Persistent or recurrent episodes of detachment characterize depersonalization disorder. During these episodes, self-awareness is temporarily altered or lost; the patient in many cases perceives this alteration in consciousness as a barrier between himself and the outside world. The sense of depersonalization may be restricted to a single body part, such as a limb, or it may encompass the whole self. The patient with this disorder may feel that he’s mechanical, in a dream, or detached from his body.
Although the patient seldom loses touch with reality completely, the episodes of depersonalization may cause him severe distress. Depersonalization disorder usually has a sudden onset in adolescence or early in adult life. It follows a chronic course, with periodic exacerbations and remissions, and resolves gradually.
Depersonalization disorder typically stems from severe stress, including war experiences, accidents, and natural disasters. It may also be due to neurologic or systemic disease.
The patient with depersonalization disorder may complain of feeling detached from his entire being and body, as if he were watching himself from a distance or living in a dream. He may also report sensory anesthesia, a loss of self-control, difficulty speaking, and feelings of derealization and losing touch with reality.
Common findings during the assessment interview include symptoms of depression, obsessive rumination, somatic concerns, anxiety, fear of going insane, a disturbed sense of time, and a prolonged recall time as well as physical complaints such as dizziness.
For characteristic findings in patients with this condition, see Diagnosing depersonalization disorder.
Psychotherapy aims to establish a trusting, therapeutic relationship in which the patient recognizes the traumatic event that triggered the disorder and the anxiety it evoked. The therapist subsequently teaches the patient to use reality-based coping strategies rather than to detach himself from the situation.
❑ When providing care in this disorder, assist the patient in using reality-based coping strategies under stress rather than those strategies that distort reality.
❑ Help the patient who has depersonalization disorder recognize and deal with experiences that produce anxiety.
❑ Establish a therapeutic, nonjudgmental relationship with the patient.
Review other book chapters online related to Depersonalization disorder:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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