Loss of reality

Of the Loss of reality is a symptom that accompanies a variety of organic and mental illnesses and in some cases can have causes of a non-pathological nature. It is therefore necessary to determine the root cause in order to initiate effective treatment.

What is Loss of Reality?

The perception of events and objects is so disturbed that those affected find themselves in a kind of individual parallel world.
© Tommaso Lizzul - stock.adobe.com

In medical and psychological terms, the term loss of reality denotes a mental state in which those affected can no longer grasp their situation as it corresponds to the facts or as most of their fellow human beings would.

The perception of events and objects is so disturbed that those affected find themselves in a kind of individual parallel world. This can lead to delusions, hearing voices, excessive self-overestimation or underestimating one's own abilities. In extreme cases, a loss of reality can result in those affected endangering themselves or others.

The loss of an adequate perception of reality can remain limited to individual dimensions, for example as a temporal loss of reality. With this, those affected no longer have any awareness of a temporal continuum.

causes

There are many possible causes for a loss of reality, and these can be both psychological and organic in nature. Loss of reality is very often associated with psychosis, but there are a number of other possible triggers.

For example, various personality disorders, depression and, in particular, the clinical picture of schizophrenia lead to a loss of reality. The symptom is psychiatrically or neurologically relevant in the case of dementia and strokes, among other things.

Furthermore, organic causes include metabolic disorders, encephalopathy, brain injuries (for example, traumatic brain injury), cachexia (pathological weight loss), gradual starvation and dehydration (lack of fluids).

Lesser-known causes such as permanent light deprivation can lead to a loss of reality, as can traumatic experiences, shock and severe exhaustion.

Alcohol and drug abuse also make up a not inconsiderable part of the causes. Persistent alcohol abuse can, for example, lead to a severe amnestic psychosyndrome (Korsakoff syndrome). The abuse of cannabis, in turn, can lead to psychosis and the associated loss of reality. And finally, in some cases the use of certain medications can lead to a distorted perception of reality.

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Diseases with this symptom

• psychosis
• Dissocial Personality Disorder
• dementia
• stroke
• paranoia

• narcissism
• Alzheimer
• Paranoid schizophrenia
• Metabolic disorder
• Cachexia

• Dissociative Identity Disorder
• Munchausen Syndrome
• schizophrenia
• Encephalopathy
• concussion

Diagnosis & course

Since loss of reality is only a symptom, diagnosis will focus on determining the underlying causes. Only when organic causes can be ruled out should mental illness be considered.

If, for example, typical symptoms such as a loss of reality occur in the course of a psychosis, the attending physician will carry out blood and urine tests after taking the anamnesis and a general health check.

This is done in order to be able to rule out substance abuse, inflammation or metabolic disorders. Further neurological tests can provide information about whether the person concerned has epilepsy or multiple sclerosis - diseases that can also lead to psychosis.

If no organic cause for the loss of reality can be determined in this way, the probability is high that the psychotic incident is based on a mental disorder. Schizophrenia is the most common cause of psychosis.

However, there can also be other mental illnesses or disorders behind it, such as severe depression or bipolar disorder, in which case we speak of an affective psychosis. Therefore, an accurate diagnosis of the causal mental disorder is essential. This is provided by means of psychological test procedures and by a psychiatrist.

Complications

A loss of reality almost always occurs in connection with a psychosis and has various complications. Schizophrenia is an example of a loss of reality. Those affected tend to consume more drugs. In addition, those affected are often dependent on nicotine. In addition, aggressive behavior is increasingly observed in schizophrenics, so that not only the risk of injury to the person concerned, but also to the immediate environment is increased.

In addition, most patients have hallucinations and delusions. Antipsychotics, which are prescribed for schizophrenia, have characteristic side effects such as an increase in blood sugar, weight gain, and a Parkinson-like appearance such as rigidity and tremors (tremor).

In general, the mentally ill are not accepted by society, so that they are socially isolated. This can lead to depression. Depression itself can also change the relationship to reality. Affected people tend to consume a lot of alcohol or drugs. Chronic alcohol abuse can damage the liver. This leads to cirrhosis of the liver via fatty liver, which can result in liver cancer.

Cirrhosis of the liver promotes the development of edema and coagulation disorders. Furthermore, depressives usually suffer from anxiety and obsessive-compulsive disorders, so that they no longer dare to go outside and the symptoms are worsened as a result. In the worst cases, the person concerned may have thoughts of suicide.

When should you go to the doctor?

An alarming number of people today suffer from a partial loss of reality. The reason is that everyone creates their own reality through opinions, prejudices or wrong views. In this case, no doctor can help those affected. However, a psychologist may be a helpful address, especially if the person concerned is suffering from a loss of reality.

Neurotics, borderline patients, and narcissists suffer from personality disorder. As a result, there can be a more or less severe loss of reality. This can also be assumed in the case of schizophrenia or psychosis. In many cases, drug therapies are indicated.

In other cases, an increasing loss of realism can be a matter of greatest concern. The loss of reality can occur through longstanding alcoholism. Connection to the real world can hardly be achieved without withdrawal therapy. Loss of reality can also indicate the increasing destruction of brain cells by strokes, lesions or plaques. An increasing loss of reality can indicate dementia or Alzheimer's disease. A visit to the doctor is essential here because the patient must be treated professionally.

A loss of reality can also result from taking some medications. Preparations such as Pramid, Pramipexole or Oprymea are known to lead to confusion or an increasing loss of reality. A visit to the doctor is essential here. The drug may have to be exchanged for another.

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Treatment & Therapy

A loss of reality is treated according to the underlying disease or cause. If the loss of reality occurs, for example, as a side effect of dehydration, the elimination of the lack of fluids is sufficient. The symptom also disappears relatively quickly when a causative drug is discontinued.

In other cases with an underlying organic disease, drug treatment may be necessary. This applies, for example, to dementias, strokes, encephalopathies and various inflammatory diseases that can attack the nervous system or the brain.

Medicines can also be used for psychological reasons for a loss of reality. In the treatment of psychoses, the administration of neuroleptics has proven particularly effective. These are part of the standard therapy for people with schizophrenia, and people may also be given anti-anxiety medication.

The use of psychotropic drugs extends over a longer period of time; in some cases, patients are dependent on such medication for their entire life. The same applies to all other mental disorders and illnesses. In the case of depression, antidepressants are used to relieve the symptoms; in the case of other disorders, the administration of mood stabilizers can be helpful.

If the loss of reality is based on a psychological cause, in most cases psychotherapy is indicated in addition to drug therapy. Occupational therapy and sociotherapeutic measures such as assisted living and a sheltered workplace are also recommended, particularly for those with schizophrenia.

Psychological support is also required if the symptoms are alcohol or drug-induced. In these cases, it is not uncommon for an addictive behavior to be in the foreground that needs to be treated and ideally overcome.

Outlook & forecast

The prospects and prognoses in the event of a loss of reality cannot be universally predicted. They depend very heavily on the psychological and physical condition of the person concerned and can develop to different degrees. The personal environment also contributes relatively much to the development of the loss of reality.

In most cases, treatment is carried out by a psychologist. Often the people affected are no longer able to go on a normal everyday life, so that they are dependent on outside help. In some cases, the loss of reality is so great that the person concerned can harm himself or other people. In these cases they are treated in a closed institution. Medicines are also used in the treatment.

The abuse of drugs often leads to a loss of reality, so that the body will remain permanently damaged. Whether the treatment is successful therefore also depends heavily on the patient's medical history. In addition to psychological disorders, patients also complain of metabolic disorders, dehydration and sleep disorders when they lose their sense of reality.

Often traumatic results are also the trigger for the loss of reality. These results are discussed and evaluated by a psychologist. However, it cannot be universally predicted whether the treatment will be successful.

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prevention

Some risk factors for a loss of reality can be avoided relatively easily - unless there is already an addiction. This is particularly true of alcohol and drug abuse, which at best should be avoided altogether.

Excessive stress, interpersonal conflicts and noise pollution should also be avoided, if possible, in order to prevent states of exhaustion. A generally healthy and balanced lifestyle can also help reduce the risk of psychological stress and the loss of reality that it may cause.

You can do that yourself

A method of self-help is hardly possible if you lose reality. In most cases, if you have this symptom, you definitely need to see a psychologist who will treat the disease. It is not uncommon for patients to be admitted to a closed clinic.

If the loss of reality occurs due to excessive consumption of alcohol or other drugs, these drugs must be stopped immediately. Smoking can also lead to a loss of reality and should be stopped. In many cases, it is not possible for the patient to stop taking the affected drug. This is where self-help groups can be helpful. In any case, self-referral to a psychiatric clinic is also possible in order to treat the loss of reality.

Often the loss of reality comes about through stress. Therefore, all possible situations in which stress or conflict can arise should be avoided. Although this restricts everyday life, it helps enormously against the symptom. If the loss of reality occurs due to medication, these should be discontinued or replaced with other medication. Friends and family in particular must pay attention to the patient and force him to undergo treatment if necessary.