This morning we posted an original article by Jeffrey Abugel, co-author with Daphne Simeon, MD, of Feeling Unreal: Depersonalization Disorder and the Loss of the Self. This afternoon we have an excerpt from their book which will hopefully help you better understand Depersonalization Disorder. Below is Trisha’s story, just one of many varied experiences with Depersonalization Disorder.
Trisha was a 21-year-old college junior majoring in fine arts at a large state university. She was bright, attractive, ambitious, and sociable. She describes her upbringing as happy and uneventful. She was the second of four children raised in a small Midwestern town, and her parents were still happily married. She got along well with both of them and was particularly close to her sister Jane, who was 2 years younger. Trisha always did well in school, was athletic, and had many friends. She had never felt particularly troubled, other than the ups and downs of normal teenagers. Prior to a fateful day that was to come, she had tried marijuana twice in her life. The first time she was in tenth grade, when she and her friends were at a party one Saturday and she took a few “tokes” of a friend’s joint. She did not feel much of anything, and her friend told her she had t try it a few times to feel the effect. Trisha, however, was not particularly curious and did not try marijuana again until her second year in college. She was at the time dating a student who smoked pot regularly, and she tried it again one night at a party with him. After inhaling deeply a few times and holding the smoke as she had seen him do, she began to feel cloudy-headed, giggly, and quite hungry. Time seemed to move slowly ad well. She didn’t feel particularly high nor enthralled with what she did feel.
A year passed and Trisha came on the occasion of smoking pot for the third time in her life, amidst a small gathering of friends. It was just a way of being sociable and joining the others. She smoked about a joint over the course of the evening, and felt “very stoned,” oddly detached from her body and from everything happening around her. “It wasn’t a pleasant sensation,” she recalls. “My head felt too present, and hollow somehow.” I felt like my mind had somehow disconnected from my body. I didn’t panic because I knew it was temporary. At least I thought it was.”
Trisha remembers going to bed much later that evening thankful that she still had Saturday and Sunday ahead of her to get straight and study some for her final exams coming up the following week. However, when she woke up the next morning she was feeling as strange and detached as the night before. Familiar objects around the room seemed somehow different in the morning light. Books, the alarm clock, a small trophy, a plant on the window sill-they had all been there each day, but now looked less familiar, as if she were seeing them for the first time. She told her boyfriend that she was still stoned, by now feeling frightened. The pot must have been stronger than usual, he said, assuring her not to worry because it would gradually dissipate over the curse of the day. He was back to his normal self, however, which did reassure Trish at all. She tried to relax her mind by having breakfast, listening to some music and studying for her first exam. She found this terribly difficult to do, as it was very hard to focus on anything, and she absorbed very little of what she was reading. As the day unfolded, she felt she was in a dream, navigating through fog in slow motion, dazed and semi-aware of what was going on around her; time seemed eternal. She decided to go for a long walk, something that she often liked to do to relax whenever she felt stressed. She thought that the cold, fresh air might clear her head and help her feel more normal again, but it didn’t. By bedtime that evening, Trish was starting to panic about her condition. She called several friends and her sister Jane and asked them whether they had ever felt stoned and hung over for pot for so long. Although no one wanted to give her too straight an answer, she sensed that no one had.
By the next morning, Trish woke up to find that nothing had changed, and she began to despair. In what turned out to be the most stressful days of her life, she somehow managed to stick it out, take her exams, and return home for winter break. She then sobbingly confided to her parents what had happened to her. She now feared that she had somehow caused herself irreparable brain damage and hated herself for having smoked. Although her family tired to comfort her by reminding her that she had done nothing different from many other good kids her age, she could not stop worrying that she had permanently damaged her brain and had only herself to blame. Within a couple days the family arranged for their doctor to see Trisha. She tried to describe to him in detail exactly what she was feeling. He suggested that she was probably stressed by the high demands of the semester that had just ended. She did not say anything, but Trisha somehow knew this was not it. Although it had been a hard semester, she had been copying well with it, and she was not aware of feeling particuarly stressed. She that this “physical” sensation had to be somehow different. She told the doctor that she was convinced that the drug had somehow damaged her brain. To reassure her, he referred her to a neurologist.
Trish saw the neurologist, who ordered a few tests to make sure she was undamaged by her brief experiences with drugs. Both the MRI scan of her brain and he electroencephalogram (EEG) test of her brain waves were normal. The neurologist then also told her that she appeared particularly stressed and anxious. So he referred her to psychiatrist. Meanwhile, there had been no change in the severity of Trish’s symptoms over 2 weeks, and fairly soon she had to return to school. She could not fathom going back and working hard with her head in a fog, a constant feeling that she was tripping or going insane. A few days later, she saw a psychiatrist who told her that her experiences had a name, depersonalization. She had never heard of it and felt vastly relieved to find out that there was a name for waht she was experiencing. The psychiatrist told her that the syndrome might have been triggered by her drug use and acknowledged knowing little about how to treat it. Given that the next week she as preparing to go back to school, he referred her to the well-known psychiatry department of the university hospital of her school. …
… How common is it for marijuana use to trigger depersonalization?
It is not considered common, but it has now become well established that marijuana can trigger depersonalization. Given the very high prevalence of marijuana use in the general population, an outcome of chronic depersonalization is probably infrequent. Still, it is clear that it does happen. The first report of a few cases of chronic depersonalization induced by cannabis came out in the early 1980s. At present, prominent investigators that specialize in researching DPD have found that about 10-15% of all cases appear to be triggered by marijuana use. Furthermore, they have found that the form of the disorder associated with this drug trigger is no different in its symptoms, severity, or course from the disorder as it appears in others circumstances.