depersonalization disorder

Many people who have suffered from anxiety or other stress related issues talk about something called depersonalization disorder.

Let me say from the start, I don’t think depersonalization disorder exists. This is just another label given to another symptom with many possible causes. And as I have written about on this blog before I don’t believe that labels help us or serve us in the long run. In fact I think they hinder our recovery.

That said, the powers that be in the world of medical/psychological nomenclature have seen fit to create the phrase depersonalization disorder. And as many people who contact this site say, depersonalization is a common symptom of panic and anxiety.

in DSM IV depersonalization is described as:

“A lasting or recurring feeling of being detached from the patient’s own body.”

In my experience, during a period of depersonalization one feels as if nothing is real. The things around you, even your own limbs, seem to be disconnected and distant. It is almost as if you are watching yourself on a screen. If you have experienced it, you will know what I am talking about.


Depersonalization can be a symptom of various illnesses. It is absolutely imperative that you speak to your doctor if you experience any kind of depersonalization.

If your doctor is satisfied that you don’t have any other condition then depersonalization is likely to be due to anxiety, stress or panic. It is in fact the third most common reported psychological symptom after anxiety and depression. Like symptoms of anxiety and panic, depersonalization is highly unpleasant but absolutely harmless. And it does pass.

Treatment of depersonalization

Assuming it is caused by anxiety or stress (and instead of assuming remember you should check with a doctor) the treatments available are roughly the same as those for anxiety. SSRI’s have been known to help, and obviously CBT and other therapies can provide a long term solution. It is unfortunately a very under-researched area of psychology, so hopefully in the future more will be understood and there will be better advice.

Stop your children inheriting anxiety

It is often asked: What can I do to stop my children inheriting my anxiety, my fear if flying, my agoraphobia. People often ask this question when they have been struggling with their own symptoms for sometime and are ready to start a family bit have a nagging fear in the back of their mind.

Genetic Link

Due the publication of various pieces of research and somewhat reckless journalism, many people who have minor mental health problems like anxiety believe their problems to be genetic. This is not entirely the case and sufferers should make sure they fully understand the research before they jump to conclusions.

False Conclusion

Anxiety is genetic. I have anxiety. I will always have anxiety as it is programmed into every cell in my body. This is the thought process of an anxiety sufferer who believes their “condition” to be genetic. It gives them nothing but hopelessness. And it is false.

Genetics may play a minor role.

Genetics may play a minor role but there is no gene that says “you have to suffer from lifelong anxiety”. It simply doesn’t exist. What may exist is genes which make you more susceptible to anxiety than others, that make anxiety your weak spot. Everyone has a weak spot: some people get severe flu every year, some have eating disorders, some have cancer…the list is endless. Whatever your weak spot, you don’t have to suffer from it just because genetically you might be at a higher risk from it than others.

Why children get their parents anxiety

There seem to be many causes of anxiety, but one factor that seems to crop up again and again is low self-esteem. I have listened to may people with anxiety describe their upbringing and more often than not it involved emotionally distant parenting. That is to say parents who, although hard working and caring, did not provide full emotional support. A story that I have heard many times is the one of a child who, when clinging to his mother is pushed away. The mother would have done better to accept his clinging, and shown the child extra love thus enabling him to explore the world knowing he was loved. Pushing a child away when they need love and attention is an example of end gaining: trying so hard to do something you sabotage yourself. If you want your child to be more confident then let them cling and let them anchor their safety in you. After all, they are only children. They will gain confidence when THEY are ready, not when you want them to.

The importance of love

There is an excellent book on providing emotional support to children for the sake of their future mental health and well being. It is called Why Love Matters and it is buy Sue Gerhardt. You can order it from UK Amazon and USA Amazon 

If you order it from Amazon by clicking on one of these links this site will get a small commission and it won’t cost you any extra.

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Anxiety in friends and family

Anti-depressant usage too high

It recently caught my eye that in the UK anti-depressant prescription has soared over the last few years. In 2006 prescriptions were up 6% despite the fact that most independent experts and mental health advocacy groups believe that alternatives to medication provide better long term hope for those with depression.

Just to recap, anti-depressants like Prozac and Celexa do not actually cure depression, they treat the symptoms for as long as you take them (if you are one of the roughly two thirds of people that find them helpful). They are best used as an aid to therapy or other lifestyle changes which promote a healthy mind.

Nice, the body which regulates drugs licensing and prescribing in the UK, recommended in 2004 that anti-depressants should not be the first option explored by doctors when patients present depression. Many studies have shown that other activities, often involving exercise like walking in the country or swimming have been very beneficial in fighting moderate depression (eg University of Essex study).

Doctors are prescribing more anti-depressants for three reasons.

1) More people are getting depressed. Our stressed, pressured, commercial society is a depressing place to live for many.

2) Doctors are learning to recognise depression more and more.

3) Doctor’s have no other options. There are not nearly enough trained therapists or alternative programmes available for those with depression. This is largely the fault of the failure of successive governments to take mental health seriously.

Until we change our attitude and our priorities depression will continue to blight many.

Overcoming Anxiety – working in a microcosm

Just a quick thought for people who are trying to overcome anxiety disorders, panic disorder and agoraphobia. When tackling situations which have been known to lead to panic attacks and anxiety attacks it may be best to work in a microcosm. 

For some people the situations that can lead to anxiety and panic will be physical (a shopping centre or subway underground train) or emotional (having to confront someone, make a complaint, end a relationship). One core trait of CBT (Cognitive Behaviour Therapy) is creating a hierarchy with the most difficult at the top and starting with the easiest at the bottom. This is all well and good for some sufferers but, depending on exactly what kind of anxiety or panic you are experiencing, and what is triggering it, it may well be that the CBT approach is much too simplistic.

What might be more appropriate is to find a weak example of the situation that causes fear, and treat it like an inoculation. Your body learns to fight viruses by examining weak versions given in vaccines. By examining a lesser version you can do something similar.

How is this different from CBT?

Well, with CBT you enter a situation, prove your negative thoughts wrong (ie you prove to yourself that you don’t die, faint, vomit, go crazy) and when the fear subsides in that situation you move to what you perceive to be a more difficult situation. The problem with this is that in many cases the anxiety or panic disorder is complex and therefore to desensitize yourself from one situation does not necessarily mean you have progressed, as the old anxiety can reappear in either the same situation or a new situation at a later date. CBT neglects to tackle the underlying problems which can and do exist in complex anxiety and panic disorder. Going back to the inoculation metaphor, when given a vaccine your body does NOT desensitize itself to the symptoms, it learns from them.

So, in order to recover we need to inoculate ourselves against the root emotions. If we fear wide open spaces and shopping centres because we lack control in those places, then we should find a place where we lack a little control and expose ourselves to it not with the intention of desensitizing ourselves so we can move up a linear hierarchy, but with the intention of gaining further insight.

When we start to feel uncomfortable, a little anxiety or panicky feelings, this is the time to question ourselves and to try to understand why. When we do this we can move on to deal with the underlying causes.

For example: if I fear public transport due to feeling out of control on vehicles from which there is no ready means of escape, then by sitting on a local bus and traveling round my local neighbourhood (much easier than flying say) I can start to gain insight into what control actually means to me, and why it is important. I may also get insight into how I can regain a feeling of control or relinquish a need for it.

This is likely to be a far more comprehensive way of understanding and changing my emotions than CBT alone. 

Depression – Friends and Family – What to do

Being close to someone who suffers from depression can be a lonely and frightening experience. Being in a relationship with a depressed person can deeply frustrating and agonizing.

Typical attitudes of a depressive person might include:

  • Nobody loves me
  • I am not worth anything
  • I don’t deserve you
  • I deserve a loser like myself
  • I have nothing to offer you
  • I can never be happy

So what can you do?

1-Firstly you must encourage your loved one to seek help. Depression is a solvable problem. No one has to suffer from it and the solution is out there. Often the people who struggle with depression for a long time are those who resist help, or unconsciously sabotage efforts to help them. That may sound harsh, but making a depressed person believe they are worth treating, and that they can recover, is hard task for anyone. And in today’s over-stretched healthcare systems we sadly can not rely on doctors and health workers to have sufficient time or resources to look after depressed patients.

Never try and force someone to seek help unless there is risk of them attempting suicide. Assuming there is not, GENTLY try and bring them round to the idea of reading a few books on depression, phoning one of the many helplines that are probably available in your location, or speaking to a doctor. Try and create a situation where they can easily chose to visit a therapist or counselor, make sure the final decision is theirs, it is empowering!

2-If you feel there is an imminent risk of a suicide attempt, seek help immediately. You could contact the Samaritans, the ambulance service or the police. Whatever you do, seek professional help at once!

3-Never succumbed to the temptation to lose your temper or show your frustration. As I said, it can be frustrating, but shouting and saying “why can’t you just cheer up?” is counter productive, a prime example of end-gaining, which is one of man-kinds most destructive inclinations. You want them to get better, right?

4-Show lots of love and consideration. You don’t know what depression is like. Depression can cause or be caused by low self-esteem. You can help a depressed person by raising their self-esteem, by encouraging them and letting them know you care.

5-Be patient.

6-When faced with negative statements like those listed above, gently try and persuade the sufferer to look at what they are saying and see if they can prove or refute their beliefs. For instance by asking them to point out who likes them and who doesn’t like them. It is normally hard to find people who truly hate you for no reason, yet the chances are the sufferer will be able to name a significant number of friends.

So stay calm, be encouraging, and help them challenge their negative thoughts. If they start to speak to a professional then they can get on the pathway to recovery.

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Advice for friends and family

Learning to say "NO".

For most people that suffer from anxiety and depression self-esteem is a problem. We might often be inclined to put other people’s thoughts and feelings before our own. Deep down, this can  be very damaging. While we might seem to be happier once we have satisfied and gained the acceptance of those around us, in fact we tend to mourn our lost desires and crave control of our lives. In some cases this emotion may manifest as episodes of anxiety, panic or depression.

Like most things in life there is a balance involved. Life does involve some compromises and as mature adults we must remember that we can’t have it all our own way. But while some things in life might be out of our control (tax, the weather, work managers, public transport) many things are within our control.

We don’t have to control everything in life that we can. This is called control freakery and is a very unpleasant character trait. We do need, however, to control some aspects of our day to day lives, and protect them from people who would control us.

Those of us with low self-esteem have a habit of surrendering our independence to dominant friends, colleagues, partners and relatives and giving our own desires secondary importance. However once we have surrendered our independence we then tend to sulk, resent whoever stole our independence, and regret not doing more. This all adds to the cycle of low self-esteem.

Sometimes we have to say “NO” without guilt.

It can be a hard thing to do without practice. But here are some tips to make it easier.

  • Lie

It is OK to lie! Just make it plausible and stick to it. For example: I am too busy, I am too tired, I can’t afford it, I am visiting my grandmother.

  • Be honest

Tell it as it is! Use a loud, matter-of-fact voice and make a statement without a hint of indecision in your voice. For example: I’m not going to do that today, I’m not in the mood, No thank you, I don’t want to, I don’t feel like it.

  • Don’t hesitate

When someone makes you an offer, or gives you an instruction that you don’t want to follow, say “No”. Don’t hesitate or think about it. If you do hesitate you are inviting them to try to persuade you, to guilt trip you into saying yes. 

  • Remember

It is much easier to say “NO” then change your mind and say “yes” when you have thought about it and decided you really want to. It is hard to say “YES” and then change to “NO” later. It causes arguments and resentment. So say “NO” and then think about, and only change your mind if you want to.

  • Guilt

Guilt is a horrible emotion. But you need to learn to ask yourself if your feeling of guilt is reasonable. Why should you sacrifice your own desires for someone else’s? Would they do the same for you day in and day out? Or do they usually do what they want to do? Be a bit militant and indignant. You have the right!


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