typically a difficult condition for psychiatrists to treat, once you go into remission with Smart TMS, we recommend maintaining the improvements with one of our aftercare packages.
The Continuous Care aftercare package recommended for patients treated for OCD is:
Smart TMS On-Demand: Become a member of our Smart TMS On-Demand scheme, entitling you to exclusive discounts on treatment, should you feel that you need it at any point following your treatment.
Your aftercare will be tailored to your symptoms, so your clinician may suggest alternative treatment programmes.
Have you had TMS treatment for OCD at another clinic? Smart TMS can offer you maintenance therapy, too!
Is TMS right for me?
DPD is treatable, and Smart TMS can help.
To help you make up your mind about treatment, our practitioners offer pre-arranged clinic visits to answer any questions you have and show you the TMS machine.
If you would like to arrange a clinic visit, call the team on 0345 222 5678.
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