Editing Depersonalization (section)

== Causes ==
Depersonalization can arise from a variety of factors, of both a psychological and physiological nature. Common immediate precipitants include instances of [[Stress (biology)|severe stress]], [[Major depressive episode|depressive episodes]], [[panic attack]]s, and the consumption of psychoactive substances such as [[marijuana]] and [[hallucinogen]]s. Additionally, there exists a correlation between frequent depersonalization and [[Childhood trauma|childhood interpersonal trauma]], particularly cases involving [[Psychological abuse|emotional maltreatment.]]<ref name="Simeon-2004" />

A [[case-control study]] conducted at a specialized depersonalization clinic included 164 individuals with chronic depersonalization symptoms, of which 40 linked their symptoms to illicit drug use. [[Phenomenology (philosophy)|Phenomenological]] similarity between drug-induced and non-drug groups was observed, and comparison with [[Matching (statistics)|matched controls]] further supported the lack of distinction. The severity of clinical depersonalization symptoms remains consistent regardless of whether they are triggered by illicit drugs or psychological factors.<ref>{{Cite journal |last1=Medford |first1=Nicholas |last2=Baker |first2=Dawn |last3=Hunter |first3=Elaine |last4=Sierra |first4=Mauricio |last5=Lawrence |first5=Emma |last6=Phillips |first6=Mary L. |last7=David |first7=Anthony S. |date=December 2003 |title=Chronic depersonalization following illicit drug use: a controlled analysis of 40 cases |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2003.00548.x |journal=Addiction |language=en |volume=98 |issue=12 |pages=1731–1736 |doi=10.1111/j.1360-0443.2003.00548.x |pmid=14651505 |issn=0965-2140 |access-date=2024-03-30 |archive-date=2023-04-30 |archive-url=https://web.archive.org/web/20230430211010/https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2003.00548.x |url-status=live |url-access=subscription }}</ref>

=== Pharmacological ===
Depersonalization has been described by some as a desirable state, particularly by those that have experienced it under the influence of mood-altering [[recreational drugs]]. It is an effect of [[dissociatives]] and [[psychedelics]], as well as a possible side effect of [[caffeine]], [[alcohol (drug)|alcohol]], [[amphetamine]], [[Cannabis (drug)|cannabis]], and [[antidepressants]].<ref>{{cite journal |last1=Stein |first1=M. B. |last2=Uhde |first2=TW |title=Depersonalization Disorder: Effects of Caffeine and Response to Pharmacotherapy |journal=[[Biological Psychiatry]] |volume=26 |issue=3 |pages=315–20 |date=July 1989 |doi=10.1016/0006-3223(89)90044-9 |pmid=2742946 |s2cid=34396397 |url=https://zenodo.org/record/1253828 |access-date=2019-07-12 |archive-date=2024-01-26 |archive-url=https://web.archive.org/web/20240126213205/https://zenodo.org/records/1253828 |url-status=live }}</ref><ref>{{cite journal |last=Raimo |first=E. B. |author2=R. A. Roemer |author3=M. Moster |author4=Y. Shan |title=Alcohol-Induced Depersonalization |journal=[[Biological Psychiatry]] |date=June 1999 |doi=10.1016/S0006-3223(98)00257-1 |volume=45 |pages=1523–6 |pmid=10356638 |issue=11|s2cid=34049706}}</ref><ref name="pmid14746427">{{cite journal |last=Cohen |first=P. R. |title=Medication-associated depersonalization symptoms: report of transient depersonalization symptoms induced by minocycline |journal=[[Southern Medical Journal]] |volume=97 |issue=1 |pages=70–73 |year=2004 |pmid=14746427 |doi=10.1097/01.SMJ.0000083857.98870.98 |s2cid=27125601}}</ref><ref>{{cite web |url=http://www.medscape.com/viewarticle/468728_3 |title=Medication-Associated Depersonalization Symptoms |publisher=medscape.com |access-date=2009-03-30 |archive-date=2015-02-14 |archive-url=https://web.archive.org/web/20150214055436/http://www.medscape.com/viewarticle/468728_3 |url-status=live }}</ref><ref>{{cite journal |title=Depersonalization Again Finds Psychiatric Spotlight |journal=[[Psychiatric News]] |date=2003-08-15 |volume=38 |issue=16 |pages=18–30 |doi=10.1176/pn.38.16.0018 |last1=Arehart-Treichel |first1=Joan}}</ref> It is a classic [[Drug withdrawal|withdrawal]] symptom from many drugs.<ref name="pmid8104417">{{cite journal |last=Marriott |first=S. |author2=P. Tyrer |title=Benzodiazepine dependence: avoidance and withdrawal |journal=Drug Safety |volume=9 |issue=2 |pages=93–103 |year=1993 |pmid=8104417 |doi=10.2165/00002018-199309020-00003|s2cid=8550990 }}</ref><ref name="pmid15889607">{{cite journal |last=Shufman |first=E. |author2=A. Lerner |author3=E. Witztum |trans-title=Depersonalization after withdrawal from cannabis usage |language=he |journal=Harefuah |volume=144 |issue=4 |pages=249–51 and 303 |year=2005 |pmid=15889607|title=Depersonalization after withdrawal from cannabis usage}}</ref><ref name="pmid7085580">{{cite journal |last=Djenderedjian |first=A. |author2=R. Tashjian |title=Agoraphobia following amphetamine withdrawal |journal=The Journal of Clinical Psychiatry |volume=43 |issue=6 |pages=248–49 |year=1982 |pmid=7085580}}</ref><ref name="pmid9696914">{{cite journal |last=Mourad |first=I. |author2=M. Lejoyeux |author3=J. Adès |title=Evaluation prospective du sevrage des antidépresseurs |trans-title=Prospective evaluation of antidepressant discontinuation |language=fr |journal=[[L'Encéphale]] |volume=24 |issue=3 |pages=215–22 |year=1998 |pmid=9696914}}</ref>

[[Benzodiazepine dependence]], which can occur with long-term use of benzodiazepines, can induce chronic depersonalization symptomatology and perceptual disturbances in some people, even in those who are taking a stable daily dosage, and it can also become a protracted feature of the [[benzodiazepine withdrawal syndrome]].<ref>{{cite journal |doi=10.1016/0740-5472(91)90023-4 |pmid=1675688 |title=Protracted withdrawal syndromes from benzodiazepines |journal=Journal of Substance Abuse Treatment |volume=8 |issue=1–2 |pages=19–28 |year=1991 |last1=Ashton |first1=Heather }}</ref><ref>{{cite journal |author=Terao T |author2=Yoshimura R |author3=Terao M |author4=Abe K |title=Depersonalization following nitrazepam withdrawal |journal=[[Biological Psychiatry]] |volume=31 |issue=2 |pages=212–3 |date=1992-01-15 |pmid=1737083 |doi=10.1016/0006-3223(92)90209-I |s2cid=26522217}}</ref>

Lieutenant Colonel [[Dave Grossman (author)|Dave Grossman]], in his book ''[[On Killing]]'', suggests that military training artificially creates depersonalization in soldiers, suppressing [[empathy]] and making it easier for them to kill other human beings.<ref>{{Cite book |last=Grossman |first=Dave |title=On Killing: The Psychological Cost of Learning to Kill in War and Society |publisher=Back Bay Books |year=1996 |isbn=978-0-316-33000-8 |url=https://books.google.com/books?id=BewqAwAAQBAJ&q=depersonalization}}</ref>

[[Graham Reed (psychologist)|Graham Reed]] (1974) claimed that depersonalization occurs in relation to the experience of falling in love.<ref>{{cite book |last1=Reed |first1=Graham |year=1972 |title=The Psychology of Anomalous Experience |url=https://archive.org/details/amf00grah |url-access=registration |publisher=Hutchinson |page=[https://archive.org/details/amf00grah/page/127 127] |isbn=9780091132408}}</ref>

=== Situational ===
Experiences of depersonalization/derealization occur on a continuum, ranging from momentary episodes in healthy individuals under conditions of [[Stress (biology)|stress]], [[fatigue]], or [[Drug|drug use]], to severe and chronic disorders that can persist for decades.<ref name=":0" /> Several studies found that up to 66% of individuals in [[Near-death experience|life-threatening accidents]] report at least transient depersonalization during or immediately after the accidents.<ref name="Sadock2017-Epid-DP-DR" />

Several studies, but not all, found age to be a significant factor: [[adolescents]] and [[young adults]] in the normal population reported the highest rate. In a study, 46% of college students reported at least one significant episode in the previous year. In another study, 20% of patients with minor head injury experience significant depersonalization and derealization.

In [[general infantry]] and [[special forces]] soldiers, measures of depersonalization and derealization increased significantly after [[Military education and training|training]] that includes experiences of uncontrollable stress, semi-starvation, [[sleep deprivation]], as well as lack of control over [[hygiene]], movement, [[communications]], and [[social interaction]]s.<ref name="Sadock2017-Epid-DP-DR" />

=== Biological ===
Studies have linked dysregulation of the [[immune system]] with depersonalisation.<ref>{{Cite journal |last=Zheng |first=Sisi |last2=Feng |first2=Sitong |last3=Song |first3=Nan |last4=Chen |first4=Guangyao |last5=Jia |first5=Yuan |last6=Zhang |first6=Guofu |last7=Liu |first7=Min |last8=Li |first8=Xue |last9=Ning |first9=Yanzhe |last10=Wang |first10=Dan |last11=Jia |first11=Hongxiao |date=2024-05-27 |title=The role of the immune system in depersonalisation disorder |url=https://www.tandfonline.com/doi/full/10.1080/15622975.2024.2346096 |journal=The World Journal of Biological Psychiatry |language=en |volume=25 |issue=5 |pages=291–303 |doi=10.1080/15622975.2024.2346096 |issn=1562-2975|url-access=subscription }}</ref> Researchers compared protein expression in serum samples of individuals with [[Depersonalization-derealization disorder|depersonalisation/derealization disorder]] (DPDR, DDD) and healthy controls, and found that many key proteins involved in maintaining [[homeostasis]] were present at altered levels. Decreased levels of [[C-reactive protein|C-reactive protein (CRP)]], [[Complement component 1q|complement C1q subcomponent subunit B]], and apolipoprotein A-IV, and increased levels of alpha-1-antichymotrypsin (SERPINA3) were observed in patients with DPDR. Furthermore, expressions of CRP and SERPINA3 were found to be linked with the ability to inhibit cognitive interference of DPDR.