# how you can deal with extreme emotional numbness



## RunToMe (May 30, 2019)

my obsessive hyperaware vicious cycle about my numbness, which leads nonstop to my thought " i cant tolerate to live with it because life is meaningless than", to that thought i cant giving me an answer that makes me soothto whom how has this kind of dp, with which mindset you started to stop this never ending loop without being frustrated not to feel something by acting for example with friends or everything. i am so broken and suicidal now by constant hyperawareness, so less sleep and drinking alcohol.


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## RunToMe (May 30, 2019)

its like a mental auto-immun disease which fights automatically every second against your mind


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## RunToMe (May 30, 2019)

for me not to feel is so absolute terrifying and to forget that never ending loop thought is like when i say to you "switch off your consciousness" and you would say its not possible only when i get narcotic or when i died


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## RunToMe (May 30, 2019)

i dont come out of this, please please please help me


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## 35467 (Dec 31, 2010)

Just reading the headline with use of "numbness" I knew it was by "RunToMe". Yes, that is a pathological obsession of yours like the idea that you have depersonalization disorder when you have major depression. Your complaint about insomnia and lack of appetite is related to major depression. So, your situation is in many ways far more serious than depersonalization.

I really don't know what to do because I have the impression that even advice of where to get treatment it not put into action. You likely don't have the energy. The only energy you have is to sit a look constantly on this forum as a solution to the Gordian knot in your head. It will never come partly because this is a depersonalization site and not a major depression site. Even a professor who specializes in depersonalization says that you do no have depersonalization, but major depression.

Obsessive ruminations and emotional anhedonia is linked in to a major depression network, Jonathan Downar who is one of leading depression researcher in rTMS says the a group that particularly responds to rTMS at the right orbital frontal cortex are marked by anhedonia and a obsessive like network in the brain. They feel that the emotions are gone. There is nothing. In reality it is because they are caught in a obsessive like network of negative ruminations that does they can't feel anything. In reality the emotions are still there but this obsessive ruminations network does they are outside other networks with pleasure, rewards and emotions. With rTMS at this location they inhibit this obsessive network that makes the feeling of anhedonia. When that is done the emotions come back.

i have referred you to the only rTMS in Europe that have the equipment to treat it these locations in Europe six months ago. A location that also have rejected me and to work with depersonalization, -a disorder you do not have. Because they use coils that is not approved for clinical use yet but only research they can work at locations only currently used in research . This was turned down as your extremely sick idea of having depersonalization disorder is something you not can break out of. So, the obsessive network that makes the anhedonia also have an obsessive delusion that you will not let go of, - you have depersonalization disorder. If you contacted the location I refers you to that will not work with depersonalization but likely major depression witch you have, you would with you obsessive and dunk brain have insisted on having depersonalization and not depression, -and they would have turned you down. So, the idea of having depersonalization is to me linked to the obsessive network that makes your emotional numbing. Your are like a dog hunting it's own tail. You will never get it.






You likely do not have the energy to structure to do anything that looking constantly on this site that will not bring you anywhere. It would be nice if there was a 3.party that could act on your behalf so a you could try other rTMS locations for depression.


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## RunToMe (May 30, 2019)

mg: i only know ,my symptom and that is numbness...how you call it i dont care and i dont say it isnt depression...there is a big intersection of depression or dp...and a lot of dp ppl has this numbness symptoms and the exterm obsession thing...so please give me help to get out of numbness...for example how you live with your numbness...you can live with it without worrying


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## RunToMe (May 30, 2019)

mg i only want help and a diagnosis discussion...here in this forum i find more accordance than on other forums...for example the member "didi" had the most simililarity to me and she didnt knew if she had dp or depression....its only a scream to the world to get help


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## RunToMe (May 30, 2019)

mg: thank you for your constant help, but i need in my hell...maybe your are a role model to live in numbness and how you do it in your mindset


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## 35467 (Dec 31, 2010)

You can get treatment for major depression symptoms you have but not for depersonalization. The locations I would wanted you to try are likely also related to depersonalization but as I wrote they will not go into depersonalization. These are locations that plays a role in depression and in obsessions, You do not have depersonalization so it do matter what you call it as the treatment options are far better for major depression than for depersonalization as it is better understood. I will not go into pointless debates about how I fell as it is just related to your obsessions and do nothing about it. I am not interested in your symptoms debates either as it leads nowhere. You asked for help and come out of your situation and that is what I try to give you. Every debate about symptoms, how you or other feels brings you nowhere. Your situation will be the same the rest of your life if you just want to debate your obsessions about your emotions and not act to brake your situation.


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## 35467 (Dec 31, 2010)

RunToMe said:


> mg i only want help and a diagnosis discussion...here in this forum i find more accordance than on other forums...for example the member "didi" had the most simililarity to me and she didnt knew if she had dp or depression....its only a scream to the world to get help


"Didi" did not have depersonalization either but major depression with secondary symptoms of depersonalization. That is likely why there was a response to rTMS at locations she tried. Anhedonia or emotional numbness is a feature of major depression too.


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## RunToMe (May 30, 2019)

i know i have the same diagnosis like her and i made rtms there but unfortunately it didnt helped me


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## 35467 (Dec 31, 2010)

RunToMe said:


> i know i have the same diagnosis like her and i made rtms there but unfortunately it didnt helped me


I really do not know what locations you have tried the place you where in the Nederland. They only have equipment to treat at the left DLPFC with high frequency and right DLPFC with low frequency that is the norm for 95% of rTMS clinics. There are one case report where a where these locations is combined. You might not have tried that or should have had more session. But, these locations only produce a response in 50% with depression and it could simply be that you don't respond at these locations. So, you could try other depression locations like the dorsomedial prefrontal cortex that also works for In many with OCD, PTSD. Many with depression and PTSD saw their PTSD go away with their depression at a research facility in Canada. It is a location very active in depersonalization too.I would like to try this location if I could. You need a deep coil to treat there. The other location is the right orbito frontal cortex that is a location that works particularly in depression with anhedonia. People feel emotions are gone and it is related to a very obsessive network with ruminations are a at play. Emotions are not gone but people can not come out of a network with negative obsessive ruminations they can not brake. They are trapped there. These locations can only be done with a deep coil not approved for clinical use yet. But, it is used at one place in Europe for depression. You can likely treat 85% of all depressions with rTMS if you try these 3.locations. You might have partially have tried one of them. If you shall contact the other place you shall never used the word depersonalization or think you have it. That is a closed door and rejections. You do not have it either so It should not be a problem.

https://twin.sci-hub.do/6321/59451d62b554f4be632b586fd60ff992/karris2017.pdf


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## RunToMe (May 30, 2019)

i had the same like didi dlpfc left 10htz and right 1 htz


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## 35467 (Dec 31, 2010)

RunToMe said:


> i had the same like didi dlpfc left 10htz and right 1 htz


So, it is the same procedure as that case report I gave a link to. Either the number of sessions were to few or you have to try the two other locations I wrote about. These are locations not formally approved for clinical use yet. So, you can stay for 5-10.years on this forum and debate your emotions and then it could be formally approved in Europe and Germany in 5-10.years time or you could try to make a serious effort to try to come in treatment in Italy with your major depression.


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## RunToMe (May 30, 2019)

next week i have an appointment at a private rtms clinic. so what do you think which region i have try on left and right side...they have neuronavigation and theta burst


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## 35467 (Dec 31, 2010)

RunToMe said:


> next week i have an appointment at a private rtms clinic. so what do you think which region i have try on left and right side...they have neuronavigation and theta burst


Ok, but they likely don't have a deep coil so they can treat the locations I wrote about. They likely only have a normal 8.coil that can go 1.cm into the brain. So, you end up with the left and right DLPFC as the only locations if that is the case.

if there is a absence of anxiety in your state it could indicate the a irreversible MAOI could be tried. You have to be on a diet where you most not eat many types of fermented foods like old cheese, red whine. Beer and white wine are ok. There must a irreversible MAOI used in Germany for refractory depressions. Depression without anxiety is usually a good indication for trying a MAOI.


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## RunToMe (May 30, 2019)

and why not a reversible maoi


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## RunToMe (May 30, 2019)

i had despair and anxiety by the thought when i stay forever in this disorder, ihad not anxietx about normal living actions even by scary actions


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## RunToMe (May 30, 2019)

mg did you try maoi ? it could be dangerous sometimes due to side effects. or is this incorrect


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## 35467 (Dec 31, 2010)

A reverseble MAO is not regarded as very effective. So, it is the very old irreversible MAOI that came out as the first ones more 60.years ago that is used when tried. The side effects are often very few is one keeps a diet. If ones breaks the diet and not come to hospital fast it can be fatal. That is very they are so rarely used. In Denmark it almost only prescribed by psychiatrists who are also doctors at hospitals and often university lectures that might see private patients for some hours a week who prescribed them. They are often used if ECT fails and there are not a state a general anxiety that often is with a depression. An absence of anxiety and many somatic symptoms in a depression is often seen as a indication to try a MAOI.


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## RunToMe (May 30, 2019)

MG Why is this so that it works when no anxiety and less somatic symptoms is given ? I have less somatic symptoms and less anxiety


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## RunToMe (May 30, 2019)

and what it means that it is irrersible, i read that it takes weeks to come back to the old homöostasis or your brain is changed for ever ?


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## RunToMe (May 30, 2019)

which meds made you the most numb ?


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## 35467 (Dec 31, 2010)

"MAOIs act by inhibiting the activity of MAO and preventing the breakdown of monoamine neurotransmitters (serotonin and NE), thereby increasing their availability. Inhibition may be reversible or irreversible. When an MAOI covalently binds to the enzyme, it is irreversibly inhibited and the enzyme is permanently deactivated.3 Enzyme activity cannot be restored until the body replaces the enzyme through new enzyme synthesis. Restoration of full activity can take up to 2 weeks. Tranylcypromine and phenelzine, the most commonly prescribed MAOIs, are nonselective, irreversible inhibitors of isoforms MAO-A and MAO-B. Tranylcypromine was originally developed as an amphetamine analogue and thus also has some amphetamine-like effects."

https://www.psychiatrictimes.com/view/irreversible-monoamine-oxidase-inhibitors-revisited


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## RunToMe (May 30, 2019)

and why is the less anxiety and somatic symptoms by irreversible mao so important ?


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## 35467 (Dec 31, 2010)

RunToMe said:


> and why is the less anxiety and somatic symptoms by irreversible mao so important ?


I didn't write that less somatic symptoms but more. But, the absence of general anxiety is seen as one marker of a MAOI might be of benefit. Many have anxiety with depression and they do not respond well to a MAOI.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> I didn't write that less somatic symptoms but more. But, the absence of general anxiety is seen as one marker of a MAOI might be of benefit. Many have anxiety with depression and they do not respond well to a MAOI.


hey mg, first of all thank you very much for being active here. its a very big gift for me to have someone like you in this forum.

well i readed once you written that you had at the begin slight emotions but after medication it has gone completely.

for me its the same case now, i have slight emotions. sometimes i can feel them even in my body but they are very damped.

but i want to try some medication for mood boosting and maybe not thinking all the time about my symptoms. and optimally reduce dpdr. but im afraid of losing those bit emotions as well..

but i have 2 questions.

1) i had first time dpdr 2011 after bad trip with drugs. but i did recovered fully and from 2015-2020 i was completely symptomfree. so is my outset now 10 years ago? or 10 months ago when i relapsed?

2) which medication i could try first (i know, i want to make rtms/deep tms for ocd as well but i want to wait for the french study. but at the same time i want to handle as early as i can.) should i try a ssri + lamotrigine? or maybe some other?


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## 35467 (Dec 31, 2010)

I have tried many medications, especially antidepressants without any effect. The only medicine that briefly took like 30% of my symptoms, especially detachment, within a few hours, was a combination of antidepressant I had taken for several months( duloxetine 60.mg) and clonazepam( rivotril) 2.5 mg. It worked for 6.months then tolerance sat in and it lost it effect. The reason I took this combination was by accident. It was not known that I had depersonalization then, at aripriprazole had just come out and was thought to be a dopamine stabilizer back then. It made me more derealized with a few hours and more anxious so clonazepam was given until aripriprazole was washed out of my system. But it work partially. After I found out it was depersonalization there was written in some texts that antipsychotics could make the symptoms worse in a antipsychotics dose, -it did in me two times. They also wrote that clonazepam in a combination with a antidepressant worked in some, -it did so in me. But, tolerance is a problem with all benzodiazepines and it is difficult to get them prescribed and the effect is not lasting. It makes problems on it own in the long run. The combination of lamotrigine in a dose of 2-300.mg with a antidepressant should be of some benefit in some-like 50%. I have heard stories of people who have had depersonalization before and they could work themselves out of it but then it re-emerged often more worse than the first time and less flexible. This might be a anecdotal impression of mine but there are no systematic studies into it either that can confirm such assumptions to my knowledge.

But you can try the lamotrigine combination and then rTMS locations later. If angular gyrus works in you (so recent outset, it likely might) you might have to have some maintenance session once a year for a period or it re-emerges after stress. But I think that rTMS might be the treatment in the long run when central locations are isolated and equipped to intervene in them is more available.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> I have heard stories of people who have had depersonalization before and they could work themselves out of it but then it re-emerged often more worse than the first time and less flexible. This might be a anecdotal impression of mine but there are no systematic studies into it either that can confirm such assumptions to my knowledge.


that makes me so hopeless tbh..


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## Saschasascha (Dec 17, 2015)

On the contrary there are many people that get out of it that still have to fight with reemergences but can manage it much better this time.


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## 35467 (Dec 31, 2010)

" Dpd diaries"who also have written a book that is not published yet tries to address it in this video. 




Depersonalisation is a disorder related to emotional regulation done by the prefrontal cortex with strong connections to anxiety and depression that also are related to emotional regulation. It likely very difficult to set something like that in a universal answer. Like you can have one episode of depression in your life and come over it untreated others might see it get worse or come back in response to stress and experience it as something progressive. There is no research done into to this. But, there is a need for a somatic intervention that can reduce the levels of symptoms. I think that the absence of such makes it a stress factor in many.


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## leminaseri (Jul 1, 2020)

Mayer-Gross said:


> " Dpd diaries"who also have written a book that is not published yet tries to address it in this video.
> 
> 
> 
> ...


for me it seems to be a progressive thing. 4-5 months ago i felt different. im already in therapy (DBT) and i even work every day. but still i feel it goes worse. what could i do to stop this.


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## Phantasm (Jul 16, 2017)

Is that dialectical behavior therapy? So what does that involve? (Last time I read a manual on CBT ten years ago it was just a footnote)

It sounds so mechanical though. Maybe some simple talk therapy or counselling might help too. It appeals to us to move into the medical and technical because that's a safe space with dissociation, but is it real or helpful?

Just thinking aloud.


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## leminaseri (Jul 1, 2020)

Phantasm said:


> Is that dialectical behavior therapy? So what does that involve? (Last time I read a manual on CBT ten years ago it was just a footnote)
> 
> It sounds so mechanical though. Maybe some simple talk therapy or counselling might help too. It appeals to us to move into the medical and technical because that's a safe space with dissociation, but is it real or helpful?
> 
> Just thinking aloud.


yes its that.

i dont know what to do. i should try medication i think. its not only about cure or full recovery. there should be a way to live with less quality but LIVE. im so desperate it changes my personality. im so powerless. so empty.

sometimes i think:"at least i dont got a blank mind or cognitive issues" but then i think what if this go to there? what if it will go everyday worse. im not sure if its like that but i feel changes. and thats a big sign for going worse.

edit: dbt is a special therapy for suicidal borderline patients


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## Phantasm (Jul 16, 2017)

It sounds like you're panicking and spiraling in a loop.

Have you heard of "pure O"?

It's a type of OCD that's purely mental.


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## leminaseri (Jul 1, 2020)

Phantasm said:


> It sounds like you're panicking and spiraling in a loop.
> 
> Have you heard of "pure O"?
> 
> It's a type of OCD that's purely mental.


okay how can i fix this?


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## Phantasm (Jul 16, 2017)

The first thing is just to be aware you are doing it. Then you can be like, "Oh, I'm 'O'ing, okay, I see that." Then you can take a few deep breathes and let it go.

This may be all you need to do, depending on how obsessive you are, but otherwise work on it with your therapist.


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## leminaseri (Jul 1, 2020)

Phantasm said:


> The first thing is just to be aware you are doing it. Then you can be like, "Oh, I'm 'O'ing, okay, I see that." Then you can take a few deep breathes and let it go.
> 
> This may be all you need to do, depending on how obsessive you are, but otherwise work on it with your therapist.


thank you very much for advices


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## forestx5 (Aug 29, 2008)

As rough as numbness is, there is something far worse. When I became ill, I lost all positive emotions. My negative emotions were amplified. I felt an extremely powerful sense of hopelessness.

The message it sent was My only option was to end my life. I had gnawing anxiety. Thoughts created physical sensations in my abdomen. I was nauseous. At times, I couldn't chew or swallow food.

I lost over 15% of my body weight without trying. I had many symptoms that generated constant fear. I was consumed by sensations of impending doom. Numbness would have been an upgrade to my symptoms. I would have given a limb to be only numb.

So, if you are simply numb, then time is likely on your side. If you are not getting worse, then you are getting better. Have patience. The brain has plasticity. You can grow new emotions to replace those you lost.

It just takes time. Time is on your side.


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