# my summary of Daphne Simeon's lastest DP article



## university girl (Aug 11, 2004)

The following contains some parts of the paper ?Depersonalization Disorder, A Contemporary Overview? by Dr. Daphne Simeon, written in my own words. Of course, anything in quotes is taken directly from the paper. The article is from the journal CNS Drugs 2004; 18 (6); 343-354. You can view the abstract here:

http://www.ncbi.nlm.nih.gov/entrez/quer ... =iconabstr

I have written this because I would like to help my fellow DP?ers who cannot access such information or do not know it exists. I did leave out quite a bit of information on the suggested neurobiology of the disorder. If you wish to know more on this, you can contact me with your questions. To find further DP-related articles, you can perform a search at http://www.ncbi.nlm.nih.gov/entrez 
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*?Patients frequently feel as if they are the only person experiencing this disorder, when in fact they are not.? *

Common descriptions of what depersonalization feels like:

?watching oneself from a distance (similar to watching a movie); candid out-of-body experiences; a sense of just going through the motions; one part of the self acting/participating while the other part is observing; feeling like you are in a dream or fog; looking in the mirror and feeling detached from one?s image; feeling detached from body parts or the whole body; not feeling in control of one?s speech or physical movements; feeling disconnected from one?s own thoughts; and feeling detached from one?s emotions (numbed or blunted).? ?the robotic, detached state? has been described as being ?analogous to the ?walking dead??. Depersonalized individuals fear ?going crazy, losing control and having permanent brain damage? and report problems with mental focus and forgetfulness. Depsite having these feelings, people with depersonalization disorder are aware their experiences are abnormal (they ?retain intact reality testing?).

DP disorder, often referred to as rare, is likely more common than it is currently thought to be because:

1) lack of knowledge of DP by clinicians 
2) unwillingness of patients to describe their symptoms for fear of being judged negatively 
3) difficulty patients experience when trying to describe their symptoms 
4) DP is often diagnosed as some variation of depression/anxiety when in fact DP is likely a separate disorder of its own

Brief depersonalization experiences are actually normal, but when it begins to interfere with our daily lives, it is a disorder. The ?normal? occurances of DP can take place while ?high? on drugs, under profound amounts of stress (ie. being hit by a car or robbed), or during a panic attack.

The onset of DP disorder can be over a period of time or quite promptly and can be chronic, epidsodic, or even something that happens briefly and never occurs again. Triggers of chronic/recurrent DP include some sort of psychological trauma or illicit drug ingestion. Some onsets of DP disorder have been known to have no obvious trigger.

Currently, the biochemistry behind DP disorder is not fully understood but studies are beginning to reveal some interesting findings and various hypotheses have been put forth. Hypotheses regarding brain chemistry suggest failure of distorted brain function to repair. But no worries, this does not mean it is unrepairable.

Dr. Simeon?s paper spoke of the following pharmacological agent categories of interest in treating DP disorder:

?SSRIs (ie. fluoxetine- unfortunately a study with fluoxetine failed to show benefit over placebo) 
?anticonvulsants (ie. lamotrigine- unfortunately a study with lamotrigine failed to show benefit over placebo) 
?opioid antagonists (ie. naloxone, naltrexone and nalmefene) 
?benzodiazepines (ie. clonazepam)- best for those with anxiety/panic

although ?*treatment recommendations and guidelines for depersonalisation disorder are still not established?? *

Currently there are no known pharmacological agents capable of significantly reducing feelings of dissociation (DP disorder is a dissociative disorder).

Over the years I have read many times that the most effective form of treatment is always a combination of meds and therapy. Which form of therapy and which med(s) is more of a circumstantial choice- it depends on your personal symptoms and what works best for you. I will attempt to keep you all updated with results of new studies when they become available. I wish you all luck as you travel down the road to recovery. I believe with perseverance we can all find the best possible med-therapy combination for ourselves. It is really up to YOU! Take care and keep hanging in there.

-university girl


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