# hey guys this video has killed all my hope please say me its not real :(



## leminaseri (Jul 1, 2020)




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## AnnaGiulia (Feb 4, 2020)

Hey leminaseri,

Would you perhaps like to share as to why this particular video killed your hope?

I am suffering from depersonalization-derealization disorder, and I am diagnosed with it, as a disorder on the spectrum of dissociative disorders. I haven't got it from drugs or (for most part) anxiety, but from a prolonged childhood abuse that I suffered, and in my case it is completely trauma-related. It means that I cannot just solve it by relieving my anxiety, even though relieving my anxiety helps, but that I have some other background issues to tackle. It does not mean that I am doomed with this disorder, it just means that my path to recovery is somewhat more complicated - but not impossible!

I have to say that I see nothing wrong with what this guy is saying. He allows for other possible causes of depersonalization to exist, but he is pointing out to what he suffers from, and that is what he is mostly talking about through his channel, from what I understood, based on this one video. It *does not have to refer to you*. Also, you should only rely on a good therapist to tell you what you suffer from, and by no means assume on your own what kind of DP do you have.

Best,

A.


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## Broken (Jan 1, 2017)

I agree totally with what Anna said. If your DP is transient and intermittent, then it is likely it is triggered by anxiety or depression. So tackling the underlying cause there would likely solve the symptom of DP/DR

Depersonalization Disorder (DPD) is a chronic and unabating illness, where the symptoms of DP, DR or both, are always there regardless of anxiety or depression. The disorder, as Anna said, is often a result of trauma (I believe) so tackling the trauma might relieve the symptoms in those cases.

All he is saying basically, is that often people making these videos don't distinguish or know the difference. Some videos talk about tackling the anxiety while others talk about the actual disorder (a lot like on this website). So for you the first step is to appreciate you either have symptoms of DP or DPD and then go from there. We are all in the same boat here though so try not to lose hope. Have faith you will find the answer you are looking for, but it may take some time


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## 35467 (Dec 31, 2010)

The video is a year old. He later became a patient at the former "Depersonalization research unit" and was given 16.sessions of cognitive behavioral therapy. He was tested prior to the sessions and after. It was found that his symptoms had increased after CBT. He also tried the combination of lamotrigine and a SSRI without effect. Then naltrexone in a dose as high as 150.mg. He had to stop that as he became to have problems with he liver metabolizing the drug. 
He was contacted by an English publisher who was interested in a book about depersonalization. He have recently submitted the manuscript to them. He is active in the depersonalization charity "Unreal" and had some interaction with former researchers at the then "Depersonalization research unit" and they have said to him that they do not have an idea what causes the disorder. So, there is more need for research.

The latest brain scans they did was in 2015. In many ways these are very old. There are scanners that are 50.times faster than those they used, there are also scanners that can go deeper into structures in the brain stem. Recent studies in the dissociative subtype of PTSD found that a structure related to fight and flight and immobilization was affected in dissociation called "periaqueductal gray". So, new scannings might give some new data about the disorder that could not be seen before. There are also changes in the possibilities of interventions with brain stimulation. When the "depersonalization research unit" did their small rTMS trail there was many location in the prefrontal cortex that could not be stimulated with a normal coil. That have and still is a problem in depression too. Many depressive states would not respond to normal rTMS as that state likely was cane from location to deep in the prefrontal cortex. There are now developed coils that can go deeper into the brain and stimulate areas that could not be stimulated a few years ago. So, there are more areas found active in depersonalization that was not accessible a few years ago that can be intervened in now. These techniques are used in a very few places on the private market in the US but for research it is more possible.

A research facility using a combination of new functional MRI scanners and rTMS could give more information about emotional regulation is done in depersonalization and a treatment. This is done in depression and have been very productive about the disorder. Most depressive can not use these location as most rTMS clinics only treat at locations found 20.years ago. They do not have the equipment to go into the other locations found yet. I think it will change the coming years.


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## Broken (Jan 1, 2017)

Symptoms increased after CBT??! Not surprised, doubt they will publish that research. I went there twice, once to see Dr Sierra who say me free of charge, diagnosed me officially and sent a letter of recommended medications to my GP ALL FOR FREE.

I then went back several years later to see Dr Elaine Hunter, who wanted to charge me several hundred pounds an hour for therapy (with no proven efficacy). I had already paid hundreds just for the initial referral. I saw a psychiatrist who clearly had no idea what DPD was. And Dr Elaine Hunter who spoke to me for 2 whole hours, then lost the notes she made so had to ring me a month later.

The place has changed for the worse IMO and seems less focused on research and more on profit.


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## 35467 (Dec 31, 2010)

It is not a research unit anymore. It stopped in 2014-2015. I do not think Elaine Hunter have worked there for many years. I think she have a private practice where people have to pay. There should only be one psychologist employed there. If you have to get medicine it will be from a psychiatrist who are just employed at the Mausely hospital and only have a superficial idea of depersonalization. Prof. Anthony David who was the leader of the unit was a prof at King's College and have moved to a chair at University College London. I think Elaine Hunter also have some connections to University College London. If you have been seen after 2015 it might explain you had to pay. It was a private practice.

So, to call it a specialist clinic today is misleading. I think the reason he got worse is it might in increase self-monitorisation in some. CBT is many many ways highly overrated. It might work in some disorders. But, in most disorders it is very dependent that there are seen some reductions from a somatic interventions. So, in states like depression, general anxiety or OCD it can be a booster in remission if there are also seen some reduction in symptoms from a medical treatment. I think that in depersonalization some of the techniques might be helpful if you have seen/felt a reduction in symptoms like 40-50%. It might work as mono therapy in some if the outset is recent. So, we really need a somatic intervention with high response rate in a majority.


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## Want2lifeagain (Jun 20, 2020)

hello, n, I saw you said you met Dr. Sierra .. I also want to meet and seek treatment with him .. where can I meet with Dr. Sierra .. please help


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## leminaseri (Jul 1, 2020)

AnnaGiulia said:


> Hey leminaseri,
> Would you perhaps like to share as to why this particular video killed your hope?
> 
> I am suffering from depersonalization-derealization disorder, and I am diagnosed with it, as a disorder on the spectrum of dissociative disorders. I haven't got it from drugs or (for most part) anxiety, but from a prolonged childhood abuse that I suffered, and in my case it is completely trauma-related. It means that I cannot just solve it by relieving my anxiety, even though relieving my anxiety helps, but that I have some other background issues to tackle. It does not mean that I am doomed with this disorder, it just means that my path to recovery is somewhat more complicated - but not impossible!
> ...


hey, thanks for your reply.

it had killed my hope because i always had believed i will recover like those people in the recovery videos. and i had asked me all time why my dp is so differently compared with 10 years ago, like „im not anxious but i have still dp" and this video had gave me the answer. this had killed my hope


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## leminaseri (Jul 1, 2020)

Broken said:


> I agree totally with what Anna said. If your DP is transient and intermittent, then it is likely it is triggered by anxiety or depression. So tackling the underlying cause there would likely solve the symptom of DP/DR
> 
> Depersonalization Disorder (DPD) is a chronic and unabating illness, where the symptoms of DP, DR or both, are always there regardless of anxiety or depression. The disorder, as Anna said, is often a result of trauma (I believe) so tackling the trauma might relieve the symptoms in those cases.
> 
> All he is saying basically, is that often people making these videos don't distinguish or know the difference. Some videos talk about tackling the anxiety while others talk about the actual disorder (a lot like on this website). So for you the first step is to appreciate you either have symptoms of DP or DPD and then go from there. We are all in the same boat here though so try not to lose hope. Have faith you will find the answer you are looking for, but it may take some time


hey thank you for replying.

its very complex for me because, 9 months ago as my journey through the hell had began, first i had gotten very weird and light anxiety attacks, very high muscle tension. later depressive symptoms like insomnia, severe pressure on my ears, no motivation to do anything and so on. but i had thought „oh no this is the beginning of my schizophrenia" and i got panic attacks. because since 2011, when i had became derealized, depersonalized i was afraid of becoming schizophrenic. when i had gotten recovered i didnt thought anymore about that fear.

but now, after 9 months, my anxiety is almost passed away, i can do everything what i want like being social or go working. im not afraid of psychosis anymore. but im still depersonalized and derealized you know?


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> The video is a year old. He later became a patient at the former "Depersonalization research unit" and was given 16.sessions of cognitive behavioral therapy. He was tested prior to the sessions and after. It was found that his symptoms had increased after CBT. He also tried the combination of lamotrigine and a SSRI without effect. Then naltrexone in a dose as high as 150.mg. He had to stop that as he became to have problems with he liver metabolizing the drug.
> He was contacted by an English publisher who was interested in a book about depersonalization. He have recently submitted the manuscript to them. He is active in the depersonalization charity "Unreal" and had some interaction with former researchers at the then "Depersonalization research unit" and they have said to him that they do not have an idea what causes the disorder. So, there is more need for research.
> The latest brain scans they did was in 2015. In many ways these are very old. There are scanners that are 50.times faster than those they used, there are also scanners that can go deeper into structures in the brain stem. Recent studies in the dissociative subtype of PTSD found that a structure related to fight and flight and immobilization was affected in dissociation called "periaqueductal gray". So, new scannings might give some new data about the disorder that could not be seen before. There are also changes in the possibilities of interventions with brain stimulation. When the "depersonalization research unit" did their small rTMS trail there was many location in the prefrontal cortex that could not be stimulated with a normal coil. That have and still is a problem in depression too. Many depressive states would not respond to normal rTMS as that state likely was cane from location to deep in the prefrontal cortex. There are now developed coils that can go deeper into the brain and stimulate areas that could not be stimulated a few years ago. So, there are more areas found active in depersonalization that was not accessible a few years ago that can be intervened in now. These techniques are used in a very few places on the private market in the US but for research it is more possible.
> 
> A research facility using a combination of new functional MRI scanners and rTMS could give more information about emotional regulation is done in depersonalization and a treatment. This is done in depression and have been very productive about the disorder. Most depressive can not use these location as most rTMS clinics only treat at locations found 20.years ago. They do not have the equipment to go into the other locations found yet. I think it will change the coming years.


thanks for the very valuable informations. i hope in the next 15-20 years there will be accurate methods to threat this mental state.


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## AnnaGiulia (Feb 4, 2020)

Hey leminaseri,

Don't lose hope by identifying with other people having DP, because we are all different - that is something you can clearly see here, at this forum.

Sure, sometimes we wish that is does not have to be so damn difficult, particularly when we are already worn out by all the struggle, but it is what it is.

Keep focus on your own experience, on your strengths and your resources. Give yourself credit for all that you have been able to do by now, and don't give up.

Best,

A.


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## leminaseri (Jul 1, 2020)

AnnaGiulia said:


> Hey leminaseri,
> 
> Don't lose hope by identifying with other people having DP, because we are all different - that is something you can clearly see here, at this forum.
> 
> ...


yes i understand.. thank you for your advices


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## 35467 (Dec 31, 2010)

Want2lifeagain said:


> hello, n, I saw you said you met Dr. Sierra .. I also want to meet and seek treatment with him .. where can I meet with Dr. Sierra .. please help


You can not see Mauricio Sierra-Siegert. He have not been employed as researcher since 2015. You could only get a consultation then when it was under English "National Health Service" and if you lived in England. For English patients not living in the London area it could take years to get a referral. He now lives in Medellin, Columbia and do not work with depersonalization. There is no formal cure for depersonalization and he do not have it either.


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## 35467 (Dec 31, 2010)

leminaseri said:


> thanks for the very valuable informations. i hope in the next 15-20 years there will be accurate methods to threat this mental state.


I expect there could be a treatment within the coming years. There are some locations found active in depersonalization you have not been able to intervene in until recently. This is also the case for depression. The locations have been to deep in the prefrontal cortex to do it. But, there are coils that can go deeper and they will likely be available for the many with depression who do not respond to normal rTMS. Many of these locations found in depression are often very active in depersonalization too. So, when these coils that can go deeper are available then other locations can be tried. The medial prefrontal cortex along with anterior cingulate is found active in some states of depression and obsessive compulsive disorder. This area is also found active in depersonalization. It is very deep in the brain to reach but a deep coil can. There is a lot of obsessive self monitoring in depersonalization and it might be related to this activity.


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## Want2lifeagain (Jun 20, 2020)

To mayer-gros My advice .. You submit yourself to the study because the cooperation of intelligent sufferers seems needed rather than passive sufferers


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## 35467 (Dec 31, 2010)

Want2lifeagain said:


> To mayer-gros My advice .. You submit yourself to the study because the cooperation of intelligent sufferers seems needed rather than passive sufferers


Thanks.

I tried rTMS in march at the right VLPFC/ventrolateral prefrontal cortex and the right TPJ. 12.session and i felt nothing. The right ventrolateral prefrontal cortex was the area that the "Depersonalization research Unit" found to be an area for rTMS intervention though they expressed interest for some other location but likely dropped them as they where to deep for a rTMS intervention then(2014).You can not do rTMS at the right ventrolateral prefrontal cortex without neuronavigation from a MRI scan - that excludes almost 90% of all rTMS providers as they do not have neuronavigation . They would not be able to find a location. So, I have thought about why I did not respond and one reason could be I am left handed some much of my emotional regulation could be in the other brain hemisphere. Left handed are almost excluded from brain imaging studies or rTMS trail because they can cause errrors for the study. Other reason is that the location that they found might not be the right one. Other studies point towards the ventromedial prefrontal cortex - again a location too deep in the brain. I re-read a text by rTMS researcher, Jonathan Downar about different locations in the prefrontal cortex and he writes that ventrolateral prefrontal cortex have some surface that can be stimulated by a normal coil but it expands into the brain where a normal coil cannot go. To him it is a location for a coil for deep rTMS. When I looked at some of the images taken in the studies by the depersonalization research unit I could see that large parts of the ventrolateral prefrontal cortex active it likely to deep to be inhibited by a normal coil. So a reason for the lack of response could be the only 1/3 to 1/2 of the ventrolateral prefrontal cortex was stimulated. So, you likely need both neuronavigation and a coil for deep rTMS to give this area a fair trail. There are some who have benefited partly at this location but if it is only 50% a normal coil can cover of the location it might explain that.


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## 35467 (Dec 31, 2010)

This brain image is from a study done by the "depersonalization research unit" done in 2015 In patients with depersonalization . The first picture A shows overactivity in the center of the brain and that is the medial prefrontal cortex. To the right is the overactivity of the right ventrolateral prefrontal cortex. Parts of it is likely too deep for a normal coil to affect. Picture B show overactivity in the anterior cingulate and it is also deep into the brain. You can with a deep coil stimulate both the medial prefrontal cortex and anterior cingulate in one session at once with a deep coil. It is done in obsessive compulsive disorder.

https://www.frontiersin.org/files/Articles/173530/fpsyg-07-00432-HTML-r2/image_m/fpsyg-07-00432-g002.jpg


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## Jackk11 (May 9, 2018)

Mayer-Gross said:


> Thanks.
> 
> I tried rTMS in march at the right VLPFC/ventrolateral prefrontal cortex and the right TPJ. 12.session and i felt nothing. The right ventrolateral prefrontal cortex was the area that the "Depersonalization research Unit" found to be an area for rTMS intervention though they expressed interest for some other location but likely dropped them as they where to deep for a rTMS intervention then(2014).You can not do rTMS at the right ventrolateral prefrontal cortex without neuronavigation from a MRI scan - that excludes almost 90% of all rTMS providers as they do not have neuronavigation . They would not be able to find a location. So, I have thought about why I did not respond and one reason could be I am left handed some much of my emotional regulation could be in the other brain hemisphere. Left handed are almost excluded from brain imaging studies or rTMS trail because they can cause errrors for the study. Other reason is that the location that they found might not be the right one. Other studies point towards the ventromedial prefrontal cortex - again a location too deep in the brain. I re-read a text by rTMS researcher, Jonathan Downar about different locations in the prefrontal cortex and he writes that ventrolateral prefrontal cortex have some surface that can be stimulated by a normal coil but it expands into the brain where a normal coil cannot go. To him it is a location for a coil for deep rTMS. When I looked at some of the images taken in the studies by the depersonalization research unit I could see that large parts of the ventrolateral prefrontal cortex active it likely to deep to be inhibited by a normal coil. So a reason for the lack of response could be the only 1/3 to 1/2 of the ventrolateral prefrontal cortex was stimulated. So, you likely need both neuronavigation and a coil for deep rTMS to give this area a fair trail. There are some who have benefited partly at this location but if it is only 50% a normal coil can cover of the location it might explain that.


 interesting. I'm left handed in some cases as well but right handed in others. I wonder if this would change anything For me in terms of TMS locations.


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## 35467 (Dec 31, 2010)

In most cases no. You have be very left handed and it is not likely that the prefrontal cortex is affected as it is more related to emotional regulation and not bodily movements that is more on the side of the head. But, you really can not give an exact answer as it is understudied. They simply just exclude left handed in trails to avoid errors that might potentially be there or not. I think the reason I did not respond is two 1) only 1/3-1/2 of the ventrolateral prefrontal cortex was stimulated due to the coil used and partly the type of neuronavigation used. Advanced neuronavigation monitor the coil position all the time and if it not on the exact area of the brain it will stop rTMS. The navigation was done separately and marked with a pen from a MRI scan of my brain in a neuronavigation system used to brain surgery , 2) the locations might not be right and the disorder might need different location for interventions from patients to patients. We see that in depression and rTMS. There are some areas in depersonalization active that have never been tried because they are to deep for the type of rTMS they had then, -could not go deeper into the brain than 1,5-2.cm. So, they might have choose a location that could be stimulated in 2014. You can partly do that at the right VLPFC with a coil used by most rTMS providers.


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## 35467 (Dec 31, 2010)

The problem with the used of coils to deep rTMS is that they have not been approved for the use in any indication. I just came across this news. The FDA have just cleared that the used of a deep coil from Magventure in the treatment of OCD. So, this might give private rTMS clinics an options to get a coil for deep rTMS. This will open up for locations in depression and depersonalization that have never been tried before besides in research. I think for OCD they will stimulate the medial prefrontal cortex and anterior cingulate . These ares are also active in depersonalization so run a OCD protocol could be interesting. I hope this coil will get a formal approval in Europe too. There is a rTMS clinic 1.hours drive from where I live. They use Magventure but have only treated at the left and right DLPFC that almost pointless to try them with that. Hope they get it.

The approval is here. https://www.magventure.com/component/k2/news/magventure-received-fda-clearance-for-ocd-2

Their coil for deep rTMS looks like this. It is used by the leading rTMS researcher like, Canadian Jonathan Downar for depression in people who do not respond to normal rTMS. With such a coil 90% of the prefrontal cortex is now open for stimulation. You are going from normal coil that can go 1,5 cm deep to a coil that can go 4-5.cm deep.New world with new treatment options.

https://www.magventure.com/tms-research/products-overview/research-coils/coils/cool-d-b80


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## 35467 (Dec 31, 2010)

I think the approval is only for Magventure. So, one have to find a rTMS provider that uses Magventure. I am not aware how huge their market share is in the US, likely 10-30% ? They are from Denmark(like me). Magventure and Magstrim from the uk are the oldest producers of rTMS and almost all research with use of rTMS uses them. The best systems for neuronavigation is also made for fit these machines. Many cheap makes of rTMS often do not have such coils and can not be fitted with neuronavigation.


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## Want2lifeagain (Jun 20, 2020)

your knowledge is 80% -90% according to reality .. how about info about research in france about tms to gyrus? have you got the latest news ?


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> I think the approval is only for Magventure. So, one have to find a rTMS provider that uses Magventure. I am not aware how huge their market share is in the US, likely 10-30% ? They are from Denmark(like me). Magventure and Magstrim from the uk are the oldest producers of rTMS and almost all research with use of rTMS uses them. The best systems for neuronavigation is also made for fit these machines. Many cheap makes of rTMS often do not have such coils and can not be fitted with neuronavigation.


if i would make a neuronavigation and they wouldnt find any abnormalities, what would that mean for my mental state? and do you recommend qeeg? here is someone who makes neurofeedback. thats actually qeeg right?


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## 35467 (Dec 31, 2010)

Want2lifeagain said:


> your knowledge is 80% -90% according to reality .. how about info about research in france about tms to gyrus? have you got the latest news ?There


There is never any "news" about research into a study. Information about a study is always closed until it is filled for a peer review and for publication. But, the study should be published by the end of the year or the beginning of the next.


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## 35467 (Dec 31, 2010)

leminaseri said:


> if i would make a neuronavigation and they wouldnt find any abnormalities, what would that mean for my mental state? and do you recommend qeeg? here is someone who makes neurofeedback. thats actually qeeg right?


 Neuronavigation is not used for diagnostics but to find locations on your brain. The physical structure and size of our brains are Slightly different from human to human and the locations of many brain areas can be difficult to find. So, you take a MRI scan of the brain so you can navigate the coil. Some locations can be found without neuronavigation and some are very difficult to find. This is a neuronavigation system for rTMS: https://www.localite.de/en/products/tms-navigator/

I would never myself use money on a qEEG. Look, we do not known exactly where depersonalization starts in the brain, what locations are central. There are some ideas take from different brain scan studies and more studies could likely be of beneficial if newer scanners are used. There have been a recent review of all brainstudies done in depersonalization. The study excluded data from: "EEG/qEEG, SPECT scans and PET scans". why are they excluded and almost never used in research today? Because they are very old technologies that can not measure many areas of the brain and have high levels of errors. These are like kind of astrology for the brain.


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## 35467 (Dec 31, 2010)

Lets add some realistic dimension to this debate. That is the current costs of rTMS in Western Europe and the US that is extremely high. In some european counties rTMS is offered for free to limited amount of people with depression. These are treatment at either the left and right dorsolateral prefrontal cortex. The response rate is around 50%. There are alternative locations that in theory might help those who didn't benefit from these locations. But, these locations are not offered because rTMS is only approved at the right or left DLPFC. So, people with depression who didn't respond to the first treatment is not offered the two other location that very likely could help them. The situation in private sector is the same. 90% of rTMS providers only have rTMS that can locate and stimulate the left and right DLPFC. They do not have neuronavigation to make locations of other areas. 10% might have and other 10-20% might have coils that can go deeper into the brain the coming years.

The cost of a rTMS session in the US is around 2-300.dollars. Some are covered by insurance if the locations are approved as a treatment by FDA. Otherwise it off-label and a experimental treatment and you pay all costs yourself. In the UK the price is also very high at 250Pounds pr.session. You likely need 10-15 session to find if it works in you. You can find cheaper treatment prices in Western Europe at 100-120. This is often with rTMS equipment that only can stimulate the left and right DLPFC. For depersonalization you need better equipment.

If you need a MRI scan of your brain it will be a cost around 500-800.euros alone. You likely have to travel to other locations, live there for 2-3.weeks. So, there is the costs of travel and staying added to rTMS treatment.

we do not know the response rate at the different locations, how lasting the effect is, a the reduction in symptoms. So, this is a potentially a very expensive lottery ticket for most.

so, if you can afford this and take such risks we can debate. I think 95% of you can't. So, this is in reality a fantasy debate with a very predictable outcome. It can never become a reality for most due to the economy.

The prices of rTMS have to come down, it have be more widely available, close where people live and there have to been more data about the correct locations in depersonalization and how lasting the effect is. In depression the effect is typically around 9-12.months in many and one have to take some maintenance sessions that is typically 50% less than the first one. rTMS is in many ways a very young and maturing treatment and waiting some years is the most realistic and productive to do for most.


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## kayak193 (Aug 21, 2020)

leminaseri said:


>


Dpdr/anxiety or any mental health issues for that matter are such an individual thing so recovery will look different for every single person. Some people's issues that sound similar to dp/dr are unknown, and put it down to something going wrong organically and basically have no choice but to accept what is and carry on with life to the best of their ability. Ones symptoms might be due to complex reasons such as childhood trauma, some people weed, and some people chronic stress/anxiety- I've even read about people getting it from certain medication withdrawals. The only thing we know for sure is everyone is different and that video shouldn't and won't determine anything about your current condition whatever that may be. The guy is simply sharing his experience. I would say however, it seems like you do suffer from anxiety, I read a few of your other posts about your fear of going psychotic and I can tell you that's an awfully common fear among anxiety suffers. A lot of the time, us anxiety suffers swear we're not feeling anxious but in reality anxiety can manifest in so many different ways even though its not currently affecting us and we don't feel 'anxious' at the time, so that's something else to keep in mind. You seem to be fixated on how your version of dp isn't gone yet, and you seem overly worried about it even though you insist you're not anxious anymore. You also say you're still able to work and go out and do anything you want, so I really don't see what the big problem is if it's not really affecting your performance in everyday life? Anyway, if you haven't already try and reduce your stress levels and slow down your lifestyle, try and stop worrying about this and that, and if you are indeed suffering from dp/dr related issues due to anxiety you might see it start to calm down along with the anxiety, but you have to start somewhere. https://www.beyondblue.org.au/the-facts/anxiety/treatments-for-anxiety/anxiety-management-strategies . Please actually try out some of the things on that website (obviously if you haven't already). And if you honestly notice no difference after trying it for a few weeks and it doesn't work at all perhaps your symptoms are related to one of the other reasons why dp dr related issues occur, and I would suggest trying to figure that out if that's what it comes to. Again don't worry about other people in regards to recovery, because like I said everyone is different, that's the one thing that everyone will agree on here. We all are working towards the same goal, just being healthy and happy, we deserve it.


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## 35467 (Dec 31, 2010)

There might be a treatment option if you live in the US and have insurance. There are something called "deep TMS" with is like a helmet. It one big coil call a "h-coil" that stimulate areas deep in the brain specific after a disorder. There are approved two coils; one for depression and one for OCD. It is the one for OCD that is interesting. In depersonalization disorder there are many obsessive compulsive features. Constantly self checking and monitoring. Constant ruminations over symptoms.There is a fear of losing control under this. These symptoms are very OCD like and both in CBT approaches and in pharmacology there have several times been focus on this OCD element in depersonalization . In some brain scans of depersonalization two areas have been found overactive that is also found active in OCD, - the medial prefrontal cortex and anterior cingulate.

The coil from "Brainsway" is designed to address this overactivity in the medial prefrontal cortex and anterior cingulate. 90% of these machines are in the US at 157 locations. Very few in Europe. It is approved by the FDA and is likely covered by some insurance companies. So, if could be interesting to try to treat at this OCD element in the disorder.

To find a provider in your state go to this list. Choose "OCD" and see if there are locations close to you. 
https://www.brainsway.com/find-a-provider/


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## ReiTheySay (Aug 5, 2016)

AnnaGiulia said:


> Hey leminaseri,
> 
> Would you perhaps like to share as to why this particular video killed your hope?
> 
> ...


Hey there,

Can I ask if your childhood trauma was a rather obvious possible cause or did you have to dig in?

Did you remember experiencing some form of DPD as a child?


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## Want2lifeagain (Jun 20, 2020)

Mayer you is brilliant broo .. that's logic about ocd


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## 35467 (Dec 31, 2010)

Where said:


> Mayer-Gross, do you think people here would benefit from TMS for depression without the cutting edge navigation, because a fair amount also have anxiety and depression? It was recommended to me, but I had no way to attend the five day a week sessions.


Most rTMS machines used in the private sector in the US and Europe and also the places where rTMS is offered as a treatment in hospitals for depression it is offered as stimulation at the either left or right DLPFC. Around 50% with depression might benefit from these locations. There are other locations that could be tried but you need more advanced and recent developed equipment to do that. So more with depression could benefit from rTMS if other locations was tried when other failed.. There are case reports that depersonalization symptoms have been reduced with rTMS at the right DLPFC. Many have tried to replicated them as they are easy to do for all rTMS machines. My impression is that the response rate at these locations in depersonalization is under 15-20%. There are others areas found active in the prefrontal cortex found active in depersonalization in brain scan. They might be of more importance and have a higher response rate. Most of these locations are too deep in the brain for a normal rTMS coil to stimulate. So, these areas are not tried. That is medial prefrontal cortex, anterior cingulate and like also ventromedial prefrontal cortex. In a brain scan where people was given THC infusion to make depersonalization there was a correlation between levels of depersonalization and activity in the anterior cingulate. It is only recently that coils have been developed and will likely be approved in the US and Europe this year and the next that can go deeper and inhibit areas like anterior cingulate that is also found active in OCD. Such a coil will be approved for OCD and could be offered the coming years.


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## 35467 (Dec 31, 2010)

A French rTMS trial should be published later this year or beginning of the next of stimulation of the right angular gyrus. They should do some fMRI scans prior to the trail and after. So, it might also give some ideas of the networks at play in depersonalization. I might try the angular gyrus too if it gives some interesting results. But, the scanning part of the trial is very interesting too.


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## Jackk11 (May 9, 2018)

Mayer-Gross said:


> A French rTMS trial should be published later this year or beginning of the next of stimulation of the right angular gyrus. They should do some fMRI scans prior to the trail and after. So, it might also give some ideas of the networks at play in depersonalization. I might try the angular gyrus too if it gives some interesting results. But, the scanning part of the trial is very interesting too.


 angular gyrus is more likely to help with Disembodiment symptoms and lack of agency rather than emotional numbing. Similar to TPJ


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## 35467 (Dec 31, 2010)

Jackk11 said:


> angular gyrus is more likely to help with Disembodiment symptoms and lack of agency rather than emotional numbing. Similar to TPJ


Yes, emotional numbing and detachment not so much. There might be some who experience some reduction that it might reduce their anxiety levels and tendency towards obsessing. They could likely see the most reduction also in emotional numbing. But, the scanning part of the trail is also very interesting as it might give some more insight into the emotional regulation. So, one who respond and have a reduction in symptoms except in emotional numbing and detachment might show some activity that might show what processes makes this inhibition. There is less noise due to the reduction in symptoms to make interpretations off.


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## Jackk11 (May 9, 2018)

Mayer-Gross said:


> Yes, emotional numbing and detachment not so much. There might be some who experience some reduction that it might reduce their anxiety levels and tendency towards obsessing. They could likely see the most reduction also in emotional numbing. But, the scanning part of the trail is also very interesting as it might give some more insight into the emotional regulation. So, one who respond and have a reduction in symptoms except in emotional numbing and detachment might show some activity that might show what processes makes this inhibition. There is less noise due to the reduction in symptoms to make interpretations off.


 I'm eager for the results.


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