Barrie Miskin was recently pregnant when she noticed a change in her appearance. Dark patches bloomed on her skin like watercolor ink. A “thick” growth of hair grew on her upper lip and chin.
The outside world was changing, too: In her neighborhood of Astoria, Queens, bright lights enveloped objects in a halo, blurring her vision. Her colleagues and even her doctors began to seem like “alien proxies” of themselves, said Ms Miskin, 46.
“I felt like I was looking at the world through a dirty glass,” he added. However, Mrs Miskin knew it was all an illusion, so she sought help.
It took more than a year of consultation with mental health experts before Ms. Miskin finally found an explanation for her symptoms: She was diagnosed with a disruptive condition called depersonalization/derealization disorder, or DDD. Before her pregnancy, Ms. Miskin had stopped taking antidepressants . Her new psychiatrist said the symptoms could have been triggered by months of untreated depression that followed.
While Mrs Miskin felt alone in her mysterious illness, she was not. Tens of thousands of posts on social media refer to depersonalization or derealization, with some likening the condition to “living in a movie or a dream” or “observing the world through a fog.”
People experiencing depersonalization may feel as if they are disconnected from their mind or body. Derealization, on the other hand, refers to feeling detached from the environment, as if the people and things in the world are unreal.
Those living with DDD know “painfully” that something is wrong, said Elena Bezubova, a psychoanalyst who specializes in treating the condition. It’s similar to seeing an apple and feeling that it’s so strange it doesn’t seem real, even though you know it is, he added.
The disorder is thought to occur in about 1 to 2 percent of the population, but it’s possible for anyone to experience fleeting symptoms.
Mental health providers have sometimes dismissed DDD as its own diagnosis not only because of a lack of familiarity with the disorder, but also because its symptoms overlap with conditions such as depression, anxiety, or panic disorder.
As new research emerged, it became more widely recognized and debated. The second edition of “Feeling Unreal,” a primer on DDD originally published in 2006, was released in 2023. And Ms. Miskin published a memoir on the subject called “Hell Gate Bridge” last June. In the same month, she released the novel Please Stop Trying to Leave Me, starring DDD. The author, Alana Saab, knows the disorder well: She was diagnosed several years ago.
“It’s what I would imagine a drug trip would be like,” she said of her experience with the disorder. “But it’s 2 in the afternoon and I’m completely sober.”
The Cambridge Depersonalization Scale is widely considered the most reliable measure of the disorder. Patients are asked to rate how often and for how long 29 different experiences occur. Examples include feeling like a ‘robot’, losing physical sensations such as hunger or thirst, and seeing a world that now looks ‘flat’ or ‘lifeless’, like an image.
People with DDD may feel disconnected from themselves and their environment for months or even years at a time. Less commonly, they may also experience auditory distortions – such as muffled or louder sounds.
DDD is often associated with a history of emotional abuse or neglect. Symptoms can be triggered by anxiety, depression, reliving early trauma, major life stressors, cannabis and hallucinogens like LSD, said Dr. Daphne Simeon, an expert on the disorder and co-author of “Feeling Unreal.” .
In some people, there may be multiple triggers, particularly if there is an underlying dissociative tendency.
“You might meet a person whose first episode was caused by panic, then it happened again when they got depressed, and then it happened a third time when they had a terrible divorce,” said Dr. Simeon.
Researchers have hypothesized that depersonalization/derealization may be part of the mind’s defense system.
“Your body and mind are telling you something,” added Dr. Simeon. “You go through an unbearable experience, basically, and then you have to walk away from it.”
Jeffrey Abugel, co-author of Dr. Simeon in “Feeling Unreal,” dealt with DDD for more than a decade before finally getting a diagnosis. He knows exactly where it came from: “Cool, plain and simple,” he said. The drug pushed him “over the edge,” he added, creating a “massive panic attack.”
Mr. Abugel, who is a health and wellness coach, eventually found help. It now offers private consultations and virtual support groups for people with the disorder.
Ms. Miskin’s symptoms improved with a combination of psychotherapy and medication. She started her antidepressant again and also began taking lamotrigine, or Lamictal, a drug best known for treating seizures and bipolar disorder.
Recovery was a painful process.
“You have to learn how to be in the world again,” she said, even though “you just want to lie in bed and pull the covers over your head and never come out.”
