Depersonalization and derealization disorder

Edvard Munch’s ‘The Scream’ is thought to have been inspired by depersonalization disorder.

I originally posted this article in 2007. At the time, I didn’t feel comfortable sharing my story online. Over the past few years, I have been amazed at the number of people who have found this post and either commented or emailed to let me know about their own struggles. Although I try to reassure them things will get better with time, I feel like those words would be more meaningful if I shared my own experience. With that goal in mind, I am rewriting this post from scratch almost seven years later.

I should probably point out that I have never been officially diagnosed with this disorder. Based on the symptoms I have had over the years, the commonality with so many who first experienced DPD after drug use, and various articles I have read online, I definitely believe I have had or continue to have depersonalization/derealization disorder.

Wikipedia describes the symptoms as follows:

The core symptom of depersonalization disorder is the subjective experience of “unreality in one’s sense of self”, and as such there are no clinical signs. Patients who suffer from depersonalization also experience an almost uncontrollable urge to question and think about the nature of reality and existence as well as other deeply philosophical questions.

Individuals who experience depersonalization can feel divorced from their own personal physicality by sensing their body sensations, feelings, emotions and behaviors as not belonging to the same person or identity. Also, a recognition of self breaks down (hence the name). Depersonalization can result in very high anxiety levels, which can intensify these perceptions even further.

Common descriptions: Feeling disconnected from one’s physicality; feeling like one is not completely occupying the body; not feeling in control of one’s speech or physical movements; and feeling detached from one’s own thoughts or emotions; experiencing one’s self and life from a distance; a sense of just going through the motions; feeling as though one is in a dream or movie; and even out-of-body experiences. Patients suffering from depersonalization disorder have also certain visual stimulations such as hallucinations and rapid fluctuations in lighting. While the exact cause of these hallucinations has not yet been determined, it is generally accepted that patients suffering from them is caused by previous drug usage. These hallucinations differ from true hallucinatory phenomena as they are closer to being optical distortions or illusions rather than psychotic breaks. Individuals with the disorder commonly describe a feeling as though time is ‘passing’ them by and they are not in the notion of the present. These experiences which strike at the core of a person’s identity and consciousness may cause a person to feel uneasy or anxious.

First experiences with depersonalization may be frightening, with patients fearing loss of control, dissociation from the rest of society and functional impairment. The majority of patients suffering from depersonalization disorder misinterpret the symptoms, thinking that they are signs of serious mental illness or brain dysfunction. This commonly leads to an increase of anxiety experienced by the patient which contributes to the worsening of symptoms.

My experience with some of these symptoms started one evening after smoking marijuana and having a panic attack while still under the effects of the drug. I freaked out, vomited, took a cold shower, and went to bed. From that point, it felt like time stopped. I literally thought I had died and entered the afterlife, because it felt like I had been suspended in time. I would look at the digital clock beside the bed, close my eyes for what seemed like forever, then reopen my eyes to discover a single minute had passed.

I was distraught to still have the same feeling when I awoke the next morning. Over the next several weeks, I had severe issues with depersonalization/derealization. My body felt foreign to me. I felt like I was living inside of a dream. I felt completely disconnected from the life that was continuing around me.

Several days after the initial onset of symptoms, I sought medical attention at the emergency room. The doctor there sent me for evaluation at a local rehabilitation facility. After explaining my symptoms, they recommended that I enter an outpatient program immediately or they felt I would be hospitalized within two weeks. I decided to try medication instead.

My doctor placed me on Paxil, and I believe it saved my life. I had never even heard of depersonalization/derealization at that point, but I remember reading a sentence about feeling disconnected in the informational brochure the doctor gave me about Paxil. I felt so relieved to have a description for what I was going through that I wept.

Although some of my symptoms lingered for a few years, they gradually subsided. The problem that hung on the longest occurred when I was driving at night. I would suddenly get a feeling that the world outside my windshield existed only in 2D, like playing an old-fashioned video game. It would cause such a surge of panic in my body that I would have to pull over and let someone else drive. Having conversations about eternity and space would often have the same effect.

The first time I ever heard of depersonalization disorder was while watching the very disturbing film Tarnation several years ago. I immediately knew there was a relation between what the director was experiencing and my own symptoms. It was nice to have a name for what I was going through, and it was comforting to know I wasn’t alone.

Today, I have little to no residual symptoms. I usually don’t even think about it. That’s why I wanted to take the time to update this post and let visitors know that even when it seems overwhelming and impossible to endure, there is hope. Talk to your doctor. Talk to your parents. Don’t suffer in silence. You will get better!

A quick footnote about marijuana

Much as been said in my post and in the following comments from others about DP/DR starting after use of marijuana. While it is easy to make the assumption that the two things are connected or that marijuana played some role in causing depersonalization, this article by Ronnie Freedman, Ph.D. concludes that marijuana is simply the trigger. He believes a combination of personality, fatigue, worry, and other mental/physical problems are the true cause of depersonalization/derealization disorder. I wish I had found his article a long time ago, because it makes a lot of sense.

It’s the same story over and over again.  Someone smoked marijuana with a group of friends and within 24 hours, usually sooner, they begin feeling unreal, depersonalized, foggy and detached. They are convinced that the marijuana had to have been laced with something that created this uncomfortable and distressing sensation. They worry that some sort of  “damage” has taken place inside their brain. When they contact the people they partied with, they are amazed to learn everyone else is feeling fine. Now they become very confused, worried and fearful…

…There is a simple explanation for this chain of events. Once understood, recovery is not difficult. It requires a simple yet specific process.

Continue reading Dr. Freedman’s full article on marijuana and depersonalization disorder here:

Updated 11/22/2014