# DPD vs. Episodic Depersonalization



## ChrisPA (Dec 22, 2009)

So, after reading numerous books on the subject of DP and learning from others struggling with the condition as well as health professionals I am confused. Some sources such as the DP Manual, Hope and Help For Your Nerves, and At Last A Life say that DP/DR is simply anxiety. Nothing more or nothing less. They say that if you eliminate the anxiety you eliminate the condition altogether. Okay, so this is what I came to believe. Then I read "Overcoming Depersonalization and Feelings of Unreality" by Anthony S. David and then just recently the new book "Overcoming Depersonalization Disorder" by Fugen Neziroglu and Katharine Donnelly and they say it can be a stand alone disorder. I have also read many different posts on this forum about the debate between Depersonalization as a stand alone disorder and it just being a side product of anxiety.

Well... now I am just totally confused. How could so many different supposedly credible sources have so many different opinions regarding this?? This just reinforces the idea in my head that no one really knows what's going on with us DP sufferers. If there is a standalone condition which the books refer to as DPD then this almost completely destroys what I at first believed when trying to beat this. I am really frustrated now and confused. Sure even the books that talk about the stand alone disorder offer up the same sort of methods to getting over it. Basically everyone preaches acceptance in some sort or another. Which, I totally have to agree. The only times I have felt like myself during the onset of this condition are when I either accepted it, or distracted myself with things that didn't allow me to think about it as much. These must be the only ways to beat this. Sure there are different approaches that these books deploy. Cognitive Behavioral Therapy, ACT, DBT etc. They are all helpful and each might work better for some than others. I don't know, I can't help but be extremely frustrated by this whole DPD vs. episodic depersonalization thing. My gut tells me mine is episodic, but even on the good days I have which luckily seems to be the majority anymore I am still having introspective and ruminating DP thoughts. I am not sure if I will ever completely rid myself of these which is really depressing and sad. Any opinions regarding this matter I would greatly appreciate, for I am becoming increasingly frustrated and beginning to feel hopeless about this condition again.

-ChrisPA


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## Guest (May 27, 2010)

ChrisPA said:


> So, after reading numerous books on the subject of DP and learning from others struggling with the condition as well as health professionals I am confused. Some sources such as the DP Manual, Hope and Help For Your Nerves, and At Last A Life say that DP/DR is simply anxiety. Nothing more or nothing less. They say that if you eliminate the anxiety you eliminate the condition altogether. Okay, so this is what I came to believe. Then I read "Overcoming Depersonalization and Feelings of Unreality" by Anthony S. David and then just recently the new book "Overcoming Depersonalization Disorder" by Fugen Neziroglu and Katharine Donnelly and they say it can be a stand alone disorder. I have also read many different posts on this forum about the debate between Depersonalization as a stand alone disorder and it just being a side product of anxiety.
> 
> Well... now I am just totally confused. How could so many different supposedly credible sources have so many different opinions regarding this?? This just reinforces the idea in my head that no one really knows what's going on with us DP sufferers. If there is a standalone condition which the books refer to as DPD then this almost completely destroys what I at first believed when trying to beat this. I am really frustrated now and confused. Sure even the books that talk about the stand alone disorder offer up the same sort of methods to getting over it. Basically everyone preaches acceptance in some sort or another. Which, I totally have to agree. The only times I have felt like myself during the onset of this condition are when I either accepted it, or distracted myself with things that didn't allow me to think about it as much. These must be the only ways to beat this. Sure there are different approaches that these books deploy. Cognitive Behavioral Therapy, ACT, DBT etc. They are all helpful and each might work better for some than others. I don't know, I can't help but be extremely frustrated by this whole DPD vs. episodic depersonalization thing. My gut tells me mine is episodic, but even on the good days I have which luckily seems to be the majority anymore I am still having introspective and ruminating DP thoughts. I am not sure if I will ever completely rid myself of these which is really depressing and sad. Any opinions regarding this matter I would greatly appreciate, for I am becoming increasingly frustrated and beginning to feel hopeless about this condition again.
> 
> -ChrisPA


Episodic DP and DPD are two different things. Episodic DP is when you will have episodes of dp and then return completely back to reality and normalcy. DPD is when the feeling never fully goes away.

Having had DP for 8 months, I can't honestly say that I am completely clear about it being a stand alone disorder or caused by anxiety/depression. I know that you can have dp symtoms as a result of anxiety and depression. I do know, that for me, I can have days where I don't feel depressed. Actually most of the time I do not. I do, however, always have this baseline anxiety happening. It never goes away and I suspect that is to be accounted for by the fight or flight response in the brain being stuck on. So, it is hard for me to say that anxiety isn't causing dp. But it could also very well be that Dp is a stand alone disorder and that is CAUSES anxiety and not the other way around.

Honestly, I don't think the details like this really are critical in overcoming it. I have noticed that every single recovery post outlines the same procedure for healing dp. I also think that Tommy is spot on, that the key to reversing the condition is to right the chemical imbalance in the brain. This is the approach that doctors use in depression with antidepressants. From what I've seen, this is more of a delicate balance thing than a "hit it hard" thing and taking one chemical that floods the brain doesn't work because it doesn't target all of the other areas that need to be addressed.

I think the important thing for you to do is to take suppliments that are going to help your brain along in recovery. I have been on fish oil, sub b complex, and vitamin D and it has done wonders to aid in my recovery. I am at about 50-75% recovered most days. For me that is in the aspect of feeling closer to reality, not the number of days that I spend feeling well. Say 0% is when you first got dp and 100% is reality. That is how I gauge things. 
Also, practice the methods that people in books and on these boards say worked. They really do all say pretty much the same thing.


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## ChrisPA (Dec 22, 2009)

I am taking all of the supplements you listed other than Vitamin D daily. They are doing me good I'm sure, but nothing considerably noticeable I also never let my DP prevent me from doing things. I have a good job in the field I went to college for, I have an awesome girlfriend, close friends and family, and get involved in a lot of activities I enjoy etc. That being said though, I am still just stuck in this rut where I think DP thoughts most of the time, and sometimes they get to me sometimes they don't. It seems really dependent on the environment I'm in and the activity I am doing at the time. For instance my DP is usually worse in social settings where there is a lot of people or when I am with my girlfriends family because I feel pressure to look and act normal. But, if I am drinking in a social setting then it usually isn't a problem. I also get a lot of DP episodes when I spend too much time sitting around.

But yeah, I am really starting to believe it's the DP that causes my anxiety not the anxiety causing the DP. I don't have anxiety issues at all unless I get a severe DP episode. That's actually the problem I still have. When the DP feelings produce strange enough uncomfortable thoughts that actually get to me and produce anxiety, that's when I have my worst days. Usually it never gets to that point and my days are largely enjoyable. Yet, not a day goes by where I don't have moments of DP thoughts. Just most days I can dismiss them and get on with what I'm doing. But just this whole premise that it's the DP causing the anxiety kinda has me flustered now. It seemed easier to take steps toward eliminating anxiety than eliminating weird chronic DP thoughts. I don't know, I know I am doing all the right things to help myself recover. I have been dealing with this for too long now to not know what I have to do. But it still is so damn frustrating. I'll just keep cherishing the good days.


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## Guest (May 28, 2010)

Dear Chris,

Though there is disagreement about DP vs. DPD all over the place, which drives me bonkers, I'm going to say _*I KNOW I have what I call a CO-MORBID SYNDROME Called Chronic Depersonalization *_-- this is how I now define it. Yes, I also have G.A.D. and clinical depression so the DP/DR are CO-MORBID, not specifically secondary. Note, I posted this somewhere else, but even the "new" DSM coming out ... there are changes in the definition of "Depersonalization Disorder"
I myself have had chronic CO-MORBID CHRONIC DEPERSONALIZATION SYNDROME, (I hate to say, for my whole life, and I am 51) ... my own name for my diagnosis. My FIRST diagnosis in early years in the 1970s-1980s WAS DEPERSONALIZATION DISORDER. See below the updated DSM-5 in progress with a CHANGE in the diagnostic criteria for DP/DR.
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http://www.dsm5.org/Pages/Default.aspx

"Publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013? will mark one the most anticipated events in the mental health field. As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are now available for public review and comment. We thank you for your interest in DSM-5 and hope that you use this opportunity not only to learn more about the proposed changes in DSM-5, but also about its history, its impact, and its developers. Please continue to check this site for updates to criteria and for more information about the development process."

*Depersonalization Disorder*

New Criteria include Section D and section E.
A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).

B. During the depersonalization experience, reality testing remains intact.

C. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The depersonalization experience is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

E. The depersonalization symptoms are not restricted to the symptoms of another mental disorder (e.g., depersonalization symptoms in Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder).

_*Rationale given for D. and E.
"D and E: Changes allow comorbid diagnoses to be made when warranted."*_

This is directly out of the draft for the new DSM-V. Register and you can make comments on any of the diagnostic changes. But write professionally and don't use profanity and such or you won't be taken seriously. You must register anonymously and are given a password. I have contributed two times. Once re: DP, and once re: another disorder.
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This is from an older post and I just cut and pasted. I also just realized I need to put this up on my website! Neurology changes every minute. Understanding changes every minute. Anything you read that is on a bookshelf this instant is out of date. We will get to the bottom of this eventually. Meantime ... spread the word! Tell your doctors .... mention this draft in the DSM, etc.

Some here have secondary, some chronic co-morbid. I KNOW it. I have the latter. As I've said a zillion times. Here I am, not anxious, typing and have my regular "DP/DR" level. It never goes away, even in my dreams, 24/7, 365 days a year. It started as far back as I can recall. And is actually the FIRST symptom I recall, BEFORE I even knew I was anxious, depressed.

Until someone really convinces me otherwise, this is my stand, after much research and life experience and talking with DPers and individuals with other mental illnesses. Nothing exists in a vacuum.

D


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## Guest (May 28, 2010)

I can't find the correct emotion! My post ends with a







... not lecturing. The key to this I believe is to understand it as yet another neurological glitch, but of course our response to any symptom can "condition it", "make us have greater fear" which is why I think CBT can be helpful in improving quality of life, etc. For me, CBT means nothing. I don't NOT have DP/DR, so how can I reinforce a "good day" ... there aren't any such days. Back in my youth, looking back, I was DP/DR MORE THAN NOT, but it was more episodic. Yes, stress, lack of sleep, panic could make it worse, and still do. Bur for me, it is CHRONIC and it is a syndrome (I prefer that word) that exists alongside my GAD (I fully fit the criteria) and clinical depression, ditto.

Cheers,
D


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