Depersonalization

Description:

Depersonalization (Latin de, lat. persona  — the personality) — the state which is followed by change or loss of feeling own "I" (dissociative frustration). It seems to patients that events of their life happen to someone another that they as if "look through" the life at movie theater. Depersonalization is accompanied, in most cases, by a derealization and mental anesthesia. The Latin name — anesthesia psychica dolorosa. In MKB-10 it is designated as F48.1  — the "Depersonalization-derealizatsii syndrome" which is historically called by depersonalization. Long depersonalization is the painful state which is often leading to suicides.

Depersonalization symptoms:

The Depersonalizatsionny symptom complex can include the following feelings of the patient:

    * Feeling of partial or total disappearance (deleting) of lines of the personality
    * Disappearance of so-called "thin emotions"
    * Muting or total disappearance of feelings (emotional relation) to relatives
    * The surrounding situation seems "flat", "dead", or is perceived, is dulled, as if through glass
    * The dulled color perception, the world around "gray", "colourless"
    * Absence or obtusion of emotional perception of the nature
    * Absence or obtusion of perception of works of art, music
    * Feeling of lack of thoughts in the head
    * Feeling of absence or decrease in memory (at its objective safety)
    * In certain cases, everything can seem absolutely unfamiliar, for the first time seen around
    * Obtusion of simple feelings, such, as resentment, rage, compassion, joy
    * Lack of the concept "mood" (the mood as if does not exist). Tells emergence of bad mood about improvement of a state.
    * Feeling of the body as automatic machine, the actions seem automatic (at objective understanding that it only seems)
    * Loss of feelings causes painful mental anguish
    * Feeling of the slowed-down current or full stop of time
    * Difficulty of figurative representation, figurative thinking
    * Obtusion or lack of painful, tactile, temperature, flavoring, proprioceptive sensitivity, feeling of weight, feelings of a dream, hunger and saturation (so-called somatopsychic depersonalization)

Depersonalization reasons:

Practically always (except for some types of schizophrenia), depersonalization is the protective mechanism of mentality at emergence of a strong emotional shock including a debut of a serious mental illness. In the situations, emergency for mentality, depersonalization allows to estimate soberly a situation, without the emotions disturbing the analysis. In that case, depersonalization is normal reaction of an organism to acute stress. Pathological consider long, ongoing, the painful course of depersonalization.

Depersonalization treatment:

Treatment of the main frustration within which there was depersonalization is usually made. However, in case of lack of other symptoms of a mental disease, depersonalization can be independent psychiatric frustration.

The komorbidnost (coherence) of depersonalization and alarm is found. Thus, at treatment of depersonalization appoint high doses of tranquilizers (Phenazepamum to 20 mg/days), and also antidepressants and neuroleptics with a strong anxiolytic (antialarming) component of action. For example, the combination of a klomipramin (Anafranil) and a kvetiapina (Serokvel) is considered quite effective — both of these drugs have the powerful cholinolytic effect which is shown including, the anxiolytic action. In case of combined use of these two drugs, the cumulative anticholinergic effect considerably increases. After removal of alarm also resistance leaves, and the antidepressive or antipsychotic effect is kept from its emergence and affect already directly the frustration reason.

Also it was revealed that at depersonalization there is a frustration of opioid system of a brain. Researches Yu. L. Nullera was found efficiency of treatment by antagonists of opioid receptors, such as Naloxonum and naltrexone.

The research D. Simeon showed efficiency of a combination of antidepressants — inhibitors of the return serotonin reuptake (SIOZS), together with an antikonvulsant lamotridzhiny. This method became the main method of treatment of depersonalization in the USA and Canada.

In some exceptional cases, there is effective an administration of cortexone (Decortenum). Such method of treatment, was formed as a result of detection of disturbance of functioning of adrenal glands, the famous psychiatrist V. Frankl, at this disease.

In some clinics, make intravenous injection of high doses of nootrop, with, preferential, antioxidant action, such as: cytoflavin, Cavintonum, мексидол, and also, high doses of vitamin C, together with benzodiazepine tranquilizers.

Use of electroconvulsive therapy at this disease is ambiguous.

In case of resistance to above-mentioned methods, tactics of "a bystry timoanalepsiya" developed by the academician S. N. Mosolov can be used. Klomipramin (Anafranil) enter intravenously kapelno, since 25-50 mg/days, with gradual increase in a dose to maximum — 150 mg/days Besides, for strengthening of effect it is possible to add 25-75 mg of Maprotilinum (Ludiomil). In 15-20 days, in the absence of effect, it is recommended to carry out single-step cancellation of therapy — against the background of which at a part of patients it is possible to reach reduction of expressiveness of anestetichesky frustration. At such sudden break, there is so-called "neuromediator chaos" which starts internal mechanisms of return of a homeostasis (autoregulyation) which remove also depersonalizatsionny symptomatology at the same time. Approximately the same mechanism of action, atropinokomatozny therapy possesses. There is a quantity of less known methods, with the similar principle of action, but not gained distribution, because of strong side effects.