# My DPDR story



## Tessam (Sep 28, 2019)

Hi everyone! Im Tessa and 26 years old. Living in the netherlands, sorry for my bad english! I have dpdr for 7 months now.. 
Never ever had psychologic problems, this came out of nowhere.
In 2018 my husband and i bought or first home, i switcht my job and married in october 2018. I had one wish, getting pregnant. I worked 55 hours a week and was always busy. In january 2019 i was getting dizzy and tired at work. Went to the doctor, blood test (vitamins) was ok, he told me a hormonal disbalance. Started to overthinking, went back to my doc - its a burn-out. Allright.

In March 2019 we had our honeymoon to newyork and a roadtrip of west usa. I was not impressed, unspontaneous, empty. A few panic attacks, en halfway throug our trip (las Vegas) i didnt recognized myself. Google told me fast about dpdr. When i was home, it was only get worser. Horrible scary thoughts came up.

Now.. ive tried a lot! And i have the dp/dr disorder from my psyc.

- Stress release, vibrate youre body
- ACT therapy 
- lorazepam and escitalopram (still using)
- RTMS, now having 15 sessions both sides

I still need to remind myself, that i have a body. Really dont know who i am anymore. Eating very good since RTMS, also speaking. But my voice is dont sound like my voice, and i seriously dont feel like a human being. My home, husband, parents, loved ones and my dog are around me but no feeling for. Also have suïcide thoughts that really make me cry and Scared! Also i have a lot of reminding to my old me, when i was a work or other things..

I called sick from work in march, and i am still not working. Try to do the daily things like cooking. Everyday i go out of my house to walk the dog with my husband. Its getting easier the last weeks to see my friends Again.

HOW CAN I GET MY LIFE BACK AND FEELING A HUMAN BEING? Sorry for my long story.. oh 3 years ago i smoked once, but i never use drugs or alcohol..


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## Broken (Jan 1, 2017)

Hi Tessa, your English is fantastic! As is most Dutch people I speak to.

It does sound like you were overworked, steamed and burnt out when this started. Perhaps learning to relax would help. Something I've noticed is how chronically tense I am and I believe that is related to my dpd. Yoga, massage, meditation, Epsom salt baths, have a nap, have a wall, read a book. You need to be looking to do things that distract and relax you, it could work wonders!

There is a book called 'at last a life' that I would recommend. What do you do to relax? I would also say googling this isnt really going to help, try and focus on things you enjoy rather than your symptoms


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## 35467 (Dec 31, 2010)

Because your outset has been quit resent and the things you have tried i think you should take a more psychological approach for the state of depersonalisation. The site "anxiety on more" can be quite helpful.https://anxietynomore.co.uk/depersonalisation_and_derealisation/

You write that you have tried rTMS on both sites without any effect. That is likely to be low frequency at the right dorsolateral prefrontal cortex(DLPFC) and high frequency on the left DLPFC. These sites are normal for rTMS for depression and the has been reports of a reduction in symptoms of depersonalisation particularly if it is secondary to depression. It will likely not have have any effect on depersonalisation as a disorder.

rTMS for depersonalisation is new and like a little bit complicated at present. Some have relation to the equipment used by most rTMS providers that makes locations of the sites under suspicion for depersonalisation difficult to locate. You have to make rTMS for a MRI with the use of a program called neuronavition that is also used for brain surgery. Most clinics can not do that in Europe or the US.

Form the perspective of rTMS depersonalisation looks like two networks being disrupted. The emotional numbing comes from a overactivity in areas in the prefrontal cortex that regulates emotions like the right DLPFC, the left medical prefrontal cortex and the right ventrolateral prefrontal cortex. The right DLPFC, you have tried, might be the less potent of the tree. The right ventrolateral prefrontal cortex the most potent,-but you need neuronavigation to do that. Emotional numbing is significantly reduced when it is inhibited with rTMS in trails but not dissociation.

But, there are also indication that symptoms like feelings of the loss of agency like alienation form body is related to other location on the side on the head like the right temporoparietal junction( TPJ) or the right angular gyrus. When these are active a sense of self is heighten, feeling of body alienation and dissociation. When rTMS is given to the right TPJ dissociation is reduced but not emotional numbing.

So, two sites is likely to be at work with when rTMS is used. The prefrontal cortex for numbing and TPJ or angular gyrus for dissociation. There has been a trail in France lasting for 3.years with over 100.patients with depersonalisation that is the most extensive trail done with rTMS to date. The trail should be published soon. I expect that is will be more effective than the trails done at the TPJ and also that emotional numbing will be reduced slightly.

I have written with a rTMS clinic in Europe that have neuronavigation and they didn't know about depersonalisation. A professor related to the clinic wrote they would look into the disorder. I think they are waiting for the result of the french trail. But, i expect that by the end of the year or the start of the next year there will be a rTMS clinic in Europe that can work more systematically at the right locations.

That is why you didn't have any effect of rTMS is related to the locations you have tried.


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## Aridity (Jun 12, 2011)

Hi Tessa, I am also from The Netherlands and you could shoot me a pm. If you would like to talk with somebody. I could give you some tips. Stay strong.


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## Tessam (Sep 28, 2019)

Thank you so much!! We are moving our shower for a bath.. take a lot of naps, try to watch tv and i love to make cake and bathfizzers.


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## Tessam (Sep 28, 2019)

Thanks Mayor! I really dont know.. I send it to my RTMS therapist Bram Wernsen from rtms international Rotterdam.


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## 35467 (Dec 31, 2010)

Tessam said:


> Thanks Mayor! I really dont know.. I send it to my RTMS therapist Bram Wernsen from rtms international Rotterdam.


But, he cannot do nothing as he don't have the equipment to make neuronavigation and make the location of these structures. I know what equipment they have. The same with SMART TMS in the UK. If one looks at the equipment for localisation 90-95% of rtMS clinics have, they cannot make a location of the areas involved in depersonalisation. Your letter will make no difference. The cost of rTMS in depersonalisation will also increase as you need a MRI scan of the totalt brain surface to make a calibration from of the locations. They do not have the equipment, computer program to make the calibration. A MRI scan will take 30-40.min and cost around 600-700.euros.


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## 35467 (Dec 31, 2010)

Here is one from Arizona who had rTMS done at the right VLPFC after a mapping of the brain was done with a MRI scan. He writes;"

So today, my VLPFC was targeted at 1HZ per second I believe? Point is, it fucking worked. Probably a 20-30% reduction in numbness. I particularly noticed when I was driving I looked at the clouds-and they looked like they used to. Really. I have tried tons of meds, and none of them has ever produced an effect remotely close to what I'm experiencing now. There really is something to this, and I'll definetly be continuing with more sessions. More to follow!"

https://www.dpselfhelp.com/forum/index.php?/topic/54723-starting-tms-next-thursday-over-tpj-and-vlpfc/


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## Aridity (Jun 12, 2011)

Mayer-Gross said:


> But, he cannot do nothing as he don't have the equipment to make neuronavigation and make the location of these structures. I know what equipment they have. The same with SMART TMS in the UK. If one looks at the equipment for localisation 90-95% of rtMS clinics have, they cannot make a location of the areas involved in depersonalisation. Your letter will make no difference. The cost of rTMS in depersonalisation will also increase as you need a MRI scan of the totalt brain surface to make a calibration from of the locations. They do not have the equipment, computer program to make the calibration. A MRI scan will take 30-40.min and cost around 600-700.euros.


Where in europe they do have that equipment then? I also went to Rotterdam.


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## 35467 (Dec 31, 2010)

Aridity said:


> Where in europe they do have that equipment then? I also went to Rotterdam


Outside universités on the private market it is only those i have written to and they have not replied me if they will try depersonalisation. They will look into it and give me a reply later. So, the situation is that there is not places who have the equipment or know how to give it a proper trail. It is a complex disorder from the perspective of rTMS due to the locations and there are several of them.


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