Overview

According to [Sierra2008], "Depersonalization disorder (DPD) is a chronic and distressing condition with a prevalence in the general population between 0.8 and 2%." The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, states that "dissociative disorder [is] characterized by a pervasive subjective sense of unreality and detachment with intact reality testing."

Please see conventional, complimentary and alternative medical treatments for important background information regarding the different types of medical treatments discussed on this page. Naturopathic, Complimentary and Alternative treatments that may be considered include:

Etiology

According to [Sierra2008], "several neurobiological studies in the last decade have shown that patients have suppressed limbic activation to emotional stimuli. Such findings are in line with a model that suggests that the condition is generated by an anxiety-triggered, 'hard-wired' inhibitory response to threat. Such a mechanism would ensure the preservation of adaptive behavior, during situations normally associated with overwhelming and potentially disorganizing anxiety. In DPD, such a response would become chronic and dysfunctional."

[Bohus1999] has pointed out that "alterations of the endogenous opiate system contribute to dissociative symptoms in [PTSD] patients," evidence of which is based on a number of studies using opiate-receptor antagonist drugs such as naltrexone and naloxone to treat depersonalization disorder [Sierra2008], [Simeon2005], [Nuller20001].

[VanDeHeijning1991] reports "the relatively mu-selective [opiate-receptor] antagonist naloxone elevated oxytocin plasma levels." This may be significant, since brain oxytocin has been shown to be a key regulator of emotional and social behaviors, and may be a target for treating "anxiety- and depression-related diseases or abnormal social behaviors including autism" [Neumann2008].

Treatment

Conventional Treatment

According to [Sierra2008], [Simeon2005], depersonalization disorders have no established pharmacological or psychotherapeutic treatments that are even partially effective; antidepressants and antipsychotics "have been found to be of little value."

Naturopathic, Complimentary and Alternative Treatments

Low Dose Naltrexone (LDN)

[LdnResearchTrust_conditions] reports that depersonalization/derealization disorder (but not dissociative identity disorder - multiple personality disorder) is a condition that LDN could help.

One published report by [Sierra2008] states that "a number of studies suggest that opioid receptor antagonists such as naltrexone ... are useful in at least a subgroup of patients."

Another published clinical report by [Simeon2005] found that high dose naltrexone (100-250mg/d) gave "an average 30% reduction of symptoms with treatment ... Three patients were very much improved, and one patient was much improved." Dr. Weyrich points out that this is a very robust response, although not perfect. Dr. Weyrich speculates that at low dose, naltrexone might be even more effective.

A related opioid receptor antagonist medication, naloxone has also been reported in small clinical trials to be useful: "in three of 14 patients, depersonalization symptoms disappeared entirely and seven patients showed a marked improvement" [Nuller20001].

Dr. Weyrich has been trained in the use of Low Dose Naltrexone (LDN). However, Dr. Weyrich has not treated any cases of depersonalization disorder with LDN.

Please see What is Low Dose Naltrexone? for more information.

Neurofeedback

Neurofeedback may be useful for treating Depersonalization Disorder. Dr. Weyrich has been certified in neurofeedback since 2008, and more recently completed an additional residency training program at ADD Clinic of Scottsdale, AZ. However, Dr. Weyrich has not treated any cases of Depersonalization Disorder with this technique.

Please see What is Neurofeedback? for more information.

Neurotransmitter Balancing

Neuro Research [Hinz2015] reports that Depersonalization Disorder can be benefited by balancing neurotransmitter levels in the body.

Dr. Weyrich has been trained in neurotransmitter balancing protocols, but has not treated Depersonalization Disorder using this technique.

Please see What is Neurotransmitter Balancing? for more information.

Hypotheses

Dr. Weyrich notes that post-traumatic stress disorder (PTSD) may be an alternative response to the same basic mechanism as depersonalization disorder (DPD), and that patients may not fit neatly into any one "diagnostic box" - in other words, patients may present with symptoms that can be categorized either as DPD or PTSD, and that both disorders may respond to the same treatments.

References