Feeling numb: What you need to know
Though everyone experiences numbness differently, there are a few symptoms that are considered to be hallmarks of the condition. When these symptoms are severe, persistent, or recurrent they may be a sign of depersonalization-derealization disorder (DD).
Currently, most doctors consider emotional numbness to be a side effect of a few different physical and mental causes. In most cases, emotional numbness goes away with self-care, emotional support, and time.
- Drug abuse is thought to be a common cause.
- Symptoms include feelings of disconnection and detachment.
- The best course of treatment for emotional numbness depends on the cause.
Classifying emotional numbness and DD
Though many people will experience a feeling of emotional numbness, for between 0.95 and 2.4 percent of the population, the sensation of feeling numb is far more profound, and the disorder is now classified as a mental health condition.
In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classified the overwhelming, long-lasting, and ever-present state of feeling unreal or disconnected as depersonalization-derealization disorder or DD.
What are the symptoms?
Emotional numbness and DD may be characterized by feelings of emptiness, exhaustion, or confusion.
Common symptoms and signs associated with emotional numbness and DD include:
- feeling disconnected from one's body or thoughts (dissociation)
- feeling detached from the outside world (derealization)
- feeling like stranger or outsider in one's own life (depersonalization)
- distorted or confused sense of time
- feeling dead or not-alive
- feeling empty or hollow
- feeling meaningless, worthless, or hopeless
- feeling as though one's sleepwalking through everyday activities
- impaired social functioning or withdrawal from social settings
- lack of emotional senses, processing, and responses
- lack of bodily senses, processing of internal signals, and responses
- altered body perceptions
- feeling a loss of control over what one says or does
- feeling disconnected from memories or memory loss
- altered sense of sight, where objects and noises appear more dim, lifeless, flat, artificial, and larger or smaller than normal
- altered sense of sound where noises appear louder or softer than normal
- feeling "crazy" or mentally unstable
- always checking to make sure outside things and perceptions are real
- feeling emotionally and physically exhausted regardless of exercise level or amount of sleep
- failing to enjoy activities or hobbies
What are the causes?
Each situation varies, but typically, people who experience emotional numbness and DD are so overwhelmed by stress, outside chemicals, or medications that emotional responses become diminished.
Researchers are still exploring the precise biology, chemistry, and brain changes that cause or are associated with numbness and DD.
Most studies into the matter have found that people with emotional numbness or DD are less responsive to emotional cues, lack social understanding, and lack emotional awareness.
Neuroimaging, however, does show that the same brain chemicals and brain areas are involved in processing each of the shared traits of the condition; a lack of emotion, empathy, and interoception (the ability to understand and sense what is going on inside the body).
Physical and mental causes
Emotional numbness and DD may be caused by exposure to violence, or traumatic injuries.
DD was only recently reclassified to include a broader range of symptoms and exclude cases caused by medical conditions and medications.
So, researchers are still trying to figure out exactly how, why, and when DD occurs. Currently, the DSM-5 does not define a specific cause; instead, it suggests diagnosis mainly by ruling out known causes, such as certain medications, as well as other mental or physical conditions.
Causes of temporary emotional numbness that are not considered to cause DD include:
- drug abuse, especially marijuana, LSD, and ketamine
- seizures, especially those caused by epilepsy, medication, or drug overdose
- panic or extreme anxiety attacks
- severe depression, especially as seen with major depressive disorder
- severe anxiety
- post-traumatic stress disorder
Common medications that are known to cause emotional numbness include:
- Anti-anxiety drugs (SSRIs): A 2014 study found that 60 percent of just over 1,800 adults who had taken anti-depressants within the past 5 years had experienced emotional numbness.
- Anti-depressant medications: A 2015 study concluded that one of the predominant, long-term side effects of antidepressant use in young adults is emotional numbness.
Trauma and stress
Some research suggests that DD and emotional numbness may develop as a sort of coping mechanism, acting to desensitize individuals exposed to extreme or continual stress.
In 2016, an article in Developmental Psychology outlined the results of a 6-year study that had followed nearly 3,500 children who had been exposed to violence. The study found that the young people became increasingly desensitized, or emotionally numb, over time regardless of age or gender.
Causes of numbness that may also potentially cause DD include:
- traumatic experiences, such as a car crash, a near-death experience, fire, or terrorist attack
- deeply emotionally disturbing events, such as the sudden or progressive loss of a loved one or friend
- physical abuse
- emotional abuse or neglect, especially in childhood
- having a mentally ill or severely physically impaired parent or spouse
- extreme interpersonal conflict or stress, usually with a spouse, close friend, family member, co-worker, or boss
- financial crisis or stress
Treatment options and coping strategies
For many people, addressing underlying stress, trauma, or grief with a medical professional and through lifestyle changes can help lessen and eventually resolve symptoms of numbness.
Maintaining healthy relationships and establishing a support network may help, when learning to cope with and treat emotional numbness.
Common coping strategies suggested for the treatment of emotional numbness include:
- reducing stress
- eating a healthy diet
- getting enough sleep
- identifying causes, triggers, and stressors and trying to avoid them or reframing one's perception of them
- discussing feelings with friends, family, or roommates and reach out for help when needed
- trying to stay busy or distracting oneself
- trying to keep in mind that often the sensation of numbness is temporary and additional stress or worry may make the feeling far worse and last longer
- scheduling an appointment with a psychologist to talk through feelings and discuss behavioral coping mechanisms
Commonly used psychotherapy methods include:
- cognitive therapy
- psychodynamic therapy
- behavioral techniques
- moment-to-moment tracking and labeling of cause and dissociation
A psychotherapist may choose to use one, or several different types of therapy and techniques to help address and treat emotional numbness and DD.
For some people, stopping or starting the use of prescription medications, such as anti-depressant and anti-anxiety medications, may be necessary to provide relief from numbness, especially when the cause is unknown.
To be prescribed medications for emotional numbness and DD, a psychiatrist's diagnosis is necessary. Doctors only prescribe drugs in situations where symptoms are:
- significantly impair everyday life for a prolonged period
- seem exaggerated for the cause
- are classified as DD
- associated with another condition or disorder
Currently, there is no reliable evidence to suggest that any medication effectively treats emotional numbness or DD unless it is considered a symptom of another disorder or condition.