Depersonalisation Management

Question 1

What pharmacological options for depersonalisation disorder

Answer 1

-Lamotrigine +/- SSRI
-Clonazepam
-Naltrexone
-Clomipramine

Question 2

Non-pharmacological management of depersonalisation disorder

Answer 2

-CBT approach
-Attentional training
(Mindfulness techniques)
- rTMS – some evidence for improvement with rTMS applied to right VLPFC

Question 3

CBT approach diary keeping - what to analyse for?

Answer 3

-Analyse diary for fluctuations
-What is the range of scores?
-What are the highest scores and the lowest scores?
-Highlight each of these in different colours
-Create a list of times with the DPRD is worse vs better
-What might the underlying mechanisms be for each of these?
-Can schedule activities in line with this information
-Often highlights the role of anxiety / low mood in worsening DP

Question 4

What are the grounding strategies in managment approach for DPD

Answer 4

> Aims to refocus a person’s attention to the present using:
-Surroundings
-Words / statements
-Image
-Posture
-Objects
-Senses: sight, sound, touch, taste, smell
-Key is to use these strategies asap during initial warning signs of DPRD

Question 5

Key CBT interventions for DPRD

Answer 5

Thinking process focused:
>Strategies to reduce rumination & worry
>Understanding and manipulating symptom focused attention (spotlight metaphor)

Behaviour focused:
>Pros and cons of checking behaviours
>Internet searching/ Dr shopping
>Avoiding avoidance
>Getting back to doing the things you’ve stopped doing because of the DPRD in a graded way, one step at a time