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Thursday, August 6, 2020

Coming to Terms with Unreality

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When I was 14 years old, I entered my freshman year of high school feeling nothing but a dull sense of disquietude. I was not happy to be starting the new school year. I was always “the quiet kid”, and that label only rang truer over time, as I retreated further into my shell with each passing school year. I had few friends, and the ones I had were fair-weather, frequently passing up hanging out with me in favor of others. I knew in the back of my mind that I should feel stressed or upset when the year began, but I just felt empty. 

My late childhood and early adolescence, meant to be a time of growth and learning, instead left me emotionally stunted. My stepfather was dying from congestive heart failure, the organ covered in scar tissue from the multitude of heart attacks he had suffered over the previous several years. He had ignored the advice and warnings of several doctors along the way, worsening his condition. My home no longer felt like a safe haven with the presence of death constantly looming. 

The lack of oxygen going to his brain and his constant feeling of general malaise cut his already short fuse down to nothing. You could not have a conversation with him for fear he would snap at you, and when he wasn’t in the hospital he barely left his bedroom. He was a husk of his former self, a bitter man consumed by sickness and regret. Every day my mother and I wondered if it was his last. As guilty as I felt for feeling this way, he was an unwelcome presence in my home. I do not think of sick people as intrusions and I know he was suffering greatly, but with the way he spoke to my mother sometimes, I could not help but feel resentment.

I was not comfortable at home, and school was certainly not an escape from stress. I had nowhere to turn, and no sense of reprieve. 

You expect to feel a certain way in response to trauma. You expect to cry frequently and have difficulty with your everyday tasks. However, instead it felt like my brain was full of TV static. 

I floated through my days in a dreamlike state, days blurring into one another. My life felt like an endless slog, each day as equally grating and unimportant as the previous one. I did not care about my subjects in school; I did my assignments on autopilot and would only speak when spoken to. Colors appeared less vibrant and my vision was hazy. The world around me and the body I was in felt foreign. Sometimes when I saw my own reflection I would barely recognize myself.

I didn’t know exactly when this detachment from reality had come to be, as I was slow to notice it happening at all. I knew that I used to feel things more deeply, and then one day, I no longer did. I didn’t give much thought to my surroundings, but over time I had a creeping realization that the ineffable connection between myself and the world around me had been severed. 

I was easily confused, my memory was spotty, and some days I was barely able to form a coherent sentence. My trains of thought were frequently derailed. I felt as though my mind was buried in a dense fog, keeping me from finding the proper words for what I wanted to communicate, forming logical connections, and digging through memories. I simply could not concentrate on anything. I had unexplained headaches and hand tremors. Distantly, I wondered if I had a brain tumor, but did nothing to investigate, even though on some level I believed it was a distinct possibility.

There were times when I thought I was going insane. I felt like I was trapped inside a body I did not recognize, forced to play the role of student and daughter in a farcical world, a cheap stage set that seemed to fool everyone but me. I understood on a fundamental level that my surroundings were real, but my physical perceptions and dampened emotional reactions seemed to indicate otherwise. No stimuli, no words, no information or person could elicit an emotional response naturally; I had to play pretend. Sad stories and events had almost no effect on me; I could not cry even if I tried. Life felt like a sick joke, and nothing mattered to me anymore. 

Back then I thought I was just “crazy” and alone in my experience. However, I later learned that these disorienting, alien sensations were not a sign of my mind unraveling. I was experiencing depersonalization coupled with derealization — a condition that I was surprised to find is not uncommon. I now think of it as my brain’s best attempt at coping with my circumstances, despite how unsettling it felt at the time.

A 2004 review by Hunter et. al. of then-current studies on depersonalization described the experience in a way that resonated with me, as it was so accurate to what I went through: the authors discussed a “dream-like state” in which the sufferer may feel a “loss of empathy and a sense of disconnection with bodily parts” to the point that one feels “as though they are observing the world from behind glass.” They pointed out that depersonalization is often accompanied by derealization, “in which the external environment also appears unfamiliar, with other people appearing as though actors and the world appearing as if two-dimensional or like a stage set” (p. 9). As I was scared to go to therapy and face my problems head-on, I spent many nights as a young teenager Googling my symptoms. Seeing my exact experience written about by clinicians and discussed in online forums made me feel less alone, and reading about its prevalence validated me further.

Clinically significant feelings of depersonalization can occur as a primary disorder (Depersonalization/Derealization Disorder), but often present as part of an array of symptoms related to a mental illness such as depression or anxiety (Michal et. al., 2011, p. 106). Depersonalization can also be triggered in response to trauma as in my case. While feeling detached from reality for an extended period of time is not considered normal, transient experiences of depersonalization are fairly common even in healthy individuals, particularly in states of high anxiety or sleep deprivation. Multiple studies have investigated the prevalence of these symptoms during traumatic events, reporting rates “varying from 31% to 66%” (Hunter et. al, 2004, p. 11). A more general “lifetime prevalence rate” of these experiences has been recorded as “between 26% and 74%” (Michal et al., 2011, p. 106). 

As I became more aware of my symptoms and had a prospective name for them, I found myself scared of my own physical body. I would stare at my hands until it hit me that they belonged to me, and I occupied a physical space in the world, and I was real. The thought sent a jolt of fear through me, as it forced me to realize with jarring clarity how truly disconnected I was from myself.

Baker et. al. (2007) described how depersonalization can cause anxiety if a person experiencing it is hypervigilant of their symptoms and worries excessively about them, considering every tiny change in their mental or physical state as a sign of their condition worsening. Symptoms of depersonalization may be “misinterpreted as indicative of severe mental illness or brain dysfunction” and hypervigilance may cause “a vicious cycle of increasing anxiety and consequently increased sensations” (p. 106). I thought I was broken inside; irreversibly damaged. Of course, that wasn’t true.

When I was 16, my stepfather passed away, and I felt as though I had sunk to the bottom of the ocean; my surroundings and emotions were muffled. Rather than dealing with my sadness right away, the emotional blowback came in flashes over the course of months. There were days when I was immobilized by the weight of it all, surrounded on both sides by months of complete numbness. 

I gave in and began going to therapy so I could come to terms with how my brain worked. What helped the most, though, was simply time. I was able to distance myself from my bad memories and cope with them as time passed, especially once I graduated high school. My symptoms improved slowly but surely over the course of a couple years, gradually returning color and vitality to my life. I noticed that I felt better overall, but whenever I became stressed or was reminded of my past trauma the barrier between myself and my surroundings returned. 

Now at 23 years old, symptoms of depersonalization show themselves when I am anxious, but they are less constant and never as severe as they were at when they first started. These feelings do not scare me as much, as I know I am not “broken”, or going insane, or dealing with a threat to my safety. Acceptance of my symptoms actually decreases their severity and helps me focus on the underlying stressor causing them. My experiences are a part of me, but I try not to let them hold me back, though some days that is easier said than done.

 

References 

Baker, D., Earle, M., Medford, N., Sierra, M., Towell, A., & David, A. (2007). Illness perceptions in depersonalization disorder: Testing an illness attribution model. Clinical Psychology & Psychotherapy, 14(2), 105–116. https://ift.tt/3i85q8G

Hunter, E.C.M, Sierra, M., & David, A.S. (2004). The epidemiology of depersonalization and derealization. Social Psychiatry and Psychiatric Epidemiology, 39, 9-18. https://ift.tt/3kitJTh

Michal, M., Glaesmer, H., Zwerenz, R., Knebel, A., Wiltink, J., Brähler, E., & Beutel, M. (2011). Base rates for depersonalization according to the 2-item version of the Cambridge Depersonalization Scale (CDS-2) and its associations with depression/anxiety in the general population. Journal of Affective Disorders, 128, 106-111. https://ift.tt/31onu7G



from Psych Central https://ift.tt/3fzf02A

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