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Depersonalisation — when nothing feels real
Depersonalisation — when nothing feels real

ABC News

time02-08-2025

  • Health
  • ABC News

Depersonalisation — when nothing feels real

Sana Qadar: This episode contains discussion of suicide. Take care while listening. Nathan Dunne: I was living in London in 2008, and I was a student, and I was in this brand new relationship with this completely enchanting woman called Maria, and in a fit of spontaneity and real excitement, we decided to go for this midnight swim. So we jumped on our bikes, and the spot of water that was close by was in Hampstead. Something happened to me during that swim which I've been trying to work out ever since really. It's taken a couple of decades, but really that moment, that particular onset, was when, it's not hyperbole to say that my life really changed forever. There's like a before and after that moment. What happened was I had a severe out-of-body experience. It was incredibly traumatic. I had no idea what was happening. I completely lost my sense of self, my identity, didn't recognize objects or the landscape around me as the same as before. Reality completely changed. Reality came into question, and my life really collapsed afterwards, honestly. Sana Qadar: Have you ever felt like things were not quite real? That you were separated from your body, outside yourself, like you didn't know who you were? Maybe it was a fleeting feeling, lasting hours or even days, but what if that feeling went on for longer? For months or even years? Nathan Dunne: I had no idea that people like myself are caught in limbo with misdiagnoses for years and sometimes decades. Sana Qadar: And what if the very nature of these feelings made recovery a very steep trek uphill? Dr Emma Cernis: It's really disabling. I think people really struggle with feeling connected to the experiences that they're having in life, and that's pervasive. So that affects their relationships, that affects their enjoyment of life, that affects their pastimes, their work, their education. Nathan Dunne: The last thing that I want to do is surrender to this illness. I want to, the instinct is to fight. You know, I want to fight this, but I have no energy left. I don't know how to fight anymore. Sana Qadar: This is All in the Mind. I'm Sana Qadar, and today we're covering a disorder called depersonalization. Senior producer James Bullen is reporting this one. Hi James. James Bullen: Hey Sana. Sana Qadar: What are we going to hear today? James Bullen: So today we're going to hear the story of one man, Nathan Dunne, and his experience with this disorder. Its full name is depersonalization, derealization disorder, but most commonly people just call it depersonalization. Sana Qadar: Right. James Bullen: And the most current scientific research says that about 1% of the population experience this disorder. Sana Qadar: Oh right, that's similar to schizophrenia, isn't it? Like that's about 1% of the population? James Bullen: Yeah, yeah, it's about the same, and that's probably a bit shocking to hear for some people, but what they think is that it's often misdiagnosed or missed, and that means that a lot of cases of this go unreported or unnoticed. Sana Qadar: Okay, yeah, I don't think I've heard much about depersonalization before. Sounds fascinating. James Bullen: Yeah, Nathan published a book really recently about his experiences with it. So we're going to hear from him about some of his journey, and then we're also going to hear from a researcher about the symptoms, the causes, and the treatments for depersonalization. Sana Qadar: Alright, let's get into it. Nathan Dunne: There was an incredibly strong physical sensation, heart palpitations, muscle palpitations, but the strongest and most overwhelming sense that I had was that something was being removed from me, some piece of me was being vacated, and the way that manifest in terms of my perception and my experience was that I was able to look at myself on the bank. So I was a spectator of the event rather than a participant in the event, and that's incredibly terrifying because at once you feel like, am I having a stroke, am I dying, but it was just as though everything of which I understood about reality in the way that I saw it visually and in a tactile manner, that completely shifted. There's really two components, one is this incredibly strong physical sensation, but that is then overridden by the fact that my knowledge and understanding of a reality completely changed, like in a moment, like a switch being flipped. James Bullen: In that early morning light up on Hampstead Heath, Nathan's life changed. There was a clear, obvious split before that moment and after it. And in the days following this split, this distortion of his sense of self, it didn't diminish, it got stronger. Nathan Dunne: I experienced an incredibly sharp decline in my mental health, my understanding of the world, this perception shift of reality and everything that was exacerbated in the domestic environment at home, back in my flat. So I kept asking myself and Maria, who am I, where am I, and she had to leave for work, I mean we had everyday lives to get on with, I was meant to be at the library, reading, taking notes, sharpening my pencils. James Bullen: When Nathan says the decline was incredibly sharp, he means it. Soon after that night at Hampstead Heath, he would try to take his own life. Nathan Dunne: There was a moment where I felt like I was very quickly moving towards the end of my life. So I felt like, because the sense that I had of being outside of myself was as if I was not my own actor, when I came to the point where I decided to end my life, then it was though the decision had already been predetermined, like it wasn't as though I was making it, it just seemed like the next inevitable step. So it was a very extreme moment, the darkest or lowest point in my life really, but it was as though I myself was not present. It was as though I was just going through the motions as though a robot would dictate the next series of minutes, hours. And so what happened is I found myself in hospital after this attempt and they were as bewildered as I was, the clinical staff, and I underwent a series of tests and there was no particular clarity that came with looking at the MRI or other scans and other kind of basic tests. James Bullen: In the weeks after this first batch of tests, Nathan would create a document he called the possibles, listing all of the possible conditions that might be causing these bizarre symptoms. Nathan Dunne: Initially I thought that there must be some kind of extreme mental illness, like I was having some kind of psychotic episode or some kind of bipolar disorder or something, and then it became all of these lesser known and obscure illnesses, I really went down a real rabbit hole. I was so in need, in real dire need of clarity and understanding. James Bullen: We've all googled symptoms before, but this was 2008, the internet was a little less comprehensive and the same goes for the research literature around this condition. It didn't click for Nathan that depersonalisation could be a possible diagnosis. He would visit one doctor, then another, then another. Most commonly they would say he had anxiety or depression, and so he'd be treated for those conditions. Nathan Dunne: So I was told very simply that it would be quickly cured, it would be all over with if I took these blue pills. Initially I was very excited, I really did think that I had presented well, I had articulated myself even ham-fistedly, and then I was going to get the help that I needed. The question seemed almost rhetorical, like, here I am, this is my problem, okay, you're a doctor, you will tell me what's wrong with me, and then ergo, we progress to the next stage. I had no idea people like myself are caught in limbo with misdiagnoses for years and sometimes decades. Dr Emma Cernis: Whenever I speak to people with depersonalisation, they have always had another label beforehand, or they get very frustrated. They're trying to describe this sensation and people keep jumping to conclusions and saying, oh, okay, well, that's depression. I think in particular things like feeling numb, feeling detached, that does sound a lot like depression. I think it takes a lot of curiosity and kind of maybe some precise questions on the clinician's part to really tease that apart. James Bullen: Dr Emma Cernis is an Assistant Professor of Clinical Psychology at the University of Birmingham in the United Kingdom. Dr Emma Cernis: And I think that's why often people sort of give up trying to describe it, because they get frustrated that they're trying to get across this very difficult to describe feeling. They feel like they're being brushed aside with, oh, that's just anxiety, that's just depression, when it feels a lot different to that. James Bullen: So if depersonalisation disorder isn't anxiety or depression, what is it? Dr Emma Cernis: It's an experience that's really hard to put into words. So the way that we try to define depersonalisation is that it's an experience or a group of experiences where people don't feel quite right in themselves in terms of feeling disconnected, detached, unreal, strange. And what we mean by that is in relation to either their physical body or even kind of a bit more abstractly their sense of self, their identity. People use a lot of metaphors to try and describe it. So they might talk about feeling like they're stuck in a dream or feeling like they're trapped in a bubble. So really, we're talking about this disconnection or separation feeling from all of the things that make us kind of who we are. James Bullen: You might recognise this feeling in yourself because short spells of depersonalisation aren't uncommon. You might have experienced symptoms as a result of anxiety or depression or witnessing a traumatic event. Dr Emma Cernis: It is a very normal thing for our brains to do. I think it can be a bit confusing and a bit bewildering at first because we don't really talk about it that much. We talk about anxiety and things like that a lot more. But over 70% of people will experience depersonalisation at some point in their life. And that's not to say it will be a depersonalisation disorder, but it's one of those experiences that is quite common. James Bullen: What distinguishes Nathan's experience and that of other people with depersonalisation disorder is the length and severity of these symptoms of dissociation. They occur again and again and they're harmful to the person's psychological health. Emma Cernis says there are a few different ideas about what causes depersonalisation disorder. Dr Emma Cernis: What I see the most is chronic stress. People have got lots of things going on in their lives and each one of those individually probably isn't that alarming or distressing. But it's the combination of having so many things to deal with for so long. And then the other really common thing that people talk about with depersonalisation is perhaps using cannabis or other kind of street drugs that might also then result in them feeling very detached and very depersonalised. And it's quite a common pattern that people then talk about that sticking around or becoming a sort of episodic type presentation. James Bullen: Some people listening might wonder what differentiates depersonalisation from psychosis, say, or mania. What makes this different? Dr Emma Cernis: I think one of the key differences between depersonalisation and psychosis or schizophrenia is what we would call the insight. Clinicians talk about insight, which basically means do you have an awareness that the experiences you're having might be a mental health difficulty or due to stress or due to trauma? Do you understand where it's coming from? And you can see that there's something different happening from your kind of normal way of being. And in depersonalisation, that's absolutely the case. People are very aware that the experiences they're having are the way that they are experiencing things. It's the way that they're seeing things. It's not that the world has actually changed, actually become two dimensional. They're not actually detached from their body. It just feels that way. So that level of insight is something that might be compromised or even completely missing in psychosis, where people might be more likely to believe that the world is a simulation or something, for example. Sana Qadar: I'm Sana Qadar. This is All in the Mind. And today we're looking at a disorder called depersonalisation. So James, coming back to Nathan Dunne's story, he's been searching for what is happening to him. He can't make sense of it. What happens next? James Bullen: What happens next is something that often happens with people who have a severe depersonalisation disorder, and that is relationship breakdown. Because until this point, he had been with Maria, the woman he took that midnight swim with, up until now. We're going to hear what happens next. Nathan Dunne: It was very difficult to articulate even to myself what was happening, let alone within the flat when you're preparing, you know, penne pasta or something, trying to say to your partner, look, I don't feel like myself. I don't even feel like I'm here. I feel like I'm somewhat invisible. These are very abstract and philosophical notions, but at the time were very strongly felt by myself. And so Maria basically just left. She just said, look, I can't cope. And after that relationship broke down, I spent at least 18 months, if not longer, trying to recover the relationship. It was a longing not only for this intense early love that we were experiencing, but also a real quest to get back to myself, to really find my way back to the before time, to before this happened, before this midnight swim, before the onset of this illness. But yeah, I found myself completely alone. James Bullen: That marked several years in Nathan's life where he felt disconnected and divorced from reality. There were good days and bad days, but on the whole, things got pretty bad. But it was a trip back to Sydney that set Nathan on the path to recovery. Nathan Dunne: I came back to Sydney and I saw Dr. C and he had a background in treating depersonalized patients and also in obsessive compulsive disorder. He kind of was able to read my medical history, hear my patient testimony, and then very quickly recognize that as part of the patients that he'd treated in the past. And so that was a truly illuminating moment, but I was also skeptical at first because as soon as he said the word for the first time depersonalization, it sounded so right on to me. It sounded like here we have this kind of golden name of diagnosis. And yet because of the multiple misdiagnoses I'd had in England, I was very wary of believing that this was going to solve all my problems. And so with Dr. C, he outlined this treatment plan and I was completely on board with it, but I did kind of tread cautiously in terms of my hope. James Bullen: There were a few different treatments he tried. One is called exposure and response prevention, ERP. Nathan Dunne: It's basically like an exposure response where typically if say a patient has a fear of being contaminated by dirt or by excrement for example, as strange as it might sound to people who don't have this kind of illness, the treatment is say you have a tissue. You fold a piece of dirt up in the tissue and you carry a tiny piece of it with you around. So it's this very slow exposure to the fear of the patient so there's no flood of symptoms. And so for me it was obviously water. And so the initial prescription was to have a piece of cloth to wet this cloth and to wrap it around my hands and just for at certain times of day and then to use what's called a Stebb's diary to record my emotions and the level of which my symptoms would become exacerbated. James Bullen: That helped a bit, but the one that really changed things for Nathan was something called repetitive transcranial magnetic stimulation, RTMS. Nathan Dunne: And basically what that means is that a doctor and a technician is able to locate areas of the brain which have been identified as dysfunctional. Over a series of treatments there are these very low magnetic pulses which are performed on these areas which have been identified. RTMS, this magnetic stimulation, in a way, I mean a colloquial way of describing it would be to say that it kind of attempts to wake them up to their baseline. Dr Emma Cernis: I think what we're beginning to understand is that there's an area at the front of the brain, sort of near your forehead, called the prefrontal cortex and that is the control room of the brain and it makes those higher level decisions about what's important, what to prioritize, how to respond. James Bullen: Dr Emma Cernis again, who researches and treats depersonalization disorder and dissociation more broadly. Dr Emma Cernis: But we've also got these really deep kind of areas of the brain that are much more involved with survival and they just respond and get us into safety if we need to be in safety. What we're beginning to understand about dissociation is that what might happen is that those deep areas of the brain about thinking about survival respond to something. They're on alarm, they're on alerts, they're trying to tell us to do the fight or flight response, they're raising our anxiety levels to get us to move and do something. But the prefrontal cortex pours cold water over everything essentially and squashes down all of those sensations and impulses and urges. And what we think in dissociation is that maybe the prefrontal cortex is doing too good a job at toning all of that alert system down. So that can end up making people feel very numb and understimulated as opposed to sort of anxiety where we might be feeling overstimulated. James Bullen: Emma says research into depersonalization disorder has focused on treatments grounded in talking therapies. So treatments like cognitive behavioral therapy where you talk through some of your problems and attempt to reframe your thinking. Dr Emma Cernis: I'm working with a team in UCL to help develop a very specific targeted form of cognitive behavioral therapy which will help with depersonalization disorder. And that is one of the few research teams I think globally that is working on a treatment for this. But I think the important thing for clinicians to realize is that they can still work with depersonalization disorder without having specific treatments at hand. So there's a lot of very helpful strategies that help with anxiety for example that would be very very helpful for people experiencing depersonalization. James Bullen: Emma says the RTMS that Nathan got is still not fully proven as an approach but anecdotal evidence suggests that it can be helpful. Dr Emma Cernis: It's an innovative approach. I think it's the evidence base for it is still building. But a lot of people who've had it say that it's been really helpful. So it seems really promising. I think because the evidence base is still building it's not widely available everywhere. More research is needed to just double check that it is as good as it seems to be. And it's certainly like any treatment it's going to work better for some people than others. So it's not a sort of magic bullet in any way. James Bullen: Nathan's symptoms of depersonalization under these treatments started to lessen after about four weeks. It took six months for them to really meaningfully reduce. Nathan Dunne: One morning I was with my mother. I was staying in the garage in Sydney. I was incredibly low point. I really was very isolated. I didn't have any friends etc. But it was one morning over a simple splashing of milk with some cereal in the bowl. I told my mother I really feel as though I'm becoming myself again. And that was an incredibly ordinary domestic moment. But it was when I really began to feel as though the world was becoming more illuminated again. James Bullen: You write in the book about recovery, the possibility of recovery. Can you tell me a bit about how you think about that and kind of perhaps where you're at now? Nathan Dunne: The way that you think about your experience in the world has to change. At least that was my case. And so one of the things that I became incredibly frustrated with and that I heard all the time was this acceptance. Acceptance and commitment therapy. Oh you have to radically accept. I could not relate to any of that. That did not help me at all. I had such pushback when it came to framing what I was experiencing in those terms. And I resisted that idea of looking at it in that way for so long because the last thing that I want to do is surrender to this illness. The instinct is to fight. I want to fight this. But I have no energy left. I don't know how to fight anymore. And when you're really at the baseline, when you're far below the base, when you've fallen right to the bottom and you can't fight anymore, then I can't accept this. I don't want to accept this. It's more surrendering to it was a portal to the real acceptance that I was being told about. So lying down in the fit of the storm is a way that I often think about it. When the symptoms are at their most extreme and their most distressing, and you feel like there's really no hope, nowhere to turn, as though this better health that you've experienced has again regressed, then it is surrender most that I relate to. And for those who know anything about chronic illness, this is the experience of it. This pattern, this oscillation is what makes for a chronic illness, which embeds itself in your life. Because I had this very extraordinary experience, as I've said, after midnight in the middle of winter, it was so freezing cold. And then I completely lost my sense of self and my identity afterwards. It was so intrinsically tied to this experience of water that even when I was in a car or on a bus, on a train, and I would go past a body of water, it would begin to trigger symptoms in me. The feeling of being outside myself would become more extreme. I would move further away from myself. I would begin to see myself becoming smaller and smaller, kind of on the street. And so, washing my hands is a very simple task. Having a bath, having a shower, these were incredibly ordinary everyday things, which became very distressing because they took me back to this initial kind of traumatic event. And so, wrapping a cloth around the palms of my hands and my wrists as an initial form of exposure was very difficult. But over time, it was as though I was able to sit with it, and I was able slowly, very slowly, to get used to it, in a way. So, water was... I mean, to this day, I kind of fear it in a way, but I fear it at a kind of core place in my memory, rather than water itself. I am able to swim now, take showers, etc. But it was only years later, in the final stage of my treatment, where I was able to return to that place in Hampstead, and swim again after so many years of difficulty and groping for answers, and be able to swim again, and feel much more like myself. Like I was coming back to this self that was vacated. This kind of split sense of self that I had, that was so profound, so pronounced, was finally beginning to cohere again. Water has played such a profound, like a seismic shift in the before and after of my life, but my wife and I recently became parents to a baby girl, and I have such a longing to be able to... She's still only a few weeks old, but to be able to take her to the beach, you know, such a very Australian thing to do. I mean, it's winter now, but in these summer months that are ahead, it will mean so much for me to be able to do that, and to be immersed in that salt water too. So I come to see water as a very powerful thing, but an element of incredible beauty. Sana Qadar: That is Nathan Dunne. His book is called When Nothing Feels Real, A Journey into the Mystery Illness of Depersonalisation. You also heard from Dr Emma Cernis, Assistant Professor of Clinical Psychology at the University of Birmingham. And if you want to hear more of Nathan's story, he did a full interview with Richard Fidler over on Conversations. You can find that on the ABC Listen app. This episode of All in the Mind was reported by Senior Producer James Bullen. Thanks also to Producer Rose Kerr and Sound Engineer Tegan Nicholls. I'm Sana Qadar. Thank you for listening. I will catch you next time.

A kiss that led to a years-long nightmare, the Dull Men's Club, and a famous feminist mother
A kiss that led to a years-long nightmare, the Dull Men's Club, and a famous feminist mother

Yahoo

time13-06-2025

  • Entertainment
  • Yahoo

A kiss that led to a years-long nightmare, the Dull Men's Club, and a famous feminist mother

Happy Saturday! There was a lot to take in this week. Spacing out for a whole 90 minutes is the kind of challenge I need. Or perhaps a trip to the cinemas. But before I do that, let me bring you five stories worth your time. After a heart attack, Andrew McKean moved to a care facility. While stuck in the confines of a room for most of the day, McKean started writing about 'the slow unfolding of a life'. Sounds dull, right? Well, no actually – not once he started posting about it in the Dull Men's Club. What is it? An international club where people share online the tedium of everyday lives. Where? The idea originated in the 1980s in New York, when founder Grover Click and some friends decided to 'embrace their dullness', Susan Chenery writes. And now? It is immensely popular, with 1.9 million Facebook members on Click's original page. How long will it take to read: three minutes. Further reading: and then you must meet 'the dullest man in Britain'. Since retaking power in Afghanistan in 2021, the Taliban have enforced repressive laws on Afghan women through their 'morality police'. But now Afghan fathers, brothers and husbands say they are under pressure to ensure women in their families observe the restrictions. 'Changing attitudes and behaviours': the Guardian, with Rukhshana Media, interviewed men and young women about how morality laws are affecting families. One man from Bamyan province said: 'Men have become unpaid soldiers of the Taliban.' How long will it take to read: three minutes. Seventeen years ago, Nathan Dunne took a midnight swim in the icy waters of Hampstead Heath in London with his then girlfriend. As she kissed him in the cold, something inside him abruptly shifted. *** 'It was like being struck. Like something came down … The flip of a switch.' – Nathan Dunne. Dunne was locked out of his body, or at least that's how it felt, and had a sudden fear of water. Years later, he was diagnosed with depersonalisation disorder. How long will it take to read: five minutes. Guardian readers love architecture, but throw in some 'weekend-long parties and carnal pleasure', as Oliver Wainwright suggests, and you've got yourself a fabulous read on the hedonistic party palaces of New York's Fire Island. A 'queer Xanadu': Wainwright celebrates the legacy of late architect Horace Gifford, who defined the area's modernist beach-houses. 'It was made for sex': Calvin Klein is name dropped, including the time he bought one of Gifford's houses and had it renovated into a home 'made for sex'. How long will it take to read: four minutes. When Erica Jong's autobiographical novel Fear of Flying was published in 1973, it catapulted her to fame. The American author broke ground by writing openly about women's sexual desires – rarely done at the time. She quickly became known for her candour and wit. But for her daughter, Molly Jong-Fast, growing up as Erica's only child told a different story. A compelling read: In this excerpt from her new memoir, Jong-Fast reflects on the lingering pain of being 'still stuck in the mire of childhood', despite having 'created a different life' as an adult. How long will it take to read: nine minutes. Enjoying the Five Great Reads email? Then you'll love our weekly culture and lifestyle newsletter, Saved for Later. Sign up here to catch up on the fun stuff with our rundown of must-reads, pop culture, trends and tips for the weekend. And check out the full list of our local and international newsletters.

I was enjoying a midnight swim. Then my girlfriend kissed me – and the nightmare began
I was enjoying a midnight swim. Then my girlfriend kissed me – and the nightmare began

The Guardian

time08-06-2025

  • Health
  • The Guardian

I was enjoying a midnight swim. Then my girlfriend kissed me – and the nightmare began

On a cold winter's night, in a 'fit of spontaneity', Nathan Dunne and his girlfriend went for a midnight swim on Hampstead Heath in London. They had been living together for a few months and, although it was dark and chilly, they 'had a summer feeling in that first flush of the relationship', Dunne says. They shed their clothes and waded into the shallows. After diving into the icy water, Dunne's girlfriend put her lips to his cheek, and as they pulled apart, his life changed beyond all recognition. 'It was like being struck. Like something came down,' he says, slicing the air with his hand. 'The flip of a switch.' Dunne's transformation sounds like a fairytale in reverse: one kiss, and his life turned into a nightmare. Seventeen years have passed since that night, and he still mostly explains the change in himself in metaphors and similes. His eyes filled with soot. His voice was a robot's. He felt as if he were locked outside his body, which became a sort of 'second body'. Any form of water, from a raindrop to a warm bath, made everything worse. His terror and panic were so great that the next day he smashed a vase and used a shard to cut himself. An 'attempt to not live any more', is how he describes it. It would take Dunne three-and-a-half years to learn that what he had experienced was the onset of depersonalisation disorder, a dissociative disorder believed to affect about 1.3 million people in the UK, a similar number to those with bipolar disorder, though the condition is far less known. When Dunne became ill, in 2008, the wait for a diagnosis on the NHS was thought to be between eight and 12 years. Awareness has since increased; in 2017 the MP Lyn Brown brought a constituent's experience of depersonalisation to the attention of parliament. A charity, Unreal, was launched two years later. Now Dunne, 45, has written a book, When Nothing Feels Real: A Journey Into the Mystery Illness of Depersonalisation. It is an eye-watering and disorienting account of a condition that Dunne evokes so vividly, it doesn't always appear to be behind him. 'Truth be told, I still have 'second body symptoms',' he says. 'I don't know if they will ever leave.' Indeed, the book's awful twist is that although researching the history of the illness felt intensely validating, and writing brought a sense of coherence to fragments of memory, it also triggered a relapse. In 2022, Dunne had a nervous breakdown. 'I was not able to function in any reasonable way,' he says. 'It was about as bad as it can get.' It's fair to say that healing is very much a continuing process. We are speaking on a video call. Dunne, who was in London studying for a PhD in art history when he fell ill, now lives in Sydney with his wife, a professor of philosophy. Last month they became parents to a baby girl. Dunne works as a freelance writer, specialising in film and art, and is sufficiently recovered that he sometimes goes for a swim. 'I hope to take my daughter to the beach. Something really super-normal. That thought fills me with joy and hope for the future,' he says. One of the greatest challenges has been the mysteriousness and unrelatability of his illness. While he knew something terrible had happened to him, he couldn't say what. The 'second body symptoms' felt impossible to convey without resorting to hyperbole and abstraction, which seemed to discredit his illness even as he described it. Each morning, he watched himself get up, dress, make his breakfast, all from above himself – this should be taken literally, he says – looking down on the top of his own head, his foreshortened body, from within the confines of a vessel that to him resembled a waterlogged black box. He knew something of bipolar disorder, having been very troubled by a visit to a family member in a psychiatric ward. But he knew he didn't have it, because unlike them, he says: 'I had an acute sense of what was happening to me.' He kept looking at his hands for reassurance, but saw only 'the hands of a ghost'. He Googled: 'Why do I feel outside my body?' 'What is happening to me when I see myself from above?' 'Am I going mad?' Doctor after doctor raised their eyebrows. His girlfriend despaired of him, and soon moved out. In the weeks and months that followed, Dunne underwent many diagnostic tests including an MRI, a chest X-ray and checks on his eyesight, blood and stool samples. All came back normal. Depersonalisation is commonly misdiagnosed as depression and before long Dunne was prescribed antidepressants. Although he sensed the error, he didn't argue. 'I felt as if I needed medicine. I could take a pill and think: 'Maybe tomorrow will be different.'' On less symptomatic days, he continued to study, but his quest to heal himself became more desperate. He went to stay with a friend in Los Angeles and drove into the Mojave desert, looking for 'a more expansive space, to try to open up this narrow view'. But he saw it all from the damp black box above his head. Some things helped briefly: listening to Dylan Thomas' Under Milk Wood on repeat; drawing pictures of himself in the womb; making a mosaic of a Rubens painting; picking at the skin of his palms, to know where his edges were, something he found 'very grounding, very physical'. Back in London, feeling outside himself and the world, and increasingly obsessive about his ex-girlfriend, he made business cards that said 'Call me', with his phone number on. A sex worker, whose card he took down from a phone box to make space for his own, was one angry respondent. Another was a man who felt suicidal; he and Dunne spoke for hours, and afterwards, Dunne changed his phone number. In the book, he appears to do this without qualms. Alongside his self-estrangement was an intense self-absorption that often creates an empathy gap between Dunne and the reader. When, for instance, his mother told him on his birthday how wonderful it had been to carry him, he replied: 'That's not how it was for me … I was trapped.' What is his understanding now of why he became ill? 'I thought I was far more robust than I was,' he says. 'I don't think I've ever found life very easy.' He was born in Brisbane, Australia, and grew up in Bengaluru, India, where his parents were Protestant missionaries. 'That makes for a particular kind of intensity in the family,' he says. Rather than look for a single cause of his depersonalisation, he has found it more fruitful to think of it as a buildup of traumas – 'neurological, biological, and just life experience'. Each day he wondered who he was, and whether he would ever go back to being the whole person he had been. The first big turning point came when he locked eyes with a woman at a Rodin lecture. She was in her 60s. 'We didn't fall in love in a romantic way, but it was an understanding of one another at first sight,' Dunne says. 'Something about our experiences of life [made us] instantly trust each other.' They went back to her house, and in one of the book's most moving sequences, she asked him: 'What's your greatest fear?' 'Having a bath,' Dunne replied. At this, she rose and turned on the hot tap in the bathroom, then sat in the room while he undressed and climbed in the tub. 'To take off your clothes and get into a bath with an older woman you've just met is not a very normal thing to do,' Dunne says. 'But something in her personality fostered an atmosphere where that was possible.' And something in Dunne's illness, his foreshortened view of the world, created an openness to oddity. A friendship grew that 'helped to rebuild my capacity to love', Dunne says. She told him: 'You think of this thing you have as for ever. But I've lived long enough to know that there are just bad seasons in life. And then, one day … The world is new again.' In 2011, with no money, job, or strength to study, Dunne complied with his mother's suggestion to return home to Sydney. He moved into his parents' garage, and she pointed out a number for a specialist she had stuck on the fridge. After a few weeks, he got a referral, and it was in this doctor's office that Dunne was diagnosed with depersonalisation. 'It was amazing when he said the word. Relief – and scepticism: 'I can't really hope this much, can I?'' Dunne left the consultation with three objects: a bottle of water, a towel and a hessian bag to keep them in – an exposure and response prevention (ERP) kit. Each morning he was to dip his fingers in the water, and each afternoon wrap the wet towel around his hand. The idea being that a person who carries a small piece of their greatest fear will dilute that fear over time. 'You are allowed to cry, but not to whine,' the doctor told him. 'It can make you treatment-resistant.' Dunne combined his ERP with repetitive transcranial magnetic stimulation at a private clinic – something else his mother came across – in which a magnetic coil is placed on a patient's head so that magnetic pulses can target parts of the brain impaired by illness; in Dunne's case, the parietal lobe, which helps to maintain a unified sense of the body. Six months later, he emerged from his parents' garage for breakfast one morning, and told his mum: 'I'm becoming myself again.' Dunne completed his PhD, and is no longer on the specialist's books. He continues to take medication and attend therapy. Most importantly, he knows which tools to use when symptoms recur. 'When you're looking down on yourself, I've been taught to speak to it. You live with it, you write with it. You help to diminish its hold over you. You accept this distorted perception, this minor confinement,' he says. Though, in truth, more than acceptance, it is the idea of 'surrender' that he has found most helpful. 'Ideas of radical acceptance – I've tried all of those things, I can't relate to that language. Perhaps 'surrender' works because it's the last thing I want to do,' he says. 'To surrender means this thing will have its way with you. When I'm in the thick of difficult symptoms, I imagine myself being steamrolled over, and being OK with that. The other word that really helped me over the years is 'float'. The last thing I want to do is float with the second body symptoms. But the word itself, the sensation – it allows you to surrender to it, by joining it.' He holds up his palms, flaky after all these years with picked skin. Sometimes, the wounds get so bad he has to go to the doctor. But he finds it 'very pleasant to go for something ordinary'. The emotional legacy is perhaps harder to confront. When Dunne started dating again, he worried he had 'limited love' to give. He and his wife have been together for 11 years now. 'I do think I am more limited than I was, and I wish that wasn't the case,' he says. 'My daughter is a week old. I wonder about how much I can give, and I hope I can give everything. 'Maybe lots of people doubt whether they can give enough to the people they love. However, I feel the illness has limited me. Like, I won't be able to recognise when I need to give more. I have to have faith in others who have been able to do it.' He and his wife have developed a phrase to support themselves through the hardest times. 'There's always the core us,' they tell each other. 'It is,' Dunne says, 'both a memory of our love and an acknowledgment of our efforts to sustain it.' When Nothing Feels Real: A Journey Into the Mystery Illness of Depersonalisation by Nathan Dunne is published by Murdoch Books (£16.99). In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@ or jo@ In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on or text HOME to 741741 to connect with a crisis counselor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at

‘I felt like a puppet': A midnight swim leads to a long-term mystery illness
‘I felt like a puppet': A midnight swim leads to a long-term mystery illness

Sydney Morning Herald

time30-05-2025

  • Entertainment
  • Sydney Morning Herald

‘I felt like a puppet': A midnight swim leads to a long-term mystery illness

This story is part of the May 31 edition of Good Weekend. See all 14 stories. On a winter night in London, my girlfriend and I decided to go night swimming. On Hampstead Heath, we shed our clothes at the edge of the pond and waded into the shallows. Stars shimmered on the water and a half-moon bobbed in the inky black. It was so cold we could see our breath. Swimming out to the middle, we fingered mosses and reeds, then began diving under the water and coming up in wild leaps, splashing one another. In the midst of our game, something happened. I was hit with a great force, torn in two, ripped from myself. I swam frantically towards the bank, trying to reach solid ground. Even though my head stayed above water, it was like a great hand was trying to push me down to the bottom of the pond. Bent over in the shallows, I clutched my chest, trying to hold my sense of self together. I was leaving my body. There was nothing I could do. I cried, tears streaming. I couldn't stop. My whole face began to shake, my cheeks going into spasms and my limbs shaking violently. My girlfriend's voice was far away. 'Nathan, Nathan. Can you hear me?' Naked before her, dripping with water, I said nothing in response. I couldn't. I stared at my wet hands. They were ghostlike, not my own. I had disappeared, and what was left of me was only a shell. One part of my elf was empty: a dusty, windswept space. The second part of myself was in a state of confinement. I felt like a puppet, manipulated by something, or someone, outside my body. I turned around to brush away this feeling of being watched, but my second self stayed behind my back. It was looking at me but I couldn't see it. I had no sense of its form or how this second self was moving me around, only that the awareness of 'me' was now gone. 'I am 28 years old,' I said to myself, trying to believe it. 'My name is Nathan Dunne.' Three years passed before I understood what was happening to me: I was experiencing depersonalisation. Its onset provoked a profound loss of identity. Like many with the illness, my response was to say, 'I'm not me', 'I have no self' and 'I am no one'. This was an attempt to describe the feeling of a severe dissociative state, the onset of mental illness, pure terror. My identity had always been intrinsically tied up with my body, fundamental to my self-consciousness. But with depersonalisation, being in its vice meant a terrifying challenge to long-held assumptions about my existence – the notion of 'me'. I struggled to explain my symptoms to doctors. Phrases like 'I feel invisible' and 'I have a dark pain' led to a misdiagnosis of anxiety-related depression. The prescribed blue pills I took caused terrible side-effects – stomach cramps, heartburn, vomiting, a stiff jaw. I sweated uncontrollably, lost my appetite, and became even more exhausted, legs tangled on the lounge. In Australia, it affects 2 per cent of the population – 500,000 people. Yet a correct diagnosis can take years. In my confusion, I searched medical journals for clues and stayed up late pondering rare diseases, compiling a Word document I saved as 'The Possibles'. Rearranging the document was like prodding a wild animal. I'd move one disease into a new column, or onto a new page, and it would immediately lash out, more alive in me than ever. I was constantly rating them. Bipolar disorder would get 8/10, then I'd bump it down to 6/10. Wolfram syndrome would be flying steady at 3/10, only to abruptly climb up to a bewildering 7/10. I'd print the document out, underlining symptoms with fat blue lines and scrawling notes to myself across the top of the pages. Things like: Blood thing probable, but check page 7. Could be muscular and optical combined, see page 14. It was not until I returned to Australia and found Dr C, a man of great clarity and insight, that I came to understand the true nature of my illness. The swim was the catalyst for my acute stress and genetic predisposition. 'Reading your file has convinced me that your accurate diagnosis is a mental illness called depersonalisation.' For the first time, I said the word aloud. How had I never heard of it before? Now that it was on my tongue it seemed so obvious. The person I knew was in confinement. According to research conducted by the Pew Research Centre in Washington DC, the global DSM-5 Research Group and a team of international doctors who specialise in depersonalisation, it is estimated that more than 75 million people worldwide suffer from the illness. In Australia, it affects 2 per cent of the population – about 500,000 people. In the United States – 6.4 million. In Britain, it's 1.3 million. 'It isn't depression, or anxiety,' says psychiatrist Daphne Simeon. 'Often, it emerges with cruel ferocity as a chronic disorder completely unto itself. Its destructive impact on an individual's sense of self is implied in its very name – depersonalisation.' My feeling of having no self meant that I remained outside my body as a detached observer. For me, the vantage point of this detachment felt like being in a specific place, a damp, black box. But for other sufferers, like Amanda, a 43-year-old office assistant, 'It is as if the real me is taken out and put on a shelf or stored somewhere.' Alex, a merchant marine, says: 'It was something like waking up to find that you're in a coffin, buried alive. Only the coffin is your body, your very existence.' Based on National Health Service data from the UK, a diagnosis for depersonalisation typically takes between eight and 12 years: a shocking statistic. The long wait occurs because doctors are trained to be sceptical of potential outlying diseases. When someone presents with a cough, it's usually a cold. Ankle pain? Probably a sprain. There's little incentive to search for obscure explanations when a common one will do. But with an illness like depersonalisation, which is easily mistaken for depression, patients like me are misdiagnosed and wait years, through trial and error, for a correct diagnosis. Although it was first named in the 19th century, depersonalisation has long been misunderstood and dismissed by the medical establishment. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) described it as merely a symptom of dissociation. Only in its most recent edition was it recognised as a disorder in its own right. Yet the DSM is a clinical resource used primarily by doctors, so the delay in identifying the condition contributed to a lack of public awareness and leaving most patients in the dark. Recent research suggests that the rapid growth of virtual reality (VR) has led to an uptick in cases. VR headsets immerse users in an unreal world. Much of digital culture relies on masks: avatars, emojis and filtered selfies. But these headsets are literal masks that plug into an alternative reality. Some behavioural scientists predict that by 2030 we will spend more time in simulated digital environments than in the physical world. With this profound shift in our way of life, depersonalisation cases are expected to increase dramatically. Loading The process of writing When Nothing Feels Real took many years. In June 2022, it felt impossible to keep going, and I suffered a major breakdown. I interpreted this as a warning not to continue, that the cost of my scribbling was too high, that my poor health simply wouldn't allow it. But several people in the community of depersonalisation sufferers assured me of the book's worth, and supported me, day and night, through the worst of the hours. Some literally sharpened my pencils. Their unwavering devotion and belief in my story, and the need for our collective stories to be heard, is what ultimately gave me the strength to finish. My hope is that with greater public awareness, there will be improved treatment options and funding for research. Most importantly, there needs to be a shift in how doctors are trained to identify the illness. We need to change the conversation from one of limited engagement and indifference to one of urgent need. Only then will there be a 'cure'. Since the onset of my illness in London, I've been through numerous stages of relapse. As I sit at my desk today, the best way to describe my current state is that I have partially recovered. Some trace of the illness will likely always remain. One of the hardest things has been accepting this – not just the symptoms, but the inability to go back in time. In therapy, I've sifted through every inch of sand: childhood, work, relationships. Only recently have I been able to reframe my need for answers. These days, I carry a realisation: acceptance is never really acceptance – it's surrender.

‘I felt like a puppet': A midnight swim leads to a long-term mystery illness
‘I felt like a puppet': A midnight swim leads to a long-term mystery illness

The Age

time30-05-2025

  • Entertainment
  • The Age

‘I felt like a puppet': A midnight swim leads to a long-term mystery illness

This story is part of the May 31 edition of Good Weekend. See all 14 stories. On a winter night in London, my girlfriend and I decided to go night swimming. On Hampstead Heath, we shed our clothes at the edge of the pond and waded into the shallows. Stars shimmered on the water and a half-moon bobbed in the inky black. It was so cold we could see our breath. Swimming out to the middle, we fingered mosses and reeds, then began diving under the water and coming up in wild leaps, splashing one another. In the midst of our game, something happened. I was hit with a great force, torn in two, ripped from myself. I swam frantically towards the bank, trying to reach solid ground. Even though my head stayed above water, it was like a great hand was trying to push me down to the bottom of the pond. Bent over in the shallows, I clutched my chest, trying to hold my sense of self together. I was leaving my body. There was nothing I could do. I cried, tears streaming. I couldn't stop. My whole face began to shake, my cheeks going into spasms and my limbs shaking violently. My girlfriend's voice was far away. 'Nathan, Nathan. Can you hear me?' Naked before her, dripping with water, I said nothing in response. I couldn't. I stared at my wet hands. They were ghostlike, not my own. I had disappeared, and what was left of me was only a shell. One part of my elf was empty: a dusty, windswept space. The second part of myself was in a state of confinement. I felt like a puppet, manipulated by something, or someone, outside my body. I turned around to brush away this feeling of being watched, but my second self stayed behind my back. It was looking at me but I couldn't see it. I had no sense of its form or how this second self was moving me around, only that the awareness of 'me' was now gone. 'I am 28 years old,' I said to myself, trying to believe it. 'My name is Nathan Dunne.' Three years passed before I understood what was happening to me: I was experiencing depersonalisation. Its onset provoked a profound loss of identity. Like many with the illness, my response was to say, 'I'm not me', 'I have no self' and 'I am no one'. This was an attempt to describe the feeling of a severe dissociative state, the onset of mental illness, pure terror. My identity had always been intrinsically tied up with my body, fundamental to my self-consciousness. But with depersonalisation, being in its vice meant a terrifying challenge to long-held assumptions about my existence – the notion of 'me'. I struggled to explain my symptoms to doctors. Phrases like 'I feel invisible' and 'I have a dark pain' led to a misdiagnosis of anxiety-related depression. The prescribed blue pills I took caused terrible side-effects – stomach cramps, heartburn, vomiting, a stiff jaw. I sweated uncontrollably, lost my appetite, and became even more exhausted, legs tangled on the lounge. In Australia, it affects 2 per cent of the population – 500,000 people. Yet a correct diagnosis can take years. In my confusion, I searched medical journals for clues and stayed up late pondering rare diseases, compiling a Word document I saved as 'The Possibles'. Rearranging the document was like prodding a wild animal. I'd move one disease into a new column, or onto a new page, and it would immediately lash out, more alive in me than ever. I was constantly rating them. Bipolar disorder would get 8/10, then I'd bump it down to 6/10. Wolfram syndrome would be flying steady at 3/10, only to abruptly climb up to a bewildering 7/10. I'd print the document out, underlining symptoms with fat blue lines and scrawling notes to myself across the top of the pages. Things like: Blood thing probable, but check page 7. Could be muscular and optical combined, see page 14. It was not until I returned to Australia and found Dr C, a man of great clarity and insight, that I came to understand the true nature of my illness. The swim was the catalyst for my acute stress and genetic predisposition. 'Reading your file has convinced me that your accurate diagnosis is a mental illness called depersonalisation.' For the first time, I said the word aloud. How had I never heard of it before? Now that it was on my tongue it seemed so obvious. The person I knew was in confinement. According to research conducted by the Pew Research Centre in Washington DC, the global DSM-5 Research Group and a team of international doctors who specialise in depersonalisation, it is estimated that more than 75 million people worldwide suffer from the illness. In Australia, it affects 2 per cent of the population – about 500,000 people. In the United States – 6.4 million. In Britain, it's 1.3 million. 'It isn't depression, or anxiety,' says psychiatrist Daphne Simeon. 'Often, it emerges with cruel ferocity as a chronic disorder completely unto itself. Its destructive impact on an individual's sense of self is implied in its very name – depersonalisation.' My feeling of having no self meant that I remained outside my body as a detached observer. For me, the vantage point of this detachment felt like being in a specific place, a damp, black box. But for other sufferers, like Amanda, a 43-year-old office assistant, 'It is as if the real me is taken out and put on a shelf or stored somewhere.' Alex, a merchant marine, says: 'It was something like waking up to find that you're in a coffin, buried alive. Only the coffin is your body, your very existence.' Based on National Health Service data from the UK, a diagnosis for depersonalisation typically takes between eight and 12 years: a shocking statistic. The long wait occurs because doctors are trained to be sceptical of potential outlying diseases. When someone presents with a cough, it's usually a cold. Ankle pain? Probably a sprain. There's little incentive to search for obscure explanations when a common one will do. But with an illness like depersonalisation, which is easily mistaken for depression, patients like me are misdiagnosed and wait years, through trial and error, for a correct diagnosis. Although it was first named in the 19th century, depersonalisation has long been misunderstood and dismissed by the medical establishment. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) described it as merely a symptom of dissociation. Only in its most recent edition was it recognised as a disorder in its own right. Yet the DSM is a clinical resource used primarily by doctors, so the delay in identifying the condition contributed to a lack of public awareness and leaving most patients in the dark. Recent research suggests that the rapid growth of virtual reality (VR) has led to an uptick in cases. VR headsets immerse users in an unreal world. Much of digital culture relies on masks: avatars, emojis and filtered selfies. But these headsets are literal masks that plug into an alternative reality. Some behavioural scientists predict that by 2030 we will spend more time in simulated digital environments than in the physical world. With this profound shift in our way of life, depersonalisation cases are expected to increase dramatically. Loading The process of writing When Nothing Feels Real took many years. In June 2022, it felt impossible to keep going, and I suffered a major breakdown. I interpreted this as a warning not to continue, that the cost of my scribbling was too high, that my poor health simply wouldn't allow it. But several people in the community of depersonalisation sufferers assured me of the book's worth, and supported me, day and night, through the worst of the hours. Some literally sharpened my pencils. Their unwavering devotion and belief in my story, and the need for our collective stories to be heard, is what ultimately gave me the strength to finish. My hope is that with greater public awareness, there will be improved treatment options and funding for research. Most importantly, there needs to be a shift in how doctors are trained to identify the illness. We need to change the conversation from one of limited engagement and indifference to one of urgent need. Only then will there be a 'cure'. Since the onset of my illness in London, I've been through numerous stages of relapse. As I sit at my desk today, the best way to describe my current state is that I have partially recovered. Some trace of the illness will likely always remain. One of the hardest things has been accepting this – not just the symptoms, but the inability to go back in time. In therapy, I've sifted through every inch of sand: childhood, work, relationships. Only recently have I been able to reframe my need for answers. These days, I carry a realisation: acceptance is never really acceptance – it's surrender.

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