Talk:Depersonalization-derealization disorder

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 October 2020 and 13 November 2020. Further details are available on the course page. Peer reviewers: Serotonin and the Dopamines.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:20, 16 January 2022 (UTC)

Dececration of article
Someone has/is seriously desecrated this article. If you look at older editions (pre-2016) you'll see that they contain far more detail and references. An admin needs to revert it to a better version before 2016 and keep an oversight on it. Even some 2014 versions are better! — Preceding unsigned comment added by 92.40.249.123 (talk) 00:45, 27 July 2016 (UTC)

Society and culture
Please see discussion regarding Collision with the Infinite at Talk:Depersonalization, I'm trying to centralize it there. WLU (t) (c) Wikipedia's rules: simple/complex 15:53, 14 April 2011 (UTC)


 * SUZANNE SEGAL and her book "COLLISION WITH THE INFINITE" are reputable and just because this is being call new age (biased), does NOT mean that this information is not important to those folks that suffer from these problems. She was diagnosed to have these problems and she was also educated, which makes her "scholary" and makes her "notable". She has her  Psy.D. degree from The Wright Institute and obtained licensure as a psychologist. See the link to her school.
 * I have asked WLU to present his "credentials" (he says this is not needed). Suzanne Segal's link was deleted at the request of WLU who seems to have a personal problem (ie biased) with this information. By the way, how many "hits" did the page that Suzanne Segal get; before WLU asked for its deletion. This would show "what" the "public interest is" and not what WLU's interests are or are not. And if WLU can't find any good links on google then he obviously is not interested in this. There ARE plenty of links to Suzanne and also references to her. How else did I find out about her, and how else do I tell other people to "find out" about her. Due to WLU desire to delete "valuable information" by defaming it (based on his lack of information) there is now even less info available (ie Wikipedia no longer is a source). This is sad.Vanlegg (talk) 16:26, 14 April 2011 (UTC)
 * As I said above - please centralize the discussion at Talk:Depersonalization. WLU (t) (c) Wikipedia's rules: simple/complex 16:32, 14 April 2011 (UTC)

Vision
Why there is nothing about visual symptoms which many of DPD sufferers experience? Like visual snow, afterimages, trails/ghosts (like on LSD or other psychedelic drugs), floaters, blue field entoptic phenomenon (seeing white blood cells on bright surfaces). — Preceding unsigned comment added by 77.255.248.219 (talk) 20:15, 14 August 2011 (UTC)
 * Are there any scientific publications that describe that phenomenon? Looie496 (talk) 21:58, 14 August 2011 (UTC)

I don't know, it's probably related to HPPD, as many DPD sufferers have it from drugs (most from cannabis, but also from MDMA, LSD, etc.), but also some people have this visual symptoms without ever trying any drugs. — Preceding unsigned comment added by 77.255.57.83 (talk) 16:00, 15 August 2011 (UTC)
 * A brief scan through Google Scholar indicates that visual derealization is considered one of the main symptoms of depersonalization disorder -- it is mentioned in the DSM section of our article but I think more could be said. I didn't, in my quick check, see any mention of the symptoms that you described.  That doesn't mean no literature exists, just that I didn't spot any.  One way or another, we would need to have a reputable published source in order to be able to discuss the phenomena in this article. Looie496 (talk) 17:11, 15 August 2011 (UTC)

There is topic about it on DP forum - http://www.dpselfhelp.com/forum/index.php?/topic/22388-tracerstrailsghosting-getting-bad-at-times/ I have the same issue and it started with DP feelings after cannabis bad trip, if there is no sources then probably it needs more research. I had also micropsia/macropsia, but it seems to be brain related issue, while symptoms described in this topic are probably more related to retina/eye dysfunction, it's just my thoughts. — Preceding unsigned comment added by 77.255.57.83 (talk) 17:26, 15 August 2011 (UTC)
 * Literature does exist describing palinopsia in the context of HPPD, of which depersonalization is also a symptom -- but there is little discussion of palinopsia without any involvement of hallucinogens. Looie496 (talk) 17:54, 15 August 2011 (UTC)

Spelling consistency.
The article head is "depersonalization," but within the article itself, "depersonalisation" (s) is sometimes used. Making the body consistent with the title. Gprobins (talk) 23:59, 11 July 2012 (UTC)

Such as shame
A year or two back this article looked well presented and was not 'jumbled' around so to speak. For example, the bulk of the symptoms as of now seem superfluously affixed within the introduction which is inappropriate for any academic or layman's reading article. That should be reserved primarily for the 'symptoms' section. Unfortunately I give up even attempting to improve this article. Everytime I attempt to improve it, it gets reverted back to the 'messy' state it is in now thus wasting my time. — Preceding unsigned comment added by 86.139.141.2 (talk) 03:38, 15 June 2014 (UTC)

Iboga treatment
I want to start a discussion about inclusion of iboga total alkaloid as a potential treatment for depersonalization disorder. I suggest the inclusion of iboga treatment in this article. Something along the lines of:

"Anecdotal reports of DPD sufferers as well as iboga treatment centers, and others have claimed that treatment with iboga total alkaloid has reversed depersonalization in those with DPD who did the treatment. Anecdotal reports appear in blogs and forums online of people claiming to find relief from DPD through iboga TA treatment. Given the theorized connection between depersonalization/derealization and the disruption of normal kappa and mu opioid receptor agonization and antagonization, outlined in the book "Inside Depersonalization: The Hidden Epidemic"  and the scientifically proven ability of flood doses of iboga TA to reset the opioid system,   which is the mechanism of action in its primary use of treating addiction, it appears clear the effect of iboga TA on opioid receptors to restore their 'factory reset' is responsible for its ability to successfully treat depersonalization and derealization disorder."

There is an unproven but potential cure for DPD and DRD (derealization disorder) which is the west African hallucinogen iboga. It is mentioned in both Depersonalization: A New Look at a Neglected Syndrome by Mauricio Sierra (Aug 16, 2012), and in Stranger To My Self: Inside Depersonalization: The Hidden Epidemic by Jeffrey Abugel (Jan 21, 2011), sorry don't know the page number off the top of my head, that depersonalization is thought to be in part caused to the overactivity or a locked state of persistent agonization of the kappa opioid receptor in the brain's opioid system, as well as under activity or persistent antagonization of the mu opioid receptor.

Iboga works by resetting the entire opioid system, this is how it miraculously brakes addiction to cocaine, heroin, meth, nicotine, caffeine, and alcholol. It does this so profoundly that a person's tolerance is reset to all substances after a flood dose. Meaning if an addict takes heroin the first time after taking iboga at their usual dose, there is a high likelihood of ODing because they have the tolerance of a non-taker. See the article on iboga for that information and exact sources. So it resets the receptors in the brain, which affects depersonalization, because the mu receptors when activated make you feel connected, present, immediate, while the kappa receptors kick in during fight or flight mode and cause the person to dissociate so they can logically deal with trauma, this causes depersonalization when the receptors get 'stuck' in the wrong mode. Iboga sets them all back to zero. This is why it is a potential cure, and there are several anecdotal stories of it working, it has only been discovered for this use in the last two years or so, and I do not believe there is a study on it yet, so this is a topic I don't really have an exact quote from a paper on, except for maybe on ibogaine.desk which is scholarly, but I will have to comb through it and find the references and quotes. Here is one anecdotal article that discusses it:

"Furthermore, certain mental illnesses and psychiatric conditions may be remedied with Iboga. It is common for people with depersonalization, a relatively new psychological disorder where one feels disconnected from his or her own self and the outside world, to find immediate, powerful and lasting relief with Iboga."

It goes on to discuss the penial gland, and I have no idea what they are talking about, but none the less, they are correct. If you contact iboga treatment centers like Iboga Life in costa rica, or Ibogaworld in Holland or the Ibogahouse they all have had cases of depersonalization being reversed. Now, there is another substance called ibogaine hydrogen chloride that is a chemical extraction of iboga, and it is not safe to treat people who have psychological problems, and one woman with depersonalization in an online forum claimed she basically went insane after taking ibogaine and iboga TA mixed together at a Mexican iboga clinic to cure her DRD. The stuff that is commonly used to treat psychological disorders with iboga is IBOGA TOTAL ALKALOID and it should clearly state that in any addition to the article. Iboga TA is a concentrated extract of the iboga plant, and not a chemical synthesis of its active ingredient ibogaine HCL. What do you guys think can we include a mention of this in the article?--Newmancbn (talk) 08:36, 22 August 2014 (UTC)

Link another article
I suggest the title "Derealization disorder" should be linked to here.--Newmancbn (talk) 08:37, 22 August 2014 (UTC)

i need help
I think I might have Depersonalization disorder what do I do. I have all the symptoms Kingstoncoolkid (talk) 13:28, 25 April 2016 (UTC)


 * @Kingstoncoolkid it's bad to hear this. You should contact specialists. Dzesuf (talk) 21:20, 11 January 2024 (UTC)

Alexithymia
How does this differ from Alexithymia? They sound similar. 194.202.213.12 (talk) 11:34, 27 September 2017 (UTC)

Moved here
Doc James (talk · contribs · email) 21:03, 15 May 2016 (UTC)
 * The first ref does not mention the topic in question
 * Other refs are not sufficient. Please see WP:MEDRS

Ego-Death
Partial or total loss of the familiarity with one's self, the defining characteristic-symptom of depersonalization disorder, is more accurately described as the "loss of ego"- or ego-death, which is most commonly brought about through the use of LSD, and is defined as "complete loss of subjective self-identity."

The ego is the name given to the part of the conscious and unconscious mind responsible for several manual and automatic psychological functions pertaining to personality, sense of identity/self, reality (and how we interact with it), the organization of thoughts, and how they make sense in context with the world around us. It is learned passively over time, starting at a young age, and is the second of three mental apparatus illustrated in Freud's structural model of the psyche. The first being the Id (basic instincts) which is monitored by the ego to stop impulse, and the third being the super-ego (perceived socially acceptable behavior and cultural rules) which "trains" the ego through negative reinforcement by causing feelings of guilt and anxiety when it's conditions are not met, or the person has thoughts that do not align with its conditions.

Defence mechanisms are the foundation of the ego, and can have positive or negative effects depending on the reason for being created. They are psychological strategies that it uses to distort reality in order to avoid, remove, or otherwise lessen anxiety and prevent acting on impulses. Defence mechanisms include; denial, displacement, intellectualisation, fantasy, compensation, projection, rationalization, and reaction formation, among others. These defense mechanisms are built up and implemented automatically in response to the following; what is believed to be acceptable behavior by the super-ego, what is instinctually necessary or wanted by the Id, and the interpretation of the world around us. These two taken are taken into consideration by the ego, creating what we know as our sense of self.

When depersonalization occurs- the ego is lost, and with it these defence mechanisms, but the Id and super-ego remain. Subjective identity is gone, but objective identity remains; i.e. super-ego and Id. Without access to these basic mechanisms, the individual is left with only their basic human instincts, impulses, personal and social beliefs, unorganized thought, and emotion; while the ability to process, filter, and understand these and the world around them has been damaged or removed. With very little or no defence mechanisms to bridge the gap between Id and super-ego, the super-ego's set of behavioral and social rules are at odds with the Id's impulses, urges, and instincts, making feelings of guilt and anxiety flood the person along with memories of events as seen from a perspective devoid of defence mechanisms, prompting more guilt and anxiety in response to those as well. All of this is happening while the person depersonalizing is trying to make sense of what is going on in the world around them without the defence mechanisms from an ego, and thus cannot do so.

Which DSM?
In the 3rd paragraph of the lede, it states "In the DSM-5, it was combined with Derealization Disorder and renamed Depersonalization/Derealization Disorder (DDPD). In the DSM-5, it remains classified as a dissociative disorder..." (emphasis mine)  To me, this appears to have misstated the first example of the DSM, which should be DSM-4, since the following sentence makes it seem as if the classification changed with the subsequent edition. Unfortunately, the citation provided is to a printed work that's not accessible to me. Can anyone confirm if this should actually read "In the DSM-4, it was combined with Derealization Disorder and renamed Depersonalization/Derealization Disorder (DDPD). In the DSM-5, it remains classified as a dissociative disorder..."? Thanks for any clarification. Bricology (talk) 00:03, 22 November 2017 (UTC)

Cannabis
I have removed the Cannabis section which previously read: "the DSM-5 excludes cases of depersonalization due to using substances, including episodes of post-marijuana or post-psychotomimetics depersonalization." That is actually not true and seems to come from a faulty reading of the DSM-5. The Differential Diagnosis section of the DSM-5 reads: "Substance/medication-induced disorders. Depersonalization/derealization associated with the physiological effects of substances during acute intoxication or withdrawal is not diagnosed as depersonalization/derealization disorder. The most common precipitating substances are the illicit drugs marijuana, hallucinogens, ketamine, ecstasy, and salvia. In about 15% of all cases of depersonalization/derealization disorder, the symptoms are pre­cipitated by ingestion of such substances. If the symptoms persist for some time in the ab­sence of any further substance or medication use, the diagnosis of depersonalization/derealization disorder applies. This diagnosis is usually easy to establish since the vast ma­jority of individuals with this presentation become highly phobic and aversive to the trig­gering substance and do not use it again." To summarize, acute DP/DR symptoms during intoxication would not be diagnosed as DP/DR, but if DP/DR symptoms persist in the absence of cannabis, then DP/DR diagnosis is, in fact, warranted.


 * This is incorrect - it is an exclusion because of the symptoms of depersonalization can be accounted for by substance use, the diagnosis is given as substance use instead. I believe it was the same in the DSM-IV. The effect of this can mean someone with a substance use disorder needs to have some time sober to determine if they also have depersonalization. What is being referred to could be clearer but is talking about the diagnostic criteria of the disorder I think. Amousey (talk) 01:44, 31 May 2020 (UTC)

UCF Wikimed 2020
Hello all,

I will be editing and adding to this article for the next few weeks. After reading through the comments on this discussion page, searching the literature, and reading up on Wikipedia medical formatting and guidelines I will be implementing the proposed following changes:

1. Edit of lead section: I saw comments regarding the extensive lead. I will attempt to shorten and move information from the lead to their respective sections.

2. Edit of cause section: The cause section seems to have 2 major components currently, including biopsychosocial causes vs neurobiology. I will either separate the two into subsections or bring the neurobiology section into its own heading under "Pathophysiology".

3. Incorporation of new studies: I found 2 new systematic reviews (2020) so far based on a Pubmed search through the last 5 years that include the topic of derealization/depersonalization. However these 2 studies mostly focus on neurobiology/imaging correlations. I will be searching additional databases for preferably secondary sources (systematic reviews, meta-analysis) but may dip into some primary sources if need be. Feel free to send sources (preferably secondary) my way if you find any.

4. DSM V: This section doesn't differentiate between DSM vs ICD; I am thinking of cleaning this section up.

5. Prognosis/Prevention: I'm thinking of including a prevention section and maybe a prognosis section based on what I can find in the literature.

6. Pictures: I would like to include some sort of image either in the infobox (top right of article), or maybe more depending on what I find.

Of course any additional changes you all see fit, feel free to respond Hiatal Hernia (talk) 18:11, 21 October 2020 (UTC)

UPDATE 10/29/20 Hey everyone, just a quick update. I have completed the 6 objectives outlined in my original post. Moving forward, I plan on adding more pictures specifically in the neuroanatomy section. I will also be cleaning up, proofreading, and possibly adding additional sources where appropriate. If time permits I will work on cleaning up some of the older citations. Any suggestions or sources, feel free to send my way. Hiatal Hernia (talk) 20:33, 29 October 2020 (UTC)

UPDATE 11/10/20 Hey everyone, final changes to the article have now been completed. Additionally, the article has been peer reviewed and edits were made as seen fit. This concludes my edits for this course. Thank you. Hiatal Hernia (talk) 01:54, 11 November 2020 (UTC)

2020 UCF Wikimed peer-review
The following is a peer review of this article.

Lead - I think your image is outstanding. It definitely conveys the meaning of the disorder. I think the content is great, it provides an appropriate overview of the article.

Causes – This is a difficult section to make clear for a general audience, but I think you do a great job of this by providing general explanations of the functions of the different brain regions. The images are helpful as well. In the second sentence of the opening paragraph, I think providing more clarity of “emotional neutrality” and how this relates to depersonalization may be helpful. (As an aside, the effect of culture on vulnerability to depersonalization is really interesting). In addition, in the first sentence of the neurobiology section, I think using a different word than “substrate” may be helpful for a general audience. Great references.

Diagnosis – I like the inclusion of DSM-5 and ICD-11 definitions. Great differential section. Excellent references.

Prevention – I would consider adding a sentence or two to this section with additional studies or explaining if there is little additional research in prevention of DPDR.

Prognosis – Similar to the prevention section, I would consider adding a bit with additional studies if they are available. If not, perhaps a sentence mentioning the lack of large-scale, long-term studies.

Serotonin and the Dopamines (talk) 15:00, 10 November 2020 (UTC)


 * Thank you for the review. I subbed out the words per your suggestion in the Cause section. I also found an additional study and added it to the Prognosis section. I did not end up editing the Prevention section as the original sentence was written by another author and I decided to leave the section as is. Hiatal Hernia (talk) 01:51, 11 November 2020 (UTC)

To Philippines
Philippines 143.44.196.48 (talk) 12:07, 9 January 2022 (UTC)

Hello, I added the Hallucinogenic Persisting Perception Disorder bullet point 12:35, 5/25/2022. I'm still a wikiedit baby, I apologize if it was an inappropriate addition, but it certainly deserves some mention. Bossa Nova Hog (talk) 05:39, 25 May 2022 (UTC)