# First time DP/DR reach out in 26 years....I would be very grateful for treatments / meds advice.



## seabreeze (Jun 2, 2015)

It started on June 6th 1989, and the night before I'd had marijuana cake. We decided to go to the movies

stoned and watch three episodes of Nightmare on Elm Street. I got 30minutes in, was sitting in the front row, and I was

so wasted. I thought I was having a heart attack, so I left and vomited and woke the next morning to

my new reality. I was at University, and 18.

So how was I different and how did I feel?

- Everything around me looked unreal.

- I would sit and "stare into space"

- I couldn't read, I just couldn't take in what was on the page,

- I couldn't retrieve and hold pictures or images in head/mind,

- I had this odd sensation that something was moving under the skin on my head,

- I didn't think I could think as clearly as I previously could, almost like I'd had a big slice out of my IQ,

- I don't remember feeling "depressed", more flat perhaps,

- I slept well, and long,

- And I don't remember the "stranger in the mirror" but he and I have become well acquainted over the years.

So I left Uni, and got onto meds for depression. The PD's didn't have any idea then did they, I'm not sure they do now....

Over the last 26 years I've been in a constant battle with psych symptoms which have been depression, anxiety and

dp like symptoms. And these symptoms have changed over time, at times I've been reasonably well, at other times I should

have been hospitalised.

I've seen 7 PD's in this time, numerous GP's, and psychologists. The diagnosis has varied, from Bipolar 2 or Soft Bipolar, to

Unipolar to Anxiety etc etc. There are lot of nuts on one side of my family tree, every second person would have some psych disorder

ranging from Schitzophrenia, Bipolar, Unipolar, Post Traumatic Stress, Chronic Fatigue Syndrome. We've got some

seriously out of whack genes.

I'm on these meds:

Lithium 3mg (4.5 capsules). Going from 225mg to 337mg just seemed to calm me a little.

Effexor/venlafaxine 150 (was as high as 225). Not sure if this is doing much.

Mirtzapine 30mg. Anxiety. Started 3 weeks ago. This has knocked back my anxiety symptoms.

Seroquel. 25 to 50mg - as a sleeping pill.

How do I feel now?

I've got everything I had back in 1989 really, and when I look in the mirror I look pretty unreal. My cognitive function is poor. My memory is shocking, it is alot worse than it was, I feel emotionally barren. On the positive side of it my depression and anxiety are all good really, I just need to kick this dp bastard.

A couple of minor things, for the first time ever earlier this year I had a period of about a month with a chronic headache/maybe migraine and in any event my doc gave my a beta blocker and I went on holiday and it resolved it self. The event that triggered this was near drowning.

And then this morning I had what I call an "Aura" and I've not had one of those in a very long time - many many years. The vision in my right eye was effected by a large white shimmering splotch and when I looked at people they looked almost double. This latest for about an hour and then faded away. I felt worse dp/dr during this period. I also felt my thoughts running away on me.

I still do a bit or rehearsing/ruminating/looping but as the anxiety is under control these symptoms are lessened, and I can control them/myself if I start on this track...

I'm looking for treatment. I lead a good lifestyle so I can best manage my "condition/s" I haven't drunk alcohol or smoked for nearly 20 years (maybe that's the problem!), I eat reasonably and exercise reasonably regularly. It is not talk therapy I think I need, as mentioned there are major genetics at play here. The best evidence of that is my now 30 year old cousin, from a great home, who as a 13 years old (poor bloody kid) told us of looking in the mirror and looking unreal to himself.

So, I need meds. I've done quite a bit of reading and I have some idea's, but I'd like to get some views from the wisdom of the crowd..I actually see my pd on Sunday, about a day and a half from now, and I intend to let him know what I want then.

I'd be so grateful for any suggestions, I've had 26 years of this shit, and I want to sort it once and for all.

Can you help?

Thank you


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## YoungKidWithDP (Jun 2, 2015)

...


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## TDX (Jul 12, 2014)

> So, I need meds. I've done quite a bit of reading and I have some idea's, but I'd like to get some views from the wisdom of the crowd..I actually see my pd on Sunday, about a day and a half from now, and I intend to let him know what I want then.


Basically you've got the following choices:

-Medications which inhibit glutamatergic activity. The most well-known (and researched) example is Lamotrigine, which was reported to work for some people. On the HPPD-Forum there also some reports that Levetiracetam worked against depersonalization. I also found some reports on the internet where Topiramate worked, too. Levetiracetam and Topiramate (which is also used to treat migraine) also inhibit glutamatergic activity, but the mechanism is not the same as Lamotrigine. Other anti-glutamatergic drugs are Riluzole (which is very expensive) and Acetylcysteine. Riluzole is different to Lamotrigine, which is obvious, because Riluzole works for ALS, while Lamotrigine does not, but I don't know the details. Acetylcysteine seems to increase activity at mGluR2/3-receptors, which inhibits glutamate release. Agonism on mGluR2/3-receptors seems to block the effects of LSD. Unfortunately there are no clinical trials which investigated the effects of meds other than Lamotrigine and even the data for Lamotrigine is far from being sufficient.

-Opioid-Antagonists, particulary if they bind to the kappa-opioid-receptor. Naltrexone and Nalmefene only do so in a very high dosage, which many people cannot tolerate. But next year the kappa-opioid-antagonist ALKS-5461 should become available.

-Agonists at the benzodiazepine-binding site of the GABA_A-receptor, like Clonazepam seem to work in some people. Unfortunately it is addictive. But this doesn't matter if it helps with your symptoms, because then you will most likely have to take it for the rest of your life to reduce your symptoms.

-There is ancedotal evidence for Meds which increase dopaminergic activity like Bupropion, Ritaline, Selegiline and Adderall.

-Antipsychotics, which block dopaminergic activity, make symptoms worse for the majority of people, although there are some execeptions.

-Antidepressants like SSRI, SNRI and so on do not work in most cases, although there is anecdotal evidence for Fluoxetine. There was a double-blind-study where Fluoxetine didn't work better than placebo.

-There is anecdotal evidence for Clomipramine and Desipramine, but no clinical trials.


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## seabreeze (Jun 2, 2015)

Thanks TDX, that was a really helpful summary.

I put it before my PD today but he wants to go with Risperidone (Risperdal) at a very low dose. I'm far from convinced but I'm going to give it a shot, the Mirtzapine he previously prescribed has helped with the strictly anxiety symptoms, so he got that right. On a day to day basis I'm going to completely continue ignore the DP/DR but I'll make sure I post an occasional update here over the next month as to how things are going with this med.


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## Meticulous (Jul 30, 2013)

YoungKidWithDP said:


> ...


Thank you for this post, very informative. +1.

Naht, hell atta here with that nonsense.

As for OP, I've experienced the aura you mentioned a few times now. It usually happens after I push myself too far physically, or once I've become really relaxed after suffering an intense bout of anxiety. You stated that you *need* meds, what has forced you to come to this conclusion? As it seems right now, you are already doped up on a medication cocktail, and this may have rewired your brain. Have you ever tried kicking the meds entirely, and tried a more holistic approach? If you have, and the meds do more for you, then so be it. Just try not to shove any pill down your throat that your psychs try to cram down there!


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## seabreeze (Jun 2, 2015)

You make a good point and in truth No, I've not thought about tapering off the meds.

Way back when it first happened I feel very much as I do now, and I was not on any meds then...

And in the mid 90's I did get fed up with my meds, and stopped taking any anti-depressant - Aropax I think. I fell of the edge of the world, I became very unwell (depression), and it took me quite some time to recover.

I'm in a situation where I also can't afford that risk now, I have a family to support. I can function as I am, I'm just "not right".

So, I think I'll stick on the med track for now, if I work though those options and don't get a response then I'm all for picking up on your suggestion - which i thank you for.

If anyone else think I'm wrong (or even right) on this I'm happy to hear your thoughts.

Oh - and the aura thing, PD said it wasn't an aura as it did not precede a migraine or epilepsy. He wondered if it is maybe a physical thing, and to talk to my GP. What he forgot I'd said though was that the dp was worse during the hour it was happening. I really wonder if there is some epileptic angle with this, which relates to the DP. I've seen that hypothesis on on other posts, and it could well be why lamotrigine and conazaepam have provided relief to some.


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## Meticulous (Jul 30, 2013)

The depression you experienced once you kicked the meds was nothing more than a part of the withdrawal process. Your brain was accustomed to receiving help via the medication, that once you stopped taking it, your brain would try and convince you that you needed the medication in order to get over the depression. The brain can be quite the trickster. Once these withdrawals subside, your brain begins to heal and will slowly but surely return back to normal. Withdrawals are a tough episode for anybody to endure, but well worth the outcome in my personal opinion. Maybe you could work something out with your family while you take some time off to deal with this? I'm sure they'll understand. Health > materialism.


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## seabreeze (Jun 2, 2015)

So I tried the Resperdal. After ten days enough was enough. I felt significantly more DP'd, just "yuck", and could hardly work. It was not for me.

What I have figured out since though is why my most recent episode of DP came on. Earlier this year February / March / April I reduced the Effexor (Venlafaxine) I took from three tablets to two as I wasn't satisfied with what it was doing. Eight days ago I bumped it back up from two to three, and my *DP symptoms have decreased dramatically in that time* although there is a little to go. I'm absolutely certain that is the answer, and while we're all different, should someone stumble upon this post one day, then Effexor could be useful for you. It would also explain why I was having other issues eg migraine like headache, the aura I had, etc after I dropped the dose.

So from here, I've still got some issues to resolve, that emotional flatness for example, and I suspect given my symptoms I may need to hit the dopamine, and it seems like Wellbutrin may be the best option. Time to get an appointment again with the PD.


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## TDX (Jul 12, 2014)

Bupropion may be a good start, but it is a rather weak dopamine reuptake inhibitor, so it might not do the trick.

I am a bit divided whether antiglutamatergic medications are an option if antipsychotics make things worse, because in the Ketamine-Model antipsychotics do *not* make the symptoms worse. But antipsychotics might increase glutamate in the prefrontal cortex which could possibly explain why they can make depersonalization worse. Unfortunately it's unknown why antipsychotics can make depersonalization worse.


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## ravenexcore (Oct 31, 2013)

I recovered when I discovered the "DpDr recovery paradox" thats what im calling it at least, I can explain it if youd like to pm me or something, I shared my story with someone who was.curious About dpdr and asked me, they then said I should try and use what I learned to help people....so thats what im going to do, but because of the.complications with people obsessing over being cured, its makes it all that Much harder to actually help them....part of the paradox lol when I work out how to put it correctly, I will post a thread explaining the method.


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## Guest (Jun 25, 2015)

Hi ravenexcore,

Do you mean that people think DP/DR is worse than they think it is, and instead of just ignoring the thoughts/feelings and symptoms, they obsess with being cured, when really it should go away by itself without meds?


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## seabreeze (Jun 2, 2015)

I agree with you raven and goldy. When I first got this in 1989 I was really scared. I thought I was going crazy and permanently damaged. I didn't stop thinking about it. This time I am ignoring it (and I know that is more difficult for some depending upon your symptoms) but that is the best strategy. So the paradox is that to get better you ignore it or give it as little attention as possible, rather than investing time and energy into "fixing it" which you'd normally do.


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## Guest (Jun 25, 2015)

That's it, just accept, ignore and heal.


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## ravenexcore (Oct 31, 2013)

seabreeze said:


> I agree with you raven and goldy. When I first got this in 1989 I was really scared. I thought I was going crazy and permanently damaged. I didn't stop thinking about it. This time I am ignoring it (and I know that is more difficult for some depending upon your symptoms) but that is the best strategy. So the paradox is that to get better you ignore it or give it as little attention as possible, rather than investing time and energy into "fixing it" which you'd normally do.


Kinda yea, it is there because of your fear of it and the stress it causes, so looking it up and checking in on it...ect only furthers the desperation to be cured. You need to let it go, not the same as ignoring it cause that in a sense is validating it. Understand that your fear of it makes it stay, that understanding alone is the first step....after that focus in bettering your life and or hobbies that draw your attention.....or get a relationship, and you will forget about it......being able to forget, is when it starts to go away and during that time you won't even notice it.


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## simonlebon (Apr 13, 2015)

All depends on the source of your DP. If anxiety/panic is the root reason for your DP, medicines that help with anxiety/panic are going to help you with your DP (normally), which would include SSRI's, low dose of antipsychotics, benzos etc. I've been on an SSRI + low dose of seroquel for years, and have been fine. Once I try to remove either, the anxiety/panic comes back, then the DP. But then again, I was prescribed this stuff when I first got panic/anxiety and once you go on them, they can be hard to come off of. But hey, some people need them, and if they work, I think that's good.

But just as important, if not more, is the CBT, working with your thoughts, being patient/loving/understanding with yourself, meditation, good diet, exercise etc.


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## hopefuluk2 (Aug 20, 2015)

Scary stories like these make me feel that this shit will never go away! lol


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## Alex617 (Sep 23, 2015)

Hey, sorry to hear about your long struggle. Few questions:

1. Have you had your hormones tested? Specifically testosterone, estrogen, thyroid?

2. Have you had any windows? Meaning, did you ever have days where you felt normal and it returned after?

3. Have you tried meditation, therapy, paleo diet?


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