The Authentic Recovery Center is a dual diagnosis treatment program located in Los Angeles, California. We specialize in treating substance abuse and co-occurring disorders. Our program is highly individualized and offers multiple treatment options for people seeking help. If you would like to learn more about our approach call 1 877 415 4673 now.
This section of the website will provide a broad overview of trauma and stress disorders. Since disorders of this nature are diagnostically broken down into several categories, the following will focus on a single sub-category, Depersonalization Disorder, outlining the basic information that is pertinent to this specific classification. Discussion will include a general summary of trauma or stress-related conditions, followed by a brief overview of the diagnostic criteria for Depersonalization Disorder, its symptoms, and finally treatment methods.
Trauma and Stress Disorders
Psychological, stress-related traumas cause a variety of conditions that result from experiencing an event that is disturbing, terrifying, or perceived as life-threatening. The stressor might be a single moment, such as a rape, or one in a series of repeated events, such as cycles of abuse or repeated molestations. In the aftermath of the occurrence, the victim is left overwhelmed and without the means of integrating the event(s) into their life. The sense of being out of control or overwhelmed can be delayed, the onset not occurring for weeks, days, or, in some cases, years. This is especially true where the event in question has lain buried, such as when an adult recalls being molested as a child.
It should be noted that in general, stress is a normal response to certain stressors and is not itself destructive. The process of trying to normalize stressful events is basic to our make-ups; and is not only natural but necessary to our survival. The fight or flight response developed as a survival instinct to situations in which the life of the individual was put in jeopardy. Typically, the causes of this form of psychological trauma are reserved for specific varieties of violence: sexual abuse, physical abuse, or severe and prolonged emotional abuse (it should be noted that natural disasters, such as earthquakes, floods, or fires, or events such as surviving genocide, also play a part in generating stress-related disorders). However, exposure, whether prolonged or for a short duration, to certain stressors have the potential to develop into debilitating conditions that in time adversely affect virtually all aspects of an individual’s life.
What is Depersonalization Disorder?
Depersonalization Disorder, or (DPD), is a stress-related syndrome that is characterized by chronic or reoccurring feelings that an individual is not real, or that their sense of self has somehow become indistinct and without borders. The feelings express themselves as a sense that one is outside of their body; that one is observing themselves, as it were, from a distance, and that they are removed from the reality of their experiences. These feelings, also referred to as depersonalization or de-realization, are frequently experienced with such intensity and authenticity that the sufferer comes to feel that they are slowly losing their grip on reality. At its worst, the disorder affects work, relationships, social life, and other areas of normal functioning.
The dream-like quality of the episodes can be so convincing that over time one begins to feel that the waking nightmare is in fact reality, leaving the person feeling further isolated and without the means of either functioning or connecting to the world around them. Ironically, the condition is a coping mechanism, affecting people who have survived some sort of traumatic event; and is in this respect a healthy, if maladaptive, reaction to something that exists outside of normal integrative processes. It should be noted that DPD does not necessarily occur in tandem with, or as an expression of, chronic and persistent mental disorders such as schizophrenia; nor is it typically the result of a substance such as LSD. Unlike states induced by hallucinogenics or schizophrenia, on some level the person suffering is usually able to perform reality testing and distinguish between the disorder’s symptoms and the reality around them.
Symptoms of Depersonalization Disorder
The primary symptoms of DPD are the subjective experiences of unreality. The sense of moving through one’s life as if in a dream is the most common description, usually attended by a sense of being disconnected from one’s speech, actions, or even thoughts. At its core, the sufferer has a tendency to question fundamental facts of their existence, such as their sense of identity and purpose. Typically, this response is antagonized by negative stimuli, e.g., being in unfamiliar locations or social situations that are perceived to be in some way threatening. The cumulative effect to long-term sufferers is a deep-seated fear that they are going insane and losing their grip on reality, which, to some extent, is accurate.
Some of the more common symptoms include:
- The constant state of being an observer in one’s life.
- Experiencing a sense that one is robotically going through the motions of one’s life.
- The sensation of being out of control of one’s life.
- The experience of being out of touch with one’s life, yet simultaneously knowing that this is untrue.
- A sense that one’s body, legs, or arms are out of proportion with the rest of their body.
- A sense of numbness to one’s surroundings.
- The feeling that one is observing themselves from out of their body, specifically from a vantage point of being above one’s self.
- Feeling emotionally isolated from loved ones.
Treatment Methods for Depersonalization Disorder
Currently there are no standardized protocols for successfully treating DPD. Although treatment measures do exist (discussed momentarily), the disorder remains stubbornly aloof to therapeutic interventions. There are a variety psychotherapeutic techniques, usually employed in some combination with medications, that seem to impact aspects of the disorder, but these modalities only treat the secondary symptoms such as anxiety or depression.
In certain circumstances, DPD resolves itself without the aid of therapy. For this reason it is common for treatment measures to be employed only if the symptoms are severe, chronic, and show no signs of ebbing of their own accord. The therapeutic techniques that are used include:
This form of therapy is a variation of what is referred to as depth psychology. The primary goal is to uncover the springs, triggers, and content of one’s psyche, with the ultimate goal to reduce or alleviate the tension that is aroused from unresolved conflict. Psychodynamic therapy rests on the assumption that the Depersonalized condition is a maladaptive trait, which is in turn responsible for the symptoms and suffering the sufferer experiences. The therapy thus focuses on revealing the maladaptive content of one’s psyche, and thereby resolving the unconscious conflicts that are driving the disorder and generating the symptoms.
Cognitive Behavioral Therapy
This modality is currently one of the most widely used therapeutic styles. In addition to helping people manage stress-related disorders, it has also proved beneficial to individuals suffering from a wide range of conditions, including anxiety disorders and substance abuse disorders. The focus is on altering the dysfunctional thinking that has developed as a response to the trauma, and requires the client to adopt modified behaviors in situations where exposure to a stressor is present. The central premise is to help the client develop new coping strategies in the face of impending or inevitable arousal.
When using Cognitive Behavioral Therapy to treat DPD, the client is instructed to maintain a record of events and their corresponding feelings, ideas, and behaviors, to help them clarify what in their environment they are reacting to. The diary becomes a tool with which the therapist has the client question their reality testing, and thus become aware of where they are falling prey to unrealistic assumptions and beliefs. Theoretically, over time, the sufferer develops new modes of behaving and reacting.
Research is ongoing regarding the use of medications to treat DPD. But to date there is no one drug that effectively treats the disorder in a comprehensive way. Although certain medications have promise, the data is incomplete. Amongst those being further studied is a class of anti-depressants known as SSRIs. SSRIs (Selective Serotonin Reuptake Inhibitors) were developed to treat depression, but seem to have some effect on symptoms of DPD. Although it is not certain, it is assumed they work because they target the depressive symptoms that attend DPD, and thus generate improvement in what is called Global Functioning. The SSRIs most commonly prescribed include:
Benzodiazepines, DPD and Dual Diagnosis:
Dual Diagnosis refers to a condition in which an individual’s addiction occurs simultaneously with another mental health problem, each aggravating the other and both contributing to the problems of the individual. In situations where a dual diagnosis has been made – especially where some form of stress-related, trauma disorder has been diagnosed in tandem with an addiction – the use of benzodiazepines is usually discouraged. Unlike the anti-depressants that are prescribed for stress-related disorders, benzodiazepines have a euphoric component and abuse potential that generally makes them inappropriate for treating a population with histories of addiction.
Because of these complications, most physicians specializing in treating dual diagnosed clients will only prescribe benzodiazepines in a very restrictive way, for the shortest duration possible. Given these considerations, dual diagnosed individuals have a better chance of receiving comprehensive care from treatment teams that are specifically trained to deal with individuals who suffer from co-occurring disorders. With regards to DPD and benzodiazepines, there is no data to date that indicates their use reduce the severity of the condition itself. Benzodiazepines do, however, reduce the secondary symptoms of anxiety and stress, which often allows for better all-round functioning.
The benzodiazepines most commonly prescribed for short-term treatment are:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Clonazepam (Klonopin)
- Lorazepam (Ativan)
- Chlordiazepoxide (Librium)
Treatment Goals for Depersonalization Disorder
As stated before, no known cure exists for DPD. And to date, studies aimed at discovering a viable treatment regiment, have proven elusive. However, with vigilance and maintenance, it is possible to manage the condition and allow for considerably better quality of life. The goal of any stress-related disorder is improved management of symptoms, in tandem with a reduction in the severity of the condition itself. Improved functionality is key, with marked demonstrations manifesting at home or work or in social situations. Ultimately, freedom from the disorder is the intention of any intervention.
The topic of Depersonalization Disorder is large, and not easily summed up in one article. Education and awareness are the first steps to acquiring help. Take the time necessary to keep yourself informed about latest practices and current treatment options. Hopefully this article will assist giving you a foundation of knowledge that will make selecting the correct rehab easier to determine.
Call to Learn More about the Authentic Recovery Center
One of the unique aspects of the Authentic Recovery Center program is the comprehensive clinical nature of the process. In situations where someone is exhibiting signs of depersonalization disorder, this fundamental element cannot be stressed enough in terms of importance. A true dual diagnosis setting is the critical ingredient that allows people with symptoms of DPD to learn how to live successfully in the world.