# Vertical heterophoria - TMD - neck tension - the cause of my DP!



## Destrudo

First of all, thanks for this great forum. It really helps when you know that you aren't the only person that lives in a bubble of unreality.

I had suffered from *constant DR and DP for almost 2 years.* My mental state was so bad that I had lost all joy in life. I didn't have any feelings for my girlfriend anymore whom I loved so much that I would have

given my life for her, hobbies that usually made me happy suddenly became boring and I was generally feeling a terrible emptyness inside me. It felt like I was almost dead. *Nothing seemed real anymore* and waking up was the worst! Someone who has never experienced DR/DP can't believe how terrifying this mental state is. As I am writing this, I have goosebumps all over my body because I become so emotional about thinking back...

As many of you, I was afraid I would be trapped in this state forever. I was googling for remedies day after day and I tried everything possible when it comes to supplements, medications and cognitive strategies.

I have read very often that anxiety is the cause of DP. Anxiety definately makes the symptoms worse, but in my case I think that I became anxious after I felt detached from reality, not vice versa. That's what many people need to consider and that's why anti-anxiety medications often doesn't work to lower people's symptoms. My symptoms were so strong that I was *constantly dizzy*, had *fainting spells* due to *panic attacks, shaky vision* and *facial pressure*. I also felt *sick* ,* weak* ,* depressed *and had *no motivation* to do anything! Also, my *tinnitus* became louder and louder...

In my case, the derealization was caused by many factors, but the root of all causes were my eyes.... *vertical heterophoria!*

It was an absolute incident that I came to this conclusion. I had a shoulder surgery and was forced to peer at my operated shoulder daily to use my ultrasound therapy device - often for 20 minutes.

I always noticed that my derealization became so much stronger after I have overused my eyes like this. After I have noticed this, I have

analysed my vision in general. I noticed that if I am trying to fixate an object my sight slightly shakes and it's near impossible for me to look at something without having a very light movement in my vision. I also came to the conclusion that the pressure behind the eyes wasn't caused by a sinusitis which was misdiagnosed by a doctor, but from my eyes. I always wondered why I have pressure in my face and I was treated with anti-allergic medications and antibiotics and wondered why it never went away.

After I have googled my vision symptoms, I have found an eye dysfunction called *heterophoria*. Basically, your eyes do not parallel to each other except if they are performing binocular fusion. My assumption was underpinned by my eye specialist. There is a simple test to see if you have heterophoria. Open both eyes and cover one of your eye with your hand. Then uncover your eye again by quickly removing your hand again and see if the eye needs to refixate and two images blend together. You can also fixate an object, close on of your eyes, reopen it and see if your vision needs to be readjusted. Now, many people have this eye condition, but in my case, it's a bit more of a problem. My eyes are not only misaligned horizontally, but also vertically. So basically, my left eye slightly points more to the left and more upwards than my right eye. Normally, a person with this condition would squint... However, your brain and your eye muscles compensate for it. This constant compensation can lead to many symptoms that no one would link to eye problems, such as nausea, dizzy spells and brain fog. I have lived for 22 years without knowing that most of my problems came from my eyes.

*You may ask: How is it possible that an eye dysfunction can lead to derealization and depersonalization?*

Well, I am no doctor, but I have researched a lot about it and I think it's the results of many factors.

First of all, your brain and your eyes are constantly overworked. This leads to fatigue, brain fog, irritability and light sensitivity.

I also suspect a connection between eye muscle tension and tension in your jaw and neck muscles. I have noticed that my tinnitus became much louder when my eye induced vertigo became stronger.

That's because chronic tension in your jaw can lead to a so called Temporomandibular Joint Dysfunction. If not treated, the slipped joint head of your jaw can press on the nerves that are connected to your ears.

The reason behind this should be obvious: the middle ear is closely connected to the jaw and is only separated from it by a very thin bone.

When your jaw muscles are tight, your whole neck tightens up within time. Your neck contains a bunch of nerves and arteries. These can become compressed not only by tight muscles, but also by a misaligned cervical spine that is often the result of muscle spasms, bad posture due to computer desk work, overworked SCM muscles and weak deep neck flexors. Two very important arteries to name are the arteria vertebralis and arteria basilaris. Both supply the brain with blood. Now imagine when they are compressed and the brain's supply of oxygen is reduced? This can lead to cognitive impairment, vertigo, derealization, brain fog, tinnitus, personality changes, fatigue, depression, anxiety and so on. You may think that this is far fetched, but I am the living proof that DP and DR can indeed be a problem that comes from your head and neck area.

In my case, the eyes were the root of my DP. But in your case, it might be something different. Temporomandibular Joint Dysfunction due to malocclusion, stress or anxiety (clenching!), foward head posture (tight Sternocleidomastoid muscles, weak deep neck flexors, bad scapula stabilization), misaligned C1, tight chest muscles... all they tend to have in common: compression of the nerves and arteries in your neck that supply the center of your awareness - your brain.

*What fixed my problem?*

Prism glasses. The vertigo went away 1 day after I have received them. 2 weeks later, the tension in my neck reduced, the facial pressure was gone and my tinnitus became almost unnoticable. But the best part of it: The DP is gone! I finally feel totally clear and aware of myself and my surroundings again. It was like someone was choking me with a cable for 2 years and finally someone cut it.

So if you are one of those people like me who have been to a hundreds of doctors without getting a diagnosis, get your eyes, jaw and neck checked out. See specialists though! Many of the school medicine doctors have no clue what they are doing! Find a doctor who thinks outside of the box and don't be desperated if it needs a few attempts till you find a doctor who knows what's he's doing.

*Here is what I would do:*

1. Get your eyes checked. If you have an eye dysfunction like me, special glasses could fix the underlying problem of your DP

2. Get your jaw tested: a malocclusion can be treated with a bite splint

3. Get your neck examined: muscle tension, C1 misalignment can be treated by an osteopath, strengthening exercises (deep neck flexors), postural changes

I hope I can help some of you to get back to reality. I wish you all the best and never give up!

Best wishes from Germany!


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## TDX

It has been known for years that there is conncetion between vertigo and depersonalization:

http://www.amsciepub.com/doi/pdf/10.2466/pr0.1989.64.2.527

http://neuro.psychiatryonline.org/doi/10.1176/jnp.14.2.141

http://jnnp.bmj.com/content/77/6/760.short

http://journals.lww.com/jonmd/Abstract/2013/07000/Depersonalization_Experiences_Are_Strongly.15.aspx


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## Ningen

Prism glasses? I don't know if this is related, but I remember when I got my new glasses It took me an hour to adjust to them when it usually takes me minutes. My eyes also wander when I read.


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## Meticulous

Thank you for this post, this definitely has me interested.

Just one question; when it comes to the prism glasses, are they glasses that you must consistently wear, like normal glasses with special lenses, or are they specifically made for treatment purposes when treatment is necessary?


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## jotteff

Very interesting post, thank you!

I'm also from Germany. Can you recommend some specialists that diagnosed your eye problems? Please write me a personal message, I'd be very happy to hear from you!


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## MichiganMade

I'm curious if anyone else has tried this?

Also - for anyone who has had any specialty with the Ear Nose and Throat doctor - I am 27 years old and still have a tube in my left ear from when I was a kid from ear infections (4-5 years old) that still hasn't fallen out yet. I've had some terrible inner ear infections.

Should I schedule an appt to get this tube removed? I've def had some instances of vertigo in the past and most notably, my knees and legs will "shake" and feel weird almost like they get very weak and I get dizzy

Mm


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