What causes depersonalization
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Causes of Depersonalization: A Comprehensive Overview
Introduction to Depersonalization
Depersonalization is a complex psychological phenomenon characterized by a profound disruption in self-awareness, often manifesting as feelings of disembodiment and emotional numbing. Individuals experiencing depersonalization may feel detached from their own thoughts, feelings, and body, leading to a sense of unreality. Understanding the causes of depersonalization involves exploring various neurobiological, psychological, and emotional factors.
Neurobiological Mechanisms
Fronto-Limbic Suppression
Research indicates that depersonalization may be caused by a suppressive mechanism in the fronto-limbic regions of the brain, particularly the anterior insula. This mechanism, mediated by attention, results in emotional numbing and a subjective feeling of unreality. Functional neuroimaging studies have shown that patients with depersonalization disorder (DPD) exhibit increased prefrontal activation and reduced activation in insula/limbic-related areas when exposed to aversive emotional stimuli 1.
Corticolimbic Disconnection
Another neurobiological perspective suggests that depersonalization involves a disconnection within the corticolimbic system. This disconnection leads to increased alertness due to the activation of prefrontal attentional systems and reciprocal inhibition of the anterior cingulate cortex. This results in experiences of "mind emptiness" and "indifference to pain." Additionally, inhibition of the amygdala by left-sided prefrontal mechanisms contributes to hypoemotionality and feelings of detachment 3.
Psychological and Cognitive Factors
Predictive Coding and Affective Processing
Depersonalization can also be understood through the lens of predictive coding, where the mind creates a model to explain the modulation of affect as the organism interacts with the world. When the world fails to produce the expected affective responses, the individual feels a sense of detachment from their experiences. This mismatch between expected and actual emotional responses leads to the characteristic feelings of depersonalization 2.
Anxiety and Catastrophic Appraisal
There is a strong link between depersonalization and anxiety disorders. Depersonalization often follows an anxiety attack and can be exacerbated by the catastrophic appraisal of transient depersonalization symptoms. Misinterpreting these symptoms as signs of severe mental illness or brain dysfunction can create a vicious cycle of increasing anxiety and depersonalization symptoms. Cognitive and behavioral responses, such as avoidance and safety behaviors, further maintain the disorder by heightening perceived threats and preventing the disconfirmation of catastrophic beliefs 45.
Emotional and Affective Dimensions
Emotional Numbing and Hypervigilance
Emotional numbing is a key symptom of depersonalization, characterized by a blunted emotional response to stimuli. Studies using electrodermal activity have shown that individuals with depersonalization exhibit high skin conductance levels and attenuated responses to negative stimuli, indicating hypervigilance and emotional detachment during threatening situations 6. This emotional blunting may be an adaptive response to inescapable stress, mediated by the deactivation of limbic structures 9.
Dysphoria and Thought Disturbance
Depersonalization is also closely associated with chronic anxiety, persistent depressive affect, and specific types of pathological thinking. Patients experiencing depersonalization often report feelings of dysphoria and disturbances in thought processes, which may contribute to the overall sense of detachment and unreality 7.
Conclusion
Depersonalization is a multifaceted phenomenon with roots in neurobiological, psychological, and emotional processes. The interplay between fronto-limbic suppression, corticolimbic disconnection, predictive coding, anxiety, and emotional numbing provides a comprehensive understanding of the causes of depersonalization. Further research is needed to explore these mechanisms in greater detail and develop effective interventions for individuals suffering from this distressing condition.
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Depersonalization: A selective impairment of self-awareness
Depersonalization in DPD patients is likely caused by a fronto-limbic suppressive mechanism, with parietal mechanisms likely underpinning feelings of disembodiment and lack of agency.
Observational Study
Highly CitedDepersonalization Disorder, Affective Processing and Predictive Coding
Depersonalization disorder (DPD) arises from a multilevel interaction between emotional, affective, and cognitive processing, where the "self" is a predictive model that adjusts to unexpected changes in the world, leading to a feeling of not being present in experience.
Depersonalization: neurobiological perspectives
Depersonalization may result from activation of prefrontal attentional systems and inhibition of the anterior cingulate, leading to experiences of mind emptiness and indifference to pain.
Highly CitedDepersonalisation ‐ symptoms, meaning, therapy
Depersonalisation is a result of anxiety and can be successfully treated with anxiolytic drugs, but can lead to lingering depressive phases and increase resistance to antidepressive therapy in endogenous depression patients.
Non-RCTDepersonalisation disorder: a cognitive-behavioural conceptualisation.
Depersonalisation disorder (DPD) is linked to anxiety disorders, particularly panic, and chronic development occurs when transient symptoms are misinterpreted as severe mental illness or brain dysfunction, leading to a vicious cycle of anxiety and increased symptoms.
Highly CitedEmotional response in depersonalization: A systematic review of electrodermal activity studies.
Depersonalization is associated with hypervigilance and emotional detachment during threatening situations, but future research should explore emotional responses to positive situations.
Systematic Review
Rigorous JournalDepersonalization, dysphoria, and thought disturbance.
Depersonalization is associated with chronic anxiety, persistent depressive affect, and some degree of psychopathological thinking.
Observational StudyDepersonalization and meditation.
Meditation can cause depersonalization and derealization, with the meanings associated with these experiences influencing anxiety levels and social or occupational functioning.
Literature ReviewCognitive-Affective Neuroscience of Depersonalization
Depersonalization disorder (DPD) may be mediated by neurocircuitry and neurotransmitters involved in sensory processing, body schema, and emotional experience, with potential evolutionary advantages in response to inescapable stress.
Depersonalization Phenomena in Psychiatric Patients
Depersonalization is a common symptom in psychiatric patients, often accompanied by a sense of unreality, and has been elevated to the status of a diagnostic entity in its own right.
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