Loss of awareness of emotional resonance. Derealization

Many people experienced a condition that they could not really explain.
According to them, they felt the unreality of what was happening, the reality around them became two-dimensional, as if drawn. The perception of sounds was also distorted. This disorder is called derealization. Attacks can be prolonged or short-lived, and the frequency of their occurrence can also vary. Derealization is sometimes called depersonalization, but these are two different pathological conditions. In the first case, a person suffers from a psychosensory perception of the world, and in the second, an internal personality disorder is observed. Simply put, depersonalization refers to processes occurring within a person, while derealization is formed as a result of the loss of the ability to sense external stimuli. But derealization and depersonalization very often accompany each other, so even in the International Classification of Diseases these disorders are combined into one syndrome.

Causes of pathology

Derealization is a neurotic disorder that affects people without any special mental pathologies who experience excessive mental and physical stress, are in a stressful situation and lack sleep. In addition, derealization can be a symptom of any disease, both somatic and mental.

The main reasons for the occurrence of such a pathological condition include:

• biochemical factors. A decrease in the number of neurotransmitters responsible for the normal functioning of the psycho-emotional sphere, as well as deterioration in the functions of the neural opiate system and a lack of gamma-aminobutyric acid;
• hereditary factors. It has been proven that the tendency to increased anxiety may have genetic background. In addition, within one family, as a rule, there is a single way of responding to stressful situations, also determined genetically;
• personal and psychological factors. This category of reasons includes excessive suspiciousness and impressionability of a person, heightened pedantry and perfectionism, increased demands on oneself and fixation on negative emotions;
• somatic factors. Some organic diseases can lead to the development of similar phenomena. Such pathologies include diseases of the respiratory and cardiac systems, thyroid dysfunction and low blood sugar levels;
• social factors. Psychological trauma received in childhood, an unfavorable environment at home or in a team, as well as various stressful situations can lead to a person feeling symptoms of derealization and depersonalization.

Derealization can be triggered by poor nutrition, non-compliance with rest and sleep schedules, and addictions.

Derealization, as well as depersonalization, are not dangerous pathologies. They will only slightly worsen the quality of life. This is how the human psyche wants to protect itself from potentially stressful situations and traumatic experiences. That is, it is a kind of defense mechanism. But you can and should get rid of this condition, but this requires the help of specialists.

Etiology

Etiology unknown. No infectious, hormonal, immunological, or psychiatric causes have been identified for this disease. It has been proven that among the many infectious agents proposed as causative agents of this disease, neither the Epstein-Barr virus, nor Lyme disease, nor candidiasis, nor cytomegalovirus are the cause of CFS. Allergic markers and immunosuppression were also not identified.

Various minor immunological disturbances have been reported. These abnormalities include low levels of IgG, abnormal IgG, decreased lymphocyte proliferation, low interferon gamma in response to mitogens, low cytotoxic activity of natural killer cells, circulating autoantibodies and immune complexes, and many other immunological abnormalities. However, nothing proposed provides adequate sensitivity and specificity for the detection of CFS. They, however, emphasize the physiological legitimacy of the existence of CFS.

Relatives of patients with CFS have an increased risk of developing the syndrome, suggesting a genetic component or common exposure to environmental pathogens. Recent research has identified several genetic markers that may be associated with susceptibility to CFS. A number of researchers believe that it will eventually be discovered that the etiology of the syndrome may be multifactorial, including genetic predisposition, exposure to microbes, toxins and other physical agents, and/or emotional trauma.

Symptoms

To recognize a disorder, you need to know its symptoms. During derealization, a person is in the following state:

1. The feeling that there is a “veil” or “haze” in the head. Visual images are perceived as if in a fog.
2. Perception of signals from the surrounding reality with some delay.
3. Everything that happens at a given moment is perceived as a movie or a dream, and the person himself feels like an outside observer. Patients often talk about a feeling of unreality of what is happening.
4. Inability to obtain a positive emotional response from things and activities that previously brought pleasure.
5. Visual and auditory perception is dulled. The colors become faded and the sounds become muffled. Tactile perception may also be impaired and taste buds may be temporarily disabled. Food and drinks seem tasteless.
6. The sense of time is distorted. A person may say that all processes have frozen or are moving too quickly.

In severe forms of the disorder, short-term memory loss may occur. After an attack, a person is unable to remember who he talked to today, what he ate, etc.

The most important symptom of derealization and depersonalization is the person's extreme anxiety about the condition. Based on this sign, the psychotherapist can assume the presence of a disorder in the patient.

(Systemic Exercise Intolerance Disease; SEI; Myalgic Encephalomyelitis; ME/CFS)

Chronic fatigue syndrome (CFS) is a state of persistent, lifestyle-related fatigue lasting > 6 months that is unexplained and has a range of associated symptoms. Patient management includes confirmation of disability, treatment of specific symptoms, and in some patients, cognitive behavioral therapy and a gradually increasing exercise program.

Although at least 25% of people consider themselves to have chronic fatigue syndrome (Fatigue), only about 0.5% of people have symptoms that meet the criteria for CFS. Although the term CFS was first used in 1988, the disorder has been fairly clearly described since at least the mid-1700s, but under different names (eg, general malaise, neurasthenia, chronic brucellosis, neurocirculatory dystonia). CFS has been most commonly described among young and middle-aged women, but cases have been reported in all age categories, including children, and in both sexes.

CFS is not malingering (deliberately faking symptoms). CFS shares many of the same symptoms as fibromyalgia, such as sleep disturbances, cognitive decline, fatigue, pain, and worsening symptoms with physical activity.

Diagnosis of derealization

If you feel as if you are drunk, but have not drunk alcohol for a long time, then this may be a reason to consult a doctor. On the Internet you can find tests to determine realization and depersonalization, but it is important not so much to detect the disorder as to identify its causes. This is extremely important, because such conditions can accompany schizophrenia and other serious mental pathologies. Only an experienced specialist can determine an accurate diagnosis.

Diagnostics will include the following steps:

• studying the medical history, talking with the patient. Among the diagnostic methods, the most important in this situation is a survey, but it is also important to comprehensively study the patient’s medical history. A history of previous mental disorders or severe somatic illnesses, as well as cases of derealization among family members of the patient, will allow a more accurate determination of the cause of this condition;
• visual examination of the patient;
• application of clinical scales developed for psychodiagnostics of derealization and depersonalization. The most famous scale is the Nuller test. At its core, this scale is a list of symptoms of the disorder, differing in the characteristics of their manifestation. If any of them was noticed in the patient, then a mark is placed opposite it. The specialist then counts the number of such symptoms and assesses the severity of the patient;
• use of other methods of psychological research;
• conducting clinical studies, including x-rays and pharmacological tests. All these measures can help identify somatic diseases that can lead to the development of derealization, as well as reduce the likelihood of developing side effects from drug treatment in the future.

The specificity of symptoms, as well as the duration of their observation, deserves special attention. If the attack of derealization was isolated and short-lived, then the cause should be sought in overwork or nervous shock. Otherwise, the disorder may indicate more serious pathological processes in the body.

Clinical manifestations

Before the onset of CFS, most patients were highly productive and prosperous.

The onset of the disease is usually sudden, often following a psychological or medical stressful situation. Many patients report an initial viral-like illness with swollen lymph nodes, extreme fatigue, fever, and upper respiratory symptoms. When the symptoms of the initial stage of the syndrome are eliminated, processes apparently begin that cause prolonged severe fatigue, which interferes with daily activities, as well as causing many other features of the syndrome.

Physical examination findings are normal, with no objective evidence of muscle weakness, arthritis, neuropathy, or organomegaly. However, some patients have low-grade fever, nonexudative pharyngitis, and/or palpable or tender (but not enlarged) lymph nodes. Before making a diagnosis of CFS, it is necessary to examine and analyze any physical abnormalities and rule out alternative diagnoses for the causes of chronic fatigue.

Treatment

Since conditions such as derealization and depersonalization are not independent diseases, treatment will be aimed at eliminating the underlying disease. This problem requires an integrated approach, which can be implemented by doctors of various specializations, but psychotherapists and psychiatrists play the leading role in correcting the disorder.

Therapy should be carried out in several directions:

1. Medicines are actively used in the treatment of derealization and depersonalization. Recommended medications include tranquilizers, antipsychotics and antidepressants. These drugs can reduce the manifestations of anxiety and eliminate depression, against the background of which pathology can develop. In addition, other medications may be recommended. Prescriptions depend on the type of the patient’s underlying disease, his individual characteristics and the severity of the pathology.
2. Among psychotherapeutic methods, the most effective are cognitive-behavioral techniques. Good results can be achieved by combining the methods of self-hypnosis, art therapy, music therapy, etc. Auxiliary techniques can improve the patient’s psycho-emotional state.
3. Rehabilitation helps to avoid the re-development of derealization. This becomes possible thanks to the normalization of sleep, work and rest patterns, as well as the elimination of stress factors that can provoke a relapse of the disease.

To prevent the need for treatment of derealization from arising at all, you need to pay special attention to strengthening the psyche and nervous system. After all, events leading to the development of stress can happen at any time to any of us. Exercising, walking in the fresh air, eating a healthy diet and maintaining a sleep schedule - all this will help a person cope with negative factors and maintain mental health.