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# The Science Behind Depersonalization/Derealization Disorder

By Angela Tao

Getting lost in a movie or daydreaming are common instances when one loses touch with his/her surroundings; they are mild examples of dissociation. Dissociation is the disconnection between mental processes such as perception, memory, and identity [5]. Symptoms might/can include memory loss and emotional numbing. Oftentimes, dissociative disorders develop in order to cope with trauma and ward off traumatic memories. A more serious case of dissociation can be diagnosed as a depersonalization/derealization disorder (DDD) [5]. People with DDD often feel as if they’re outside their body (depersonalization) and that their surroundings aren't real (derealization) [4]. Although the exact neurobiological causes of DDD are unknown, recent research conducted on it has shed light on how brain structure is connected to dissociative experiences.

Through neuroimaging, measures of brain activity that occur while doing tasks/resting are able to be taken [5]. Neuroimaging is the process of creating images of the brain using methods like functional magnetic resonance imaging (fMRI), which can help spot abnormalities in the brain. A model, proposed by Sierra and Berrios, suggests that symptoms of DDD are related to a lack of continuity in the cortico-limbic brain system, which consists of the amygdala, anterior cingulate cortex, and prefrontal structures [7]. Those areas of the brain play a part in cognitive control, attention, and arousal modulation [5]. Furthermore, the amygdala controls emotional processing, so an inactivity in that area would explain the state of detachment of DDD [8]. In an experiment where aversive pictures were shown to a group of people, individuals with DDD had less brain activity than others in the anterior cingulate cortex and insula on their fMRI scans [9]. Since those brain regions affect attention modulation and emotions, diminished activity in those areas indicates the decrease in emotional/interoceptive awareness that comes with DDD [6]. Studies have also shown a possible connection between areas of the brain linked to self-referential functions and DDD [3]. To further solidify this, more neuroimaging studies on the neurobiological causes of DDD would need to be conducted.

References:

1. (n.d.). Retrieved October 21, 2020, from https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders

2. Davis, M., & Whalen, P. (2000, December 14). The amygdala: Vigilance and emotion. Retrieved October 21, 2020, from https://www.nature.com/articles/4000812

3. Depersonalization Disorder: A Functional Neuroanatomical Perspective. (n.d.). Retrieved October 21, 2020, from https://www.tandfonline.com/doi/abs/10.1080/1025389031000138538

4. Fritscher, L. (n.d.). What Is Depersonalization/Derealization Disorder? Retrieved October 21, 2020, from https://www.verywellmind.com/derealization-2671582

5. Krause-Utz, A., Frost, R., Winter, D., & Elzinga, B. (2017, January). Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder. Retrieved October 21, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5283511/

6. Lemche, E., Brammer, M., David, A., Surguladze, S., Phillips, M., Sierra, M., . . . Giampietro, V. (2013, August 07). Interoceptive–reflective regions differentiate alexithymia traits in depersonalization disorder. Retrieved October 21, 2020, from https://www.sciencedirect.com/science/article/pii/S0925492713001492

7. M;, B. (n.d.). Depersonalization: A conceptual history. Retrieved October 21, 2020, from https://pubmed.ncbi.nlm.nih.gov/11619439/

8. Phan, K., Wager, T., & Liberzon, I. (2014, November 07). Functional Neuroimaging Studies of Human Emotions: CNS Spectrums. Retrieved October 21, 2020, from https://www.cambridge.org/core/journals/cns-spectrums/article/functional-neuroimaging-studies-of-human-emotions/EA34590FBE2FCD0DC6F23DF6CF80221C

9. Phillips, M., Medford, N., Senior, C., Bullmore, E., Suckling, J., Brammer, M., . . . David, A. (2001, December 21). Depersonalization disorder: Thinking without feeling. Retrieved October 21, 2020, from https://www.sciencedirect.com/science/article/abs/pii/S0925492701001196

https://www.sciencedirect.com/science/article/abs/pii/S0925492701001196

https://www.sciencedirect.com/science/article/pii/S0925492713001492

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