# Recovery - Seven Year Later



## apteron105 (Sep 6, 2018)

[An important note: if you are 'new' to all of this, do yourself a favor: turn off your computer and try to forget about depersonalization or derealization.]

You can find my introductory post from 2012 here: https://www.dpselfhelp.com/forum/index.php?/topic/30903-slowly-but-surely/?hl=eppy105#entry250687

Rereading it now, I barely recognize that person. I wish so badly that I could go back in time and comfort him, and give him the reassurance that no one else could, and tell him about all of the incredible things he would get to experience down the line. Sometimes I think about him and I want to cry, because I know how much pain he was in. It is a pain that has haunted me for seven years, and though the idea of quantifying my recovery still leaves me uneasy, I owe it to that scared kid to come back here now.

For about 4 years after that post, I feared suicide every day. I felt certain that I was done for, that I'd get worse, that I'd reach a breaking point and snap. I read this forum obsessively. I was rushed to an emergency psychiatrist multiple times after admitting to thoughts of self-harm. I was put on sertraline (Zoloft), which was essentially a sugar pill for me, but I was too terrified to try anything else. Strangely enough, I never wanted to hurt myself, and really never considered myself 'depressed'--I just wanted a way out, any way out. There's no shame in feeling that way.

I still can't quite comprehend it, but somehow it never happened. I am stronger than I ever knew possible, and you are too.

Another mystery to me: I managed to drag myself out of bed and not only survived, but outwardly thrived. I came out of the closet, graduated high school with honors, got into my dream university, traveled, made new friends, fell in love (many times), had my heart broken (many times), made art, won awards, discovered new passions, and read voraciously, all the while seeing the world around me as a nightmare from which I could not awake. I sometimes joked with my therapist that I was the most high-functioning fuckup of all time. I have no advice in this department, but please know that despite everything, every moment was hell; the only way I did it was by convincing myself that, if I allowed myself to admit defeat, I would not get back up.

I feel a great sadness for how little of those years I actually experienced.

The turning point came when it did get worse, and I became non-functional. The worst night of my life was spent clutching my dorm room extra-long twin mattress, unaffected by the emergency klonopin I had popped an hour earlier, certain that if I let go, I'd run into the kitchen and stab myself. Having read all of the DPD research, I contacted Daphne Simeon and made an appointment. I remember taking the subway to her office, afraid that I'd jump onto the tracks, so dissociated that I did not know which train I was on. I broke down in her office and was prescribed clomipramine (Anafranil). Very slowly over a month, the derealization faded into the background. Clomipramine saved my life. It's done the same for others on here, but--and this isn't bullshit!--everyone's different.

After a few months, Dr. Simeon recommended that I begin psychotherapy with Orna Guralnik (another name that pops up in the DPD research) in order to deal with my own personal traumas. I had been self-loathing in regards to my sexuality from the time I was 7 years old, and I knew that it had royally fucked me up. My experience with Dr. Guralnik has been the most formative of my life, and though I don't necessarily feel that it impacted my derealization directly, it did allow me to really figure out my own narrative. People scoff at psychoanalysis, and in many cases I believe it to be useless, but as a guiding tool with which to deconstruct oneself, it is unmatched. It certainly did a lot more for me than the bullshit CBT therapist to whom NYU referred me.

Dr. Guralnik also diagnosed me with Bipolar II, which I had sort of known my entire life. I was prescribed lamotrigine (Lamictal), which, though subtle, has effectively put an end to my depressive cycles without numbing my positive hypomanic or obsessive tendencies.

So where am I now? I somehow snagged an absurdly high-paying job with a liberal arts degree (HA). I'm planning to work a few years before going to med school to specialize in--you guessed it--psychiatry and neurology. The brain (and its discontents) has always been at the pinnacle of my interests, and my experience with the mind's darkest corners has only strengthened my resolve to scratch at its secrets and ameliorate the pain of its sufferers. The reason I've come back here is because I tried to come off of clomipramine two months ago and had a relapse of symptoms. Now, a month of being back on it, I feel fine again. If taking a pill once a day is the price I pay for sanity, there's really no question.

Now, here are my two hard-won opinions:

1. I do not believe that everyone on this forum suffers from the same mental health problem. The disparity in etiology, symptoms, and effective treatments from person to person is too great to wrap it all snugly under the umbrella term of "Depersonalization Disorder." That is not to say that DPD doesn't exist, as it clearly does and clearly wreaks havoc on people's lives, but I think that the co-morbid disorders that come with it are the perpetuating culprits. For some of us, it's an anxiety disorder, or acute depression, or bipolar disorder, or PTSD, or HPPD, or schizophrenia*. Personally, I feel that my issue was a mix between PTSD and and HPPD, but regardless, the phrase "treatment resistant" does NOT mean untreatable. Keep trying new things.

*Relax.

1. People who shame others for taking medication should be put before a firing squad. Yes, the over-saturation of psycho-pharmaceuticals in the modern world is worrying, but even more worrying is the amount of suffering that can be avoided if people weren't terrified of trying them. Depersonalization seems to be behavioral for some people and chemical for others--medication can exponentially help in both cases. If you are suffering tremendously and are willing to give medication a shot, here's a short list of meds that have clinically or anecdotally helped people with DPD, but, of course, do not take my layman's knowledge as fact, and know that what works for some may not work for others:

--Lamictal + SSRI ("The London Combo")

--Clomipramine

--Lexapro

--Abilify

--Remeron

--Keppra/Sinemet (for HPPD)

--Klonopin/Xanax (Proceed with extreme caution. I'm wary of benzos, but some people experience complete relief on them. If they work for you, your doctor can hopefully fine-tune a regimen that mimics its effects without inducing dependency)

Be sure to do your research on a drug and discuss any concerns with a doctor, and don't be discouraged by failures. Unfortunately, medication is still a game of trial-and-error, but that will [hopefully] be changing in the next two decades.

So. I am doing well. I'm so glad I held out and survived, though I still feel horrified about what I went through. It's something that no human being should ever know. I got the help I needed, but I also had the support [familial, fraternal, monetary] to get that help. The number of people in the world without those luxuries is a farce unto the universe, and my heart aches for all of you. If you have no support system, look up organizations or programs that may be able to assist you. Be strong. Keep going. You're gonna make it. Really.

I want to leave you with something that always made me feel better in my darkest moments. This is the introduction to Bertrand Russell's autobiography:

"Three passions, simple but overwhelmingly strong, have governed my life: the longing for love, the search for knowledge, and unbearable pity for the suffering of mankind. These passions, like great winds, have blown me hither and thither, in a wayward course, over a great ocean of anguish, reaching to the very verge of despair.

I have sought love, first, because it brings ecstasy - ecstasy so great that I would often have sacrificed all the rest of life for a few hours of this joy. I have sought it, next, because it relieves loneliness--that terrible loneliness in which one shivering consciousness looks over the rim of the world into the cold unfathomable lifeless abyss. I have sought it finally, because in the union of love I have seen, in a mystic miniature, the prefiguring vision of the heaven that saints and poets have imagined. This is what I sought, and though it might seem too good for human life, this is what--at last--I have found.

With equal passion I have sought knowledge. I have wished to understand the hearts of men. I have wished to know why the stars shine. And I have tried to apprehend the Pythagorean power by which number holds sway above the flux. A little of this, but not much, I have achieved.

Love and knowledge, so far as they were possible, led upward toward the heavens. But always pity brought me back to earth. Echoes of cries of pain reverberate in my heart. Children in famine, victims tortured by oppressors, helpless old people a burden to their sons, and the whole world of loneliness, poverty, and pain make a mockery of what human life should be. I long to alleviate this evil, but I cannot, and I too suffer.

This has been my life. I have found it worth living, and would gladly live it again if the chance were offered me."

And just to lighten the mood a bit:

"Let the credulous and vulgar continue to believe that all mental woes can be cured by a daily application of old Greek myths to their private parts."‬ ‪- Nabokov

Love always,

Jonathan


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## Tomisahoss (Feb 22, 2018)

I would love to talk to you. We have much in common but you seemed to have found a way, or even just a mindset, to work your way through it. I'm 22 and somewhere around the two year mark of suffering. I quit my job recently and haven't left my basement in 2 weeks unless it was to go buy beer or take a shower. Normally the DR is what gets to me, but when I woke up earlier, the DP I experienced was appalling and this has persisted all day. I have felt DP intensely before but this was like a polar opposite of phantom limb syndrome. As if I could somewhat detect my arms and fingers but I felt like they shouldn't be there at all. I could really use some advice. Regardless, thank you for your story. I've saved it to the homescreen on my phone and plan to read it whenever I need a little push. You're rad, and I'm proud of you.


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## Broken (Jan 1, 2017)

Thank you for coming back to tell your story. And congratulations! Glad things are working out for you. I have found myself losing hope recently and actually had clomipramine next on my list to try. I have tried many many meds without effect, but will give this a go. What are the side effects for you? Not wanting to get too personal (lol) but the sexual side effects of some of these meds makes it very off putting for me..

I experienced sexual side effects before with effexor and asked my doctor about permanent impotence caused by this drug. He shook his head and knew nothing about it, despite me reading endless anecdotal evidence online, and with that lost faith in him and stopped taking it


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## apteron105 (Sep 6, 2018)

Tomisahoss said:


> I would love to talk to you. We have much in common but you seemed to have found a way, or even just a mindset, to work your way through it. I'm 22 and somewhere around the two year mark of suffering. I quit my job recently and haven't left my basement in 2 weeks unless it was to go buy beer or take a shower. Normally the DR is what gets to me, but when I woke up earlier, the DP I experienced was appalling and this has persisted all day. I have felt DP intensely before but this was like a polar opposite of phantom limb syndrome. As if I could somewhat detect my arms and fingers but I felt like they shouldn't be there at all. I could really use some advice. Regardless, thank you for your story. I've saved it to the homescreen on my phone and plan to read it whenever I need a little push. You're rad, and I'm proud of you.


Hey! Thanks for the kind words. First off, I'm so sorry you're feeling this way. I'm lucky that I never got stuck in the agoraphobia trap. I don't have any specific tips on how I did that, but, contrary to popular opinion, I believe that doing what's most comfortable and 'not forcing yourself' can be beneficial while you try to get back on your feet. Of course, perpetually paralyzing your life can be very harmful, but I know that there were many times that prioritizing my comfort in whatever way possible would have been more beneficial than throwing myself into something out of illogical pride. There was a recent recovery post with which I strongly agreed, and wish I had seen much earlier in my DPD experience: https://www.dpselfhelp.com/forum/index.php?/topic/49819-recovered-after-6-months-citalopram-and-mirtazapine/?hl=forcing

Everyone's different. Some people recover by ignoring it and moving on with life; their suffering is just as valid and their courage and strength should be commended. But for some of us, it just doesn't work that way. That doesn't signify weakness, it signifies a different lived experience.

I found that cutting alcohol always cleared my head, but, being around the same age, it was impossible to avoid booze in order to maintain a social life. Thus, my recommendation is to only drink when you're out with friends, and limit your intake to 2-3 drinks if possible. The pleasure of spending time with people I love and having a good night was always worth the ensuing haziness, even if I felt disconnected at the bar/party/weird Brooklyn performance art show.

I forgot to mention this in my original post: EVERYBODY should read The Body Keeps The Score by Bessel van der Kolk. I judged the book by its cover and had dismissed it as pop psychology when it was recommended by friends, but the information in there is invaluable, and will give you a greater perspective on your condition (spoiler: it's not as rare or misunderstood as you've been led to believe) and what you can do to feel better. People on this forum frequently recommend At Last a Life by Paul David, and while I'm sure that there's great stuff in there as well, I found the words of a seasoned psychiatric professional--with an acute understanding and track record of treating traumatic illness--more compelling than the testimonies of fellow sufferers.

Feel free to PM me if you'd like!


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## apteron105 (Sep 6, 2018)

Broken said:


> Thank you for coming back to tell your story. And congratulations! Glad things are working out for you. I have found myself losing hope recently and actually had clomipramine next on my list to try. I have tried many many meds without effect, but will give this a go. What are the side effects for you? Not wanting to get too personal (lol) but the sexual side effects of some of these meds makes it very off putting for me..
> 
> I experienced sexual side effects before with effexor and asked my doctor about permanent impotence caused by this drug. He shook his head and knew nothing about it, despite me reading endless anecdotal evidence online, and with that lost faith in him and stopped taking it


The reason I had tried to come off clomipramine a few months ago was because 1. I felt 100% and 2. it gives me the 'ability' to sleep too long if I don't have work or weekend plans, and makes me a bit groggy in the morning. These are really minor complaints...I moved to Seattle a couple months ago and thought, "Ah, a new start! If I stop taking this unnecessary pill! I'll be out of bed by 6 AM on Saturdays and Sundays, ready to explore! Surely my mental health woes were left behind on the East Coast!". Unfortunately, it doesn't quite work that way 

RE: sex stuff

I think people frequently lay the bulk of the blame for sexual dysfunction on medication but forget that it's hard (hehe) to be aroused when you're feeling anxious and miserable. That being said, I'm hornier in general than the average lad or lass. On clomipramine, I occasionally find it hard to finish while masturbating, but it's never been an issue when I'm playing with anyone other than myself.

Interesting side-note: after I finished titrating off of it, the slightest breeze made me orgasm. It was ridiculous. I actually avoided sex during that time in order to save myself from embarrassment.


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## Broken (Jan 1, 2017)

Thank you for your reply, I appreciate it. Plus the good thing is we are all anonymous here so can talk about wanking and stuff lol Yes clomipramine is the only med I have seen depersonalization disorder listed under it's 'medical uses' tab on Wikipedia (not that this is an overly reliable source, but still).

Sleep is a huge issue for me as in getting off to sleep. I really do need to be on meds, effexor seemed to start helping me but I panicked when it messed with my junk. I know I have a mental illness but most men think with their dick lol... If my doctor had been more concerned or knowledgeable about this I may well have continued it. Although the 'brain zaps' on effexor were also strange.

I have been putting it off for some time, as my DPD is largely trauma related and was hoping therapy would help me more than it has. But because of this post I am seeing my doctor tomorrow to start clomipramine, so thank you. I hope it helps me as it has you. Mind me asking what your symptoms were and if your DP was chronic? Caused by a weed panic attack? Did it affect socialising as in listening to other people talk/ (my main symptom that bothers me)


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## apteron105 (Sep 6, 2018)

Broken said:


> Thank you for your reply, I appreciate it. Plus the good thing is we are all anonymous here so can talk about wanking and stuff lol Yes clomipramine is the only med I have seen depersonalization disorder listed under it's 'medical uses' tab on Wikipedia (not that this is an overly reliable source, but still).
> 
> Sleep is a huge issue for me as in getting off to sleep. I really do need to be on meds, effexor seemed to start helping me but I panicked when it messed with my junk. I know I have a mental illness but most men think with their dick lol... If my doctor had been more concerned or knowledgeable about this I may well have continued it. Although the 'brain zaps' on effexor were also strange.
> 
> I have been putting it off for some time, as my DPD is largely trauma related and was hoping therapy would help me more than it has. But because of this post I am seeing my doctor tomorrow to start clomipramine, so thank you. I hope it helps me as it has you. Mind me asking what your symptoms were and if your DP was chronic? Caused by a weed panic attack? Did it affect socialising as in listening to other people talk/ (my main symptom that bothers me)


Mine was from a weed-induced panic attack, but the more I learn, the more I realize that different people have different thresholds for trauma. My panic attack was definitely traumatic (ALL panic attacks are traumatic!), and for a long time I either refused to believe that out of bravado or was convinced it had to be something different. Again, I can't recommend The Body Keeps The Score enough. You'll be better able to understand what has happened to you, and that it's not some mystery illness; in fact, it's quite well-studied.

Yes, I was chronic 24/7. My DR (I did not suffer from DP) would wax and wane in intensity throughout the day, but it was never gone. I felt like my eyes had been replaced with different lenses, everything looked bizarre and trippy, people looked 'off', my sense of spatial awareness was dramatically off, I had visual snow and tracers, my sense of time was distorted, and my memory was shit (although my memory's never been the best). You can find more in my post from 2012 that I linked to in my original post. It basically felt like I got high and never came down. And yes, it made it difficult to interact with people I didn't feel comfortable around, especially at work. I'd be in a meeting and be unable to focus on what anyone was saying, thinking to myself, "This is so bizarre-looking, none of this looks right." Not fun.

Therapy is definitely important, but I personally couldn't reap its benefits until I got to a certain level of comfort, which was only possible with meds. If yours is trauma-induced, there are a lot of reports on the efficacy of Eye Movement Desensitization and Reintegration (EMDR) therapy in treating trauma-related disorders. It's seems a bit pseudoscience-y and the current literature doesn't articulate why it works, but hey, if it works it works. I personally have never tried it, but you'll find some people's positive experiences on here.


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## Broken (Jan 1, 2017)

What exactly did you learn from the book? Was it more of an understanding as to why things were happening or is there any practical advice? I know DP is often experienced in fight or flight (especially the freeze response).

Yes mine is mainly DR as well as being weed induced. I just feel spacey and dreamy but no out of body experiences so I guess not really DP either. Yeh me too, it was as if I got high and never came down from it. Although I spoke to a friend about it once and he said 'that's not what being high feels like'. So I suspect smoking weed actually caused me to disconnect in a sense but that felt better than emotional pain or anxiety. Socialising is particularly difficult for me. I zone out mid sentance and get distracted by people moving in my peripheral or surrounding noises. Like hypervigilance but my brain is over tired from it so it's like my head is in a goldfish bowl.

I have tried EMDR with some effect after about 5-6 sessions and then it was discontinued as that's all that could be afforded. I should perhaps try it again from home, there are youtube videos that are worth trying if you are interested. It is comforting to know that we have/had very similar symptoms and causes and you pulled through with the help of this medication. Thank you for coming back to tell your story, to be honest I was running out of hope. It has been a very long 14 years for me of chronic DPD that has only gradually worsened. Fingers crossed clomipramine helps


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## apteron105 (Sep 6, 2018)

Broken said:


> What exactly did you learn from the book? Was it more of an understanding as to why things were happening or is there any practical advice? I know DP is often experienced in fight or flight (especially the freeze response).
> 
> Yes mine is mainly DR as well as being weed induced. I just feel spacey and dreamy but no out of body experiences so I guess not really DP either. Yeh me too, it was as if I got high and never came down from it. Although I spoke to a friend about it once and he said 'that's not what being high feels like'. So I suspect smoking weed actually caused me to disconnect in a sense but that felt better than emotional pain or anxiety. Socialising is particularly difficult for me. I zone out mid sentance and get distracted by people moving in my peripheral or surrounding noises. Like hypervigilance but my brain is over tired from it so it's like my head is in a goldfish bowl.
> 
> I have tried EMDR with some effect after about 5-6 sessions and then it was discontinued as that's all that could be afforded. I should perhaps try it again from home, there are youtube videos that are worth trying if you are interested. It is comforting to know that we have/had very similar symptoms and causes and you pulled through with the help of this medication. Thank you for coming back to tell your story, to be honest I was running out of hope. It has been a very long 14 years for me of chronic DPD that has only gradually worsened. Fingers crossed clomipramine helps


I absolutely understand. Feeling that you're in a dream 24/7 is fucking miserable, but I truly think that every can find great relief, if not an outright remission of symptoms.

The book is great because it goes into the biology of trauma. There's research and recommendations for treatment, but the hard neuroscience and anecdotal accounts of traumatized individuals really made me reconsider my 'mystery affliction' and realize why I felt so messed up. Some people experience a traumatic event and then forget about it, others get 'stuck' in the moment of their trauma and parts of their bnbrain responsible for emotional and perceptual processing literally shut down. There's also some nice theorizing as to why a person may be unable to self-soothe, and thus become chronically traumatized.

I wish you the best of luck with clomipramine!


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## Broken (Jan 1, 2017)

For whatever reason it has taken me this long to take Clomipramine (actually Imipramine but same difference). Couldn't get Clomipramine due to supply issues in the uk so safer to go with what is available constantly. Clomipramine just has a chlorine molecule attached as I understand it. I was on Effexor once many years ago and started to show some benefits. But I read horror stories online and my GP had no knowledge of any of this so I panicked and stopped.

Only been 4 days on Imipramine but there are benefits already. More physically relaxed and seem to be sleeping better (although not the first few nights). Did you feel muscles relaxing in the back/chest/abdomen and generally all over?

It is a twitching I have experienced before but take it as a good thing (called neurogenic tremors). It happens in wild animals when they get the startle reflex ie a deer hears a twig snap and bolts it head up and stands perfectly still looking in the direction of the sound. Once it realises there is no danger it shakes off the tension (there are videos on youtube kind of cool). There is also a video of a polar bear doing it. The issue is in human society we are encouraged not to shake, which is really bad of you start to shake after a severe trauma and consciously tense up and stop yourself.

Anyway, I doubt you will see this but wanted to ask how things are going? Hope the Clomipramine continues to work out for you. This is at the end of a long list of meds for me so am really hoping this one works. Have to say though after just 4 days it has been the most fast acting drug, particularly considering it is an antidepressant

P.s can you like my comment if you reply? Not fishing for likes lol its just that things get lost in the feed and you dont get notifications for replies unfortunately!


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