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khagihara, Doctor
Category: Mental Health
Satisfied Customers: 6590
Experience:  Trained in multiple medical fields for many years
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This week, I discovered that I likely have chronic

Customer Question

This week, I discovered that I likely have chronic depersonalization-derealization disorder. Previously I was unfamiliar with the disorder; however, I have described almost word-for-word the same symptoms associated with the disorder. I have also experienced bouts of mild depression that seem to have stemmed from derealization disorder traits. However, from my research, it seems that there aren't many treatment options, which makes me hesitant to work to reach out to professionals. What are symptoms I should be looking for to know when it's time to get help? What options for diagnosis are there?
Submitted: 9 months ago.
Category: Mental Health
Expert:  khagihara replied 9 months ago.
What treatments did you find?
Customer: replied 9 months ago.
Psychotherapy seems to be the most common treatment, esp. cognitive-behavioral. According to various forums and articles, this may or may not be helpful. Some patients seem to report worsening symptoms, especially in response to relaxation techniques. I think specific aspects of DP/DR are often the focus of treatments, such as targeting PTSD symptoms or healing family relationships. There doesn't seem to be an agreed upon medication for DP/DR (if there were, I would still avoid them for religious reasons). Nick Medford, Mauricio Sierra, Dawn Baker, and Anthony S. David have a peer-reviewed article that was useful, but a little old (2005).For me, DP/DR hasn't been seriously disruptive for the past 2 years, although it was in the past. My biggest concern: I will be engaged in the spring, and recognizing this as a disorder for the first time, want to know how this could affect my relationships.
Expert:  khagihara replied 9 months ago.

Diagnostic criteria

●A. The presence of persistent or recurrent experiences of depersonalization, derealization, or both:

•1. Depersonalization – Experiences of unreality, detachment, or being an outside observer with respect to one's thoughts, feelings, sensations, body, or actions (eg, perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing).

•2. Derealization – Experiences of unreality or detachment with respect to surroundings (eg, individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted).

●B. During the depersonalization or derealization experiences, reality testing remains intact.

●C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

●D. The disturbance is not attributable to the physiological effects of a substance (eg, a drug of abuse, medication) or another medical condition (eg, seizures).

●E. The disturbance is not better explained by another mental disorder such as schizophrenia, panic disorder, major depressive disorder, acute stress disorder, posttraumatic stress disorder, or another dissociative disorder.

Can you tell me more about your symptoms?

Customer: replied 9 months ago.
For me, memories seem like they happened to someone else, and things I'm experiencing seem kind of like I'm watching them through a cloud or watching a play. When I'm telling someone my story, I feel kind of detached from it emotionally. I have a hard time identifying my emotions or physical sensations with myself, or my experiences--but I know they belong to me. Looking into a mirror is a really strange feeling--kind of like seeing someone else; only not quite, because I know it's me. The world feels kind of less real than it used to--but I know what's real, I know how things should feel. I started feeling like this, sort of distinct from other reality, after working with sexually abused women internationally for a few years, and experiencing large-scale natural disasters. I remember when I first started feeling episodes of feeling like my mind or experiences were distinct, I was very disturbed--I questioned my faith and spirituality, and felt a little as if I was unprepared to safely experience my surroundings. Around the same time, I developed a very high pain threshold. All of this was in episodes at first, but then I began to feel different degrees of detachment very consistently for about a year. Mentors suggested that it might be some form of depression or PTSD from my experiences, but I was never officially diagnosed with either.
Customer: replied 9 months ago.
Recently, I've felt less detached, but still experience episodes where I can't quite "connect" with the world. Sometimes I feel as if I want to seek extra adrenaline or more high-intensity emotional experiences, but I know that's unhealthy... so, I try to keep it safe, and work out more (or something like that) because I know I shouldn't feel detached.
Expert:  khagihara replied 9 months ago.
How old are you? How tall are you? How much do you weigh? Any weight change? Does anything make your symptoms better or worse? When did it start? Is it consistent? Is it getting worse? Any other symptoms? Are you aware of anything which might have triggered it? Any medical problems? Any surgeries? Any medications including over-the-counter pills and herbs? Any family medical history including mental diseases?
Customer: replied 9 months ago.
I'm 19, and 5'6. I've gained weight, because I've stopped playing sports. Sending time with my significant other seems to reduce symptoms, lack of sleep definitely makes the symptoms more extreme. Symptoms started five years ago. They were inconsistent or sporadic for two years, then consistent for two, and are now sporadic again. As I mentioned above, I worked directly with victims of sexual violence, and lived through multiple large scale natural disasters. There was also some trauma inside the family. Symptoms developed as each of these occurred and were significantly worse following an ugly breakup. I have asthma, I'' not really sure what runs in the extended family, and the only medication is the inhaler.
Expert:  khagihara replied 9 months ago.

You should see a psychiatrist to exclude panic disorder, major depressive disorder, posttraumatic stress disorder, and another dissociative disorder before sh/e determines you may have it.