Editing Depersonalization-derealization disorder (section)

==Signs and symptoms==
The core symptoms of depersonalization-derealization disorder are the subjective experience of "unreality in one's self",<ref>{{cite journal|last=Radovic F|title=Feelings of Unreality: A Conceptual and Phenomenological Analysis of the Language of Depersonalization|journal=Philosophy, Psychiatry, & Psychology|year=2002|volume=9|issue=3|pages=9: 271–279|doi=10.1353/ppp.2003.0048|s2cid=145074433|url=http://muse.jhu.edu/journals/philosophy_psychiatry_and_psychology/v009/9.3radovic01.html|url-access=subscription}}</ref> or detachment from one's surroundings. People who are diagnosed with depersonalization also often experience an urge to question and think critically about the nature of reality and existence.<ref name="Sierra 123–127"/>

Individuals with depersonalization describe feeling disconnected from their physicality; feeling as if they are not completely occupying their own body; feeling as if their speech or physical movements are out of their control; feeling detached from their own thoughts or emotions; and experiencing themselves and their lives from a distance.<ref name="Simeon D 2004 343–354">{{cite journal|author=Simeon D|year=2004|title=Depersonalisation Disorder: A Contemporary Overview|journal=CNS Drugs|volume=18|issue=6|pages=343–354|doi=10.2165/00023210-200418060-00002|pmid=15089102|s2cid=18506672}}</ref><ref>{{Cite journal |last1=Radovic |first1=Filip |last2=Radovic |first2=Susanna |date=September 2002 |title=Feelings of Unreality: A Conceptual and Phenomenological Analysis of the Language of Depersonalization |url=https://muse.jhu.edu/article/44428 |journal=Philosophy, Psychiatry, & Psychology |language=en |volume=9 |issue=3 |pages=271–279 |doi=10.1353/ppp.2003.0048 |issn=1086-3303 |access-date=11 May 2024 |archive-date=6 May 2024 |archive-url=https://web.archive.org/web/20240506091144/https://muse.jhu.edu/article/44428 |url-status=live |url-access=subscription }}</ref> While depersonalization involves detachment from one's self, individuals with derealization feel detached from their surroundings, as if the world around them is foggy, dreamlike, or visually distorted. Individuals with the disorder commonly describe a feeling as though time is passing them by and they are not in the notion of the present. In some cases, individuals may be unable to accept their reflection as their own, or they may have [[out-of-body experiences]].<ref name="Simeon D 2004 343–354" /> Additionally some individuals experience difficulty concentrating and problems with [[memory retrieval]]. These individuals sometimes lack the "feeling" of a memory where they are able to recall a memory but feel as if they did not personally experience it.<ref>{{Cite journal|last1=Lambert|first1=M. V.|last2=Senior|first2=C.|last3=Fewtrell|first3=W. D.|last4=Phillips|first4=M. L.|last5=David|first5=A. S.|date=March 2001|title=Primary and secondary depersonalisation disorder: a psychometric study|url=https://pubmed.ncbi.nlm.nih.gov/11246104/|journal=Journal of Affective Disorders|volume=63|issue=1–3|pages=249–256|doi=10.1016/s0165-0327(00)00197-x|issn=0165-0327|pmid=11246104|access-date=27 October 2020|archive-date=2 November 2020|archive-url=https://web.archive.org/web/20201102005743/https://pubmed.ncbi.nlm.nih.gov/11246104/|url-status=live}}</ref><ref>{{Cite journal|last1=Sierra|first1=Mauricio|last2=David|first2=Anthony S.|date=March 2011|title=Depersonalization: a selective impairment of self-awareness|url=https://pubmed.ncbi.nlm.nih.gov/21087873/|journal=Consciousness and Cognition|volume=20|issue=1|pages=99–108|doi=10.1016/j.concog.2010.10.018|issn=1090-2376|pmid=21087873|s2cid=17211680|access-date=27 October 2020|archive-date=31 October 2020|archive-url=https://web.archive.org/web/20201031150057/https://pubmed.ncbi.nlm.nih.gov/21087873/|url-status=live}}</ref> These experiences which strike at the core of a person's identity and consciousness may cause a person to feel uneasy or anxious.<ref name="Sierra 123–127" /> The inner turmoil created by the disorder can also result in [[Depression (mood)|depression]].<ref name="Symptoms and causes - Mayo Clinic">{{Cite web|title=Symptoms and causes - Mayo Clinic|url=https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911?p=1|access-date=2019-11-20|website=www.mayoclinic.org|archive-date=10 October 2019|archive-url=https://web.archive.org/web/20191010215327/https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911?p=1|url-status=live}}</ref>

First experiences with depersonalization may be frightening, with patients fearing loss of control, dissociation from the rest of society and functional impairment.<ref name="Blevins 539–553" /> The majority of people with depersonalization-derealization disorder misinterpret the symptoms, thinking that they are signs of serious psychosis or brain dysfunction. This commonly leads to an increase of anxiety and obsession, which contributes to the worsening of symptoms.<ref>{{cite journal|last=Sacco|first=Robert G.|date=December 2010|title=The Circumplex Structure of Depersonalization/Derealization|journal=International Journal of Psychological Studies|volume=2|issue=2|pages=26–40|doi=10.5539/ijps.v2n2p26|doi-access=free}}</ref>

Factors that tend to diminish symptoms are comforting personal interactions, intense physical or emotional stimulation, and relaxation.<ref name= "Simeon 03">{{cite journal | doi = 10.4088/JCP.v64n0903 |vauthors=Simeon D, Knutelska M, Nelson D, Guralnik O | year = 2003 | title = Feeling unreal: a depersonalization disorder update of 117 cases | journal = Journal of Clinical Psychiatry | volume = 64 | issue = 9| pages = 990–7 | pmid = 14628973 }}</ref> Distracting oneself (by engaging in conversation or watching a movie, for example) may also provide temporary relief. Some other factors that are identified as relieving symptom severity are diet or exercise, while [[Alcohol intoxication|alcohol]] and [[fatigue]] are listed by some as worsening their symptoms.<ref name="Baker 03">{{cite journal | doi = 10.1192/bjp.182.5.428 | pmid = 12724246 | journal = The British Journal of Psychiatry | volume = 182 | title = Depersonalisation disorder: clinical features of 204 cases | date = May 2003 | pages = 428–33 | vauthors = Baker D, Hunter E, Lawrence E, etal | issue = 5 | df = dmy-all | doi-access = free }}</ref>

Occasional, brief moments of mild depersonalization can be experienced by many members of the general population;<ref name="SimeonAbugel2008">{{cite book|author1=Daphne Simeon|author2=Jeffrey Abugel|title=Feeling Unreal: Depersonalization Disorder and the Loss of the Self|url=https://books.google.com/books?id=ONLyq-mVLuIC&pg=PA3|date=7 November 2008|publisher=Oxford University Press|isbn=978-0-19-976635-2|page=3|access-date=17 November 2016|archive-date=1 August 2020|archive-url=https://web.archive.org/web/20200801020628/https://books.google.com/books?id=ONLyq-mVLuIC&pg=PA3|url-status=live}}</ref> however, depersonalization-derealization disorder occurs when these feelings are strong, severe, persistent, or recurrent and when these feelings interfere with daily functioning.<ref name="Sierra 123–127" /><ref name="Symptoms and causes - Mayo Clinic" /> DPDR is most commonly experienced as chronic and continuous. However, for a minority who have DPDR as an episodic condition, duration of these episodes is highly variable with some lasting as long as, or longer than several weeks.<ref name=":1">{{Cite book |title=The American Psychiatric Association Publishing textbook of psychiatry |date=2 May 2019 |editor=Roberts, Laura Weiss |publisher=American Psychiatric Association Publishing |isbn=978-1-61537-256-0 |edition=Seventh |location=Washington, D.C. |oclc=1090279671}}</ref><ref name="Black">{{Cite book |last1=Black |first1=Donald W. |title=Introductory textbook of psychiatry |last2=Andreasen |first2=Nancy C. |publisher=[[American Psychiatric Publishing]] |year=2014 |isbn=978-1-58562-469-0 |edition=Sixth |location=Washington, DC |oclc=865641999}}</ref>