Lifestyle
Defining Depersonalization Derealization Disorder
Barrie Miskin was newly pregnant when she noticed her appearance was changing. Dark patches bloomed on her skin like watercolor ink. A “thicket” of hairs sprouted 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. Co-workers and even her doctors started to seem like “alien proxies” of themselves, Ms. Miskin, 46, said.
“I felt like I was viewing the world through a pane of dirty glass,” she added. Yet Ms. Miskin knew it was all an illusion, so she sought help.
It took more than a year of consulting with mental health specialists before Ms. Miskin finally found an explanation for her symptoms: She was diagnosed with a dissociative condition called depersonalization/derealization disorder, or D.D.D. 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 Ms. Miskin felt alone in her mystery illness, she wasn’t. Tens of thousands of posts on social media reference depersonalization or derealization, with some likening the condition to “living in a movie or a dream” or “observing the world through a fog.”
People who experience depersonalization can feel as though they are detached from their mind or body. Derealization, on the other hand, refers to feeling detached from the environment, as though the people and things in the world are unreal.
Those who are living with D.D.D. are “painfully aware” that something is amiss, said Elena Bezzubova, a psychoanalyst who specializes in treating the condition. It’s akin to seeing an apple and feeling that it is so strange it doesn’t seem real, even though you know that it is, she 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 D.D.D. as its own diagnosis not only because of a lack of familiarity with the disorder, but also because its symptoms overlap with conditions like depression, anxiety or panic disorder.
As new research has emerged, it has become more widely acknowledged and discussed. The second edition of “Feeling Unreal,” a primer on D.D.D. originally published in 2006, was released in 2023. And Ms. Miskin published a memoir on the subject titled “Hell Gate Bridge” last June. The same month, the novel “Please Stop Trying to Leave Me” came out, featuring a protagonist with D.D.D. The author, Alana Saab, knows the disorder well: She was diagnosed several years ago.
“It’s kind of what I would imagine a drug trip would be,” 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 how long 29 different experiences occur. Examples include feeling like “a robot,” losing bodily sensations like hunger or thirst and seeing a world that now looks “flat” or “lifeless,” like a picture.
People with D.D.D. may feel disconnected from themselves and their surroundings for months or even years at a time. Less commonly, they may also experience auditory distortions — like muffled or louder sounds.
D.D.D. is often associated with a history of emotional abuse or neglect. The symptoms can be brought on by anxiety, depression, the resurfacing of early trauma, major life stressors, cannabis and hallucinogens like LSD, said Dr. Daphne Simeon, an expert on the disorder and the co-author of “Feeling Unreal.”
In some people, there can be multiple triggers, particularly if there is an underlying propensity to dissociate.
“You can meet a person whose first episode was triggered by panic and then it happened again when they got depressed and then it happened a third time when they had a terrible divorce,” Dr. Simeon said.
Researchers have hypothesized that depersonalization/derealization might be part of the mind’s defense system.
“Your body and your mind are telling you something,” Dr. Simeon added. “You’re having an intolerable experience, essentially, from which you then have to detach.”
Jeffrey Abugel, Dr. Simeon’s co-author on “Feeling Unreal,” dealt with D.D.D. for more than a decade before finally getting a diagnosis. He knows exactly where it stemmed from: “Pot, 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. He 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 restarted her antidepressant and also began taking lamotrigine, or Lamictal, a medicine best known for treating seizures and bipolar disorder.
Recovery was a painful process.
“You have to relearn how to be in the world,” she said, even though “you just want to lay in bed and pull the covers over your head and never come out.”
Lifestyle
Thanksgiving far from Home: How Americans abroad celebrate
A traditional Thanksgiving dinner can be hard to come by when you’re overseas. How do Americans living abroad celebrate when they’re far, far from home?
Rita Maas/Getty Images
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Rita Maas/Getty Images

A traditional Thanksgiving dinner can be hard to come by when you’re overseas. How do Americans living abroad celebrate when they’re far, far from home?
Rita Maas/Getty Images
Are you an American celebrating Thanksgiving abroad?
Is it tough to get turkey or pumpkin for pumpkin pie? How do you explain Thanksgiving to your international friends? Has the holiday taken on a new meaning for you?
You can tell NPR how you and yours keep the holiday tradition alive when you’re far from home by filling in the form below.
Don’t forget to tell us where you live and what brought you there.
Your story might end up on NPR’s Morning Edition
Please submit your story to us through the form below by Nov. 20 at 6 pm ET.
Lifestyle
L.A. Affairs: During my year of yes, could I find love at LACMA’s jazz night?
We were invited to Los Angeles County Museum of Art’s jazz night by our mutual friends, Rich and Nicole. I, the self-appointed queen of snacks, brought a plethora of goodies and drinks from my Sherman Oaks apartment. This was one of my very first forays back into the world post-COVID-19 vaccine, and I was mostly ready to mix and mingle again with the masses.
Nicole waved me over to the chairs up front, coveted seats that Alex had saved by getting there an hour early on the bus. I said “Hi” and extended my apologies for being late.
“Tho thsorry,” I sighed with a slight lisp from my new Invisaligns. (I would later learn Alex thought my orthodontia-induced speech impediment was pretty cute.) “I parked so far away I might as well be in the Valley.”
Alex chuckled.
I would soon learn that this die-hard Westsider had not owned a car since his 2001 Cadillac DeVille’s transmission blew up on the 5 Freeway four years ago. I passed out thimbles of sake I brought to share and noticed a woman sitting next to Alex. She was smiling at the group. I asked her if she’d like some too.
I thought Alex was pretty cute in his light maroon jacket — the kind that’s perfect for those May gray evenings — and one that highlighted his wispy blond hair. But I figured the smiling sake lady and he were together.
The next two hours were filled with chitchat in between sets: Nicole’s end-of-school-year frenzy, Rich’s musician thoughts about those sweet drum riffs and where we should all go to grab a bite after. The Grove or Canter’s? Alex and I were seated at opposite ends in our row. I passed down snacks and at some point noticed the woman who was sitting next to him was no longer there.
Maybe, that wasn’t his girlfriend. Could it be that he was unattached?
After the concert, we strolled on Fairfax Avenue. I learned that Alex was originally from Long Island, N.Y., and asked him to break out an accent like “The Sopranos.” He gave me a dutiful “fuhgeddaboudit.” As a Midwestern transplant, I found this hilarious. We stopped for ice cream at Wanderlust.
Conversation was easy. After all, we had each known Rich and Nicole for years. Somehow, though, Alex and I had never met at the Friendsgivings or birthday get-togethers. We would later recount the almosts and the maybes in our nearly 20 years in Los Angeles. At one point, he was staying at a motel just a five-minute walk from my first apartment near Hollywood Boulevard and Western Avenue.
Could we have run into each other at the nearby Ralphs? Maybe it was just not the right time — till now.
The next month, the four of us met up for another jazz club and wandered again to Wanderlust. A few weeks later, I got a text from Alex asking if we should keep jazz club going while Rich and Nicole were on their honeymoon.
This was my self-proclaimed, post-isolation year of yes, and I made a promise to myself to be more open by saying more yeses to things. I texted him back: Yes!
I was unsure if this was a date, but I packed my summer picnic bag full of yummy snacks and once again headed over the hill to Mid-Wilshire. When I got there, Alex had saved two seats, and I realized it would just be the two of us for two hours of jazz. I offered him a Trader Joe’s drink and reminded myself that I was in my 40s now and that it was OK to just be myself. With the background of those sweet drum riffs and a little liquid courage, Alex and I shared how we both ended up in L.A. Turns out we were both in search of a new life path — one that wasn’t already figured out for us back home.
After the concert, we headed toward our routine haunt but then opted to make a new memory at the Original Farmers Market, where we ordered a couple of coffees and doughnuts before Bob’s Coffee & Doughnuts closed.
As I swiveled on my diner stool, the butterflies started to grow.
We strolled back to my car, and I offered him a ride. He declined, but I couldn’t quite fathom how he was going to get home so late at night. (Two years later, I would opt in to Alex’s car-free lifestyle too.)
In my teacher-voice, I insisted.
He hopped in the car and extended the seat, his 6-foot-2 frame expanded like an accordion. I unabashedly asked him to hand me my night-driving glasses. He calmly said, “I don’t know where those are.”
I was so comfortable with him already that I forgot we didn’t really know each other yet. As I opened the glove compartment, our hands slightly brushed each other’s, and there was a moment of excitement. Per his request, I dropped him near La Cienega and Santa Monica boulevards. He would catch the No. 4 bus home, which runs all night on Santa Monica Boulevard, and I would take the Canyon over the hill back to my place.
We said our goodbyes as we watched a sedan make a left and get stuck in the middle of the median. Never a dull moment out west.
Our second date at the Getty summer concert yielded a third date at SoFi Stadium, where the Red Hot Chili Peppers sang our song: “Sometimes I feel like I don’t have a partner / sometimes I feel like my only friend is the city I live in, the City of Angels / Lonely as a I am, together we cry.”
As we kissed, I knew that this would be something special, a gift that only L.A. could offer.
The author lives with her boyfriend, Alex, on the Westside. They are car-free and still take the No. 4 bus to jazz club at the LACMA every summer.
L.A. Affairs chronicles the search for romantic love in all its glorious expressions in the L.A. area, and we want to hear your true story. We pay $400 for a published essay. Email LAAffairs@latimes.com. You can find submission guidelines here. You can find past columns here.
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