Anomalous subjective recall consists of difficulties remembering or imagining things. They're subtle subjective impairments affecting recall and imagery. The ability to retrieve information is unaffected, but episodic memories seem to have lost any personal meaning. Additionally, autobiographic memories are often remembered from a vantage point outside of the body. This component may serve as an avoidant function for people affected by trauma.

Anomalous Subjective Recall

Emotional numbing is the inability to feel emotions. In DDD patients, this may be observed on a spectrum. It often manifests as a loss of affection, pleasure, fear, or disgust. Sometimes it's an absolute inability to experience emotional states and other times it's a more subtle impairment (unable to experience emotional feelings that normally color perception and mental activity). An inability to perceive objects or concrete situations with emotional feeling, rather than a general inability to experience emotional states is also seen. Cognitive empathy is intact, but affective empathy is impaired.

Emotional Numbing

Feelings of disembodiment can be described as feeling "dead" or automaton-like. DDD patients feel a lack of body ownership feelings, a loss of agency, and can experience disembodiment anywhere from a non-specific feeling of not being in the body to an out-of-body experience.

Feelings of Disembodiment

Derealization is a dissociative symptom characterized by a feeling of detachment or unfamiliarity with the external world. People, objects, and surroundings may seem unreal, distant, or distorted.

Derealization

- Derealization
- Anomalous subjective recall
- Emotional numbing
- Feelings of disembodiment

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- Physiological or emotional numbing
- Sensory impairments feelings of disembodiment
- Distorted experience of time
- Feeling as if one is in a dream
- Visual perceptual distortions
- An unreal/absent sense of self
- May hear voices (dissociative episodes; distinct from the auditory hallucinations experienced in psychosis)
- DON’T have psychosis and HAVE intact reality testing
- Symptoms often overlap with both anxiety and other dissociative disorders (PTSD or panic disorder, OCD, depression, schizophrenia)

Depersonalization-Derealization Disorder Symptoms

Gentile, J. P., Snyder, M., & Gillig, P. M. (2014). STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/ Derealization Disorder. Innovations in Clinical Neuroscience, 11(7–8), 37–41. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204471/pdf/icns_11_7-8_37.pdf

STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder

Sierra, M., & David, A. S. (2011). Depersonalization: A selective impairment of self-awareness. Consciousness and Cognition, 20(1), 99–108. https://doi.org/10.1016/j.concog.2010.10.018

Depersonalization: A selective impairment of self-awareness

DDD manifests as a pervasive disruption of self-awareness at its most basic level (what it feels like to be an entity; to exist). Other dissociative disorders/conditions usually impair identity at levels involving autobiographical memory, self-narratives, and personality.

Depersonalization-Derealization Disorder (DDD) vs. Other Dissociative Disorders

Post-traumatic Stress Disorder (PTSD) is a condition where an individual experiences a collection of persistent symptoms following a traumatic or profoundly stressful event, such as combat, sexual assault, or a natural disaster. For a diagnosis, these symptoms must last for at least one month. The traumatic event can be witnessed firsthand or secondhand. Historically, PTSD was referred to by terms like 'shell shock' and 'combat neurosis' due to its frequent association with war, but it is now recognized as affecting a wider population.

Post-traumatic Stress Disorder (PTSD)

Schizophrenia is a severe psychological disorder that leads to a profound breakdown in an individual's ability to function, often necessitating hospitalization. It is characterized by significant disruptions in thought, perception, emotion, and behavior, including symptoms like hallucinations, delusions, incoherent thinking, bizarre actions, flat emotions, and a lack of motivation for basic activities. It is important to distinguish schizophrenia from dissociative identity disorder ('split personality'), as the term 'schizophrenia' refers to a 'splitting of psychic functions,' not a divided personality.

Schizophrenia

Generally speaking, depression is an overall feeling of sadness. More specifically, those with depression tend to experience several things such as: an increase or decrease in weight, troubles with concentration, feelings of meaninglessness or worthlessness, thoughts of death or suicide, and so on. 

Depression

Experiential Components of DDD

Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions and/or compulsions. Obsessions are defined as intrusive and unwanted thoughts, mental images, fears, sensations, or urges. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform, often in response to an obsession. These cycles of obsessions and compulsions are typically distressing, time-consuming, and can significantly disrupt a person's daily activities.

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