- We've been talking a lot recently about dissociation,
and many of you have asked follow-up questions
about the different types of dissociative disorders.
Now, dissociative disorders involve a breakdown
in awareness, consciousness, or memory,
and they are the result
of our brains doing the best they can to cope
with the trauma and overwhelm.
Now, after my recent videos on dissociation,
I saw a lot of comments about depersonalization
and derealization disorder, otherwise known as DPDR.
So I'm going to talk you through what it is,
the symptoms of derealization and depersonalization,
the causes for it, and finally, how to treat it.
So let's get into it and first talk about what it is.
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Depersonalization-derealization disorder is a disorder
where we can feel that breakdown in awareness
that comes with dissociation,
in relation to two core things,
ourselves and our surroundings.
It can be a really strange
and deeply distressing experience.
And those of us going through it
can feel like we're going crazy.
We can think that we're having a mental breakdown,
or like we've developed a psychotic disorder.
It can really feel uncomfortable and odd.
But depersonalization and derealization
are not a form of psychosis.
And the key distinction is that
when you're experiencing depersonalization
or derealization, you are aware that the detachment
or distortion you're experiencing isn't reality,
versus in psychosis, we can often believe we are detached
from our bodies or our surroundings.
We believe it's really happening
instead of just feeling that way, if that makes sense.
A lot of us might have experienced
moments of depersonalization or derealization.
Brief, transient experiences like that
are actually fairly common,
occurring in at least 50% of people.
Have you ever felt like you were watching yourself
in a movie, or like you're floating
above your body watching your life unfold?
Or maybe feeling like there's a big glass bubble
between you and the people or the things surrounding you?
I would love to hear your stories
and your thoughts on this in the comments.
Sensations like this last only for a few seconds,
and are gone before we can even grasp what happened,
and we can shrug it off.
But when these experiences linger for more
than a few seconds or occur more frequently,
they can interrupt our lives
and do significant damage to our mental health.
That is when we move into the camp
of depersonalization or derealization disorder.
For those of us with this disorder, these episodes
of detachment can last for hours, days, weeks,
and sometimes even months.
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Let's talk about the symptoms.
How do we know if we're being affected
by depersonalization or derealization?
The Mayo Clinic lists the symptoms of depersonalization as
feeling outside of yourself,
like you're watching your thoughts or feelings,
or even your own body parts,
almost like you're floating in the air above yourself.
Next, you can have the sensation that you are a robot,
or sensing you are not in control
of your speech or movements.
And I've heard from a lot of you that this is the component
of it that can make it embarrassing,
or we can do and say things
that we're just not really aware of.
Third, you can have a feeling
like your body parts are distorted,
bigger or smaller than they are,
or a sensation that your head is wrapped in cotton.
You can have a physical or emotional numbness,
and when it comes to memories,
you may have the sense that the emotion
associated with that memory has been sucked right out of it,
or even a feeling like they aren't your memories,
like you're watching someone else's life.
Derealization is a little bit different.
If depersonalization deals with the sensations we have
in relation to ourselves, derealization is more about
the sensations that we have in relation to the world
and the people around us.
We may feel disconnected from our surroundings
like we're living in a movie or a dream,
and some people have described it as if
there's this clear wall between them
and the people that they care about.
Almost like a sense of emotional disconnection.
And surroundings can appear different too, distorted,
blurry, or gray, or artificial in some way.
You might experience a shift in your relationship with time.
Events that happened recently
may feel like they were years ago.
Also objects around you may seem distorted as well.
They can be further away or closer,
or their size and shape is altered.
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So what causes DPDR?
The exact cause is hard to pin down.
Certain kinds of drugs like hallucinogens
can definitely trigger it,
or extreme sleep deprivation or sensory stimulation.
One of the big factors associated with DPDR
is childhood trauma,
specifically emotional abuse or neglect.
Moments of intense trauma are so terrifying
and hard to navigate, especially for our child brains.
So we tend to dissociate as a way to cope.
The same way fight, flight, freeze, fawn is our body's way
of protecting ourselves against physical threats,
dissociation can be a way of protecting our minds
against psychological threats.
And it's commonly connected to our freeze response.
Almost like we can't get away physically,
so we run away psychologically.
We may be at a higher risk
for developing dissociative disorders like DPDR
because a biological factor is like a nervous system
that is more reactive to emotions,
meaning our level of resilience is just lower than others.
Or if we are predisposed to certain conditions
like seizures or other mental illnesses
like anxiety, depression, et cetera.
So what do I do about it?
Isn't that the million dollar question?
And does everyone out there get tired
of hearing therapists give the same answer to questions
like this, but the reality is the answer is often
the same when it comes to dissociation.
And that answer is leaning into therapy and specialists.
When treating any underlying trauma,
we can look to three types of therapy
that have been proven effective.
The first is talk therapy.
It can help you unravel past trauma,
and also learn to manage distressing sensations
that come with DPDR, or related conditions.
We can put together a timeline of our trauma
and work through the process
of putting our trauma into a cohesive narrative.
Overall, we find this to be effective
for about 40% of people.
The second is psychodynamic therapy.
Often we may not be able to consciously address the trauma
because it can be overwhelming
and lead to more dissociation.
So there are treatments available
in psychodynamic therapy that help us access
those unconscious barriers that can keep us
from integrating past experiences.
And this is when we look for patterns
in the way that we interact with others
or things that come up for us
in our relationships with our therapist,
and also acknowledging any of our defense mechanisms.
This can be a sneaky way of getting us to work through
some of our past issues
without having to address the trauma head on.
And third, somatic experiencing therapy.
Again, if words are difficult to come by or talking about
the trauma only increases our dissociation,
which is really common, using movement to
unfreeze ourselves can be healing.
In short, we are hoping to change our trauma response
from freeze, which is where dissociation comes from,
to fight or flight.
So offering our body the movement that it's been wanting
can be the release that we've been waiting for.
Additionally, there have been
amazing breakthroughs in medication,
and there are some that may be helpful.
Specifically, medication to support related symptoms
like anxiety or depression, think SSRI, SNRI.
Those may be helpful, but please reach out
to a psychiatrist in your area
to see if medication is right for you.
Finally, there are coping skills
that you can try here at home, such as grounding techniques.
Now, we've talked about these a lot before,
and these are things like counting colors.
So you look around the room, how many things
in your space are brown, or blue, or black?
You can also do the ABCs.
Look for things that's start with the letter A,
the letter B, and so on.
And even changing your temperature, like holding ice cubes
or putting a cold washcloth on your face
or your neck to change your body's temperature.
That can be really helpful
when we're struggling with dissociation.
The next coping skill is distress tolerance
because we're gonna try to allow ourselves
to tolerate the distress a little bit better, right?
It's the distress that causes our dissociation.
Now, a little tip that I have for this
is called tipp, T-I-P-P.
Now, it stands for temperature,
intense exercise, paced breathing,
impaired muscle relaxation.
Overall, this tool can help us
calm our nervous system down and keep us present.
And it's like a grounding technique, to be honest.
Another tool is accepts, A-C-C-E-P-T-S.
And it's another distress tolerance skill
that helps us manage a negative emotion
until we're able to actually do something about it.
It stands for activities, right?
Distract ourselves from what we're going through,
contributing, meaning take some time
to help somebody else out.
Comparisons can give us perspective, right?
We can look at someone else's situation and be like,
ours actually isn't that bad.
Emotions, meaning we can take some time
to force an opposite emotion.
Just because I'm feeling sad
doesn't mean I have to ruminate in it.
I can force myself to think and feel a different way.
Next is push away,
which is otherwise known as back burner.
Right now, I can't do anything about this.
I can't cry in my meeting, that's not gonna be helpful.
But I can make time to do that later today.
And so, mentally I do that, I push it away.
The next is thoughts.
So we're gonna stop those anxious thoughts,
and we can use bridge statements to move them
in a more neutral position, we've talked about those before,
and we can also use thought distractions.
So think about something else.
Tell me about one of your favorite memories.
And finally is sensation.
Use your five senses to help calm you down.
Maybe that means we pop a peppermint candy in our mouth
or we smell some lavender,
or maybe we just notice how our clothes feel on our body.
All of that can be extremely helpful
when we're trying to tolerate some of that distress.
And the final coping skill, mantras.
Sometimes having a few phrases
to repeat over and over can be helpful.
I know my personal mantra is life's got my back,
and it's something that my therapist said to me
when I was stressing about work and money
and just life in general.
She asked me if I had ever not made it through before,
and if life had ever done me so wrong
that I couldn't recover or keep going.
And the answer, obviously, even though I didn't like it
was no, it hasn't gotten that bad.
And she said, that's 'cause life's got your back.
And so I use that phrase as a mantra when I'm worrying
or even freaking out because something isn't quite
going the way that I thought it would.
It's a reminder that I'll get through, and I'll be okay.
So what are some mantras that have helped you?
Please leave those in the comments down below.
You never know who it could help.
Thank you so much for watching.
I hope you found this helpful.
And as always, feel free to share your own thoughts
in those comments down below.
Have a wonderful rest of your week,
and I will see you next time.
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