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Saw a DP/DR specialist today


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#1 Freddy_Fred

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Posted 19 March 2015 - 09:02 PM

I was quite surprised with my DP specialist visit. Not sure how to feel about it to be honest. She said that my sudden DP/DR is a result of a lifetime of untreated depression and stress. She said this last stressful semester of school accompanied with the holiday rush was the straw that broke the camel's back. For a long time, I deemed my "problems" and "depression" as minimal bumps in the road. Its her opinion that they weren't. To my disappointment, she said I need to be medicated while this is going on :(

 

I feel defeated. I never thought in my life that I would need medication. I'm soo scared and paranoid of SSRI's. 

I find it hard to believe that depression and stress is the root of all this. 



#2 Tanith

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Posted 19 March 2015 - 09:52 PM

It's possible, though I should highlight that it's not the same for everyone.

For me depression is certainly a factor but due to the dissociation caused by DP I don't feel it to anywhere near the same degree as I would if I didn't have DP. In my case this condition has sort of acted like a defence mechanism & over time it's been easy to underplay the things it's been preventing me from feeling since I'm not feeling those emotions.

It is possible that when the DP symptoms reduce, the potential negative emotions a 'normal' person experiences could hit you like a ton of bricks due to how powerful emotions feel when compared to how they feel to someone with DP. It takes a lot to adjust back into that and to then cope once you do (so I've heard).

#3 Freddy_Fred

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Posted 19 March 2015 - 10:15 PM

Yes. My current symptoms do not apply to everyone. It was her concern that I'm so distraught and emotional about the way I'm feeling. She wants to put a band aid on the depression so that life can be a bit more bearable while I try to recover. I asked her," i wasn't THIS devastated and sad before DP set in. How can depression  cause all  of this? She explained that I have to try to alleviate my sadness and dark thoughts regardless if I wasn't feeling like this before DP.  



#4 Guest_Zed_*

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Posted 20 March 2015 - 03:44 PM

Well the thing is… you don't have to take any medication you don't want to, it's completely up to you NOT the specialist. 

 

I went down this path with a psychiatrist who prescribed SSRI's and anti psychotics and to be honest they made me feel far worse than I was to start with. So much the disappointment of the specialist, I stopped. I saw this psych every week for 2 years and though I did make some very good ground understanding and coping with the myriad of symptoms i decided in the end I much preferred to seek out a psychologist so as not to have medication pushed on me all the time, and I've never looked back. 

 

Freddy_Fred.. why don't you say to the specialist you don't want to rush into this and take medication just yet? Ask for some other options. Try other options. See what they say. You'll notice a lot of people here react very badly to SSRI's (and their DPD skyrockets), they really don't seem like a great first option. And besides, most people I know who are on SSRI's are depressed as hell anyway.

 

Therapy should be the first treatment option for dissociative disorders imo, and a decent amount so you can evaluate how it's going before jumping on the psyche drug 'campaign'. 

 

You'll find a lot of people here have severe depression and anxiety when this disorder first hits them, and like you, many people also have dp/dr 24/7 so you're not alone on that one. 



#5 Guest_Selig_*

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Posted 23 March 2015 - 08:25 AM

If you don't want to take them, don't. The recent evidence for the efficacy of SSRIs in both depression and DPD paints a grim picture. In the worst case, new studies are finding SSRIs no more effective than placebo for depression. It amazes me that these things are still being prescribed in huge quantities despite a plethora of potential side-effects and underwhelming evidence to support their use.

The only reason I have agreed to take an SSRI is for a combination therapy with lamotrigine, which has been shown to be effective in many cases.

It's far more likely that your DP is rooted in depression and stress than it being spontaneous. Although such cases do exist - much to the discomfort of the dogmatic anxiety hypothesis crowd - they're not particularly common. Usually there is a trigger and depression and stress are good ones.


They are still being prescribed because they also act as an anxiolytic and mitigate OCD symptoms for some.

#6 Guest_Selig_*

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Posted 23 March 2015 - 09:59 AM

I'm well aware of their indication for panic disorders and OCD. That doesn't explain their continued use for depression, which was my primary complaint. Of course, Dr Sierra also concludes in his psychiatric textbook that SSRIs are not indicated in the treatment of DP.

 

I think it's either naive or disingenuous to assume that doctors and psychiatrists actually think about that shit. GPs are still handing out SSRIs like candy for depression under the dubious impression that it will help. The last two psychiatrists I went to see about DP wanted to prescribe SSRIs on the basis that it was a primary treatment. They didn't know any better. They expected my DP symptoms to improve as a direct result of the SSRIs, which was just never going to happen, especially given my diagnosis of primary DPD.

 

In cases of SSRIs reducing comorbid anxiety, the reduction seems to be rarely (never?) accompanied by a concomitant reduction in DP symptoms. The observation is backed up by the studies that prompted Dr Sierra's conclusions. SSRIs can't really be considered a serious treatment for DP.

 

Just to be clear, I think SSRIs may have some tangential benefits (i.e. making the condition more bearable) for a percentage of DP sufferers but not enough for me to attempt to encourage someone to take them when they don't want to.

 

The goal with SSRI's was never to reduce depersonalization directly, this has been been known for awhile. They became an alternative to benzodiazepines in combating underlying anxiety contributing to symptoms. 

 

I've seen them help many in my 9 years on this site. Typically what happens is people experience the initial side effects and discontinue the medication before any beneficial effects can happen. 



#7 NoFluxes

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Posted 23 March 2015 - 01:35 PM

SSRI's chemically change your brain long term, I wouldn't stay on them longer than 3 months tops, they really mess with you in other ways as well, some cause sexual dysfunction too, the benefits don't outway the negatives, I'm bipolar and antidepressants nearly ruined my life, pulled me out of deep depression one time only, and now I'm on lamotrigine only, which I plan to stop taking after DP subsides. I wish you the best of luck, and I believe in you and myself that recovery is possible, for some it's harder naturally, I get that.

 

DP won't be treated by SSRI's, it will change your mindset though, as you don't feel as miserable if they do work, if you can live your life in better ways and stop fearing depersonalization or derealization, and stop feeding it with thoughts, you will recover, we all have our own pace though, mine has been going on for almost 9 months now. Mine was drug induced panic attacks, near death experience... I am seeing some improvements with time and I will love life for what it is when I get my emotions and feelings back.

 

Peace.

 

-Chris "Fluxes"



#8 Guest_Jeff_*

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Posted 23 March 2015 - 02:04 PM

SSRI's are meant to be a long term medication. The chemical changes they are making are chemical imbalances that are being adjusted for the needs of serotonin levels. 



#9 NoFluxes

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Posted 23 March 2015 - 05:59 PM

I'm sorry you had a bad experience with SSRIs but be careful not to spread misinformation. 3 months is barely long enough for SSRIs to reach their full potential effect in some people. Yeah, they mess with my sex drive too but it's a reversible process and if the drug contributes to my recovery, that's a sacrifice I'm prepared to make. Let each individual weigh up the benefits and drawbacks for themselves.

 

Regarding the "long term changes": like every other psychiatric medication, SSRIs do cause reversible neurochemical changes (in the case of SSRIs, I would guess takes the form of either serotonin receptor downregulation or decreased release of serotonin). Of course, if you plan to stay on them indefinitely, it doesn't really matter. If it's a particular concern to anyone, it's possible to taper very slowly in a process that will cause the changes to start reversing almost imperceptibly . You should always taper off of SSRIs anyway to avoid the horrible discontinuation syndrome that occurs in withdrawal.

 

They're generally a pretty safe, if not particularly effective, group of medications.

 

 

That's exactly what I was talking about with the downregulation, the receptors can take a bit to go back to their previous state. There aren't full benefits for me, rather rapid cycling for me, I'm bipolar it isn't meant for me, taking a mood stabilizer like Lamotrigine does well enough. My DP may have improved from Lamotrigine as well, but what I can tell you is that there are a lot of natural ways to treat both anxiety and depression without medication as well. I've tried it all. Fish oil is probably the best thing out there, it won't cure anything but it gives a mood lift and is healthy for your body. It's your choice, but I refuse to take meds that I don't actually need, in the end it's all in your mind, we have chemical imbalances though I understand that very well, but they may not be permanent either, you're talking to a guy who did some hard ass drugs and is recovering. Everything is a long healing process including DP/DR.



#10 *Dreamer*

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Posted 24 March 2015 - 01:27 PM

I am 56 and have been on an SSRI for more than 15 years.  I take it for clinical depression.  I have friends my age and older who take these medications and have for decades.  They don't work for everyone -- treatment resistant ... but for many, they are lifesavers.  It is a risk benefit ... you lose your job, your social life, and could commit suicide without them or other antidepressants -- I have been on many other types of ADs before SSRIs were even on the market.  I was not helped by any of them.

MAO inhibiters, Imipramine, etc.  Drugs that were common when I grew up.  The SSRIs I believe showed up in the 1980s.  I first saw a psychiatrist in the 1970s when I was 16.  Klonopin had come out one year before I started seeing a psychiatrist. It was market strictly as an anticonvulsant.  I wish I had been able to take it in 1975.  Who knows how my life might have improved.  IDK.  My DP/DR would get better and worse.  Now it is chronic.


SSRIs make a differece -- or I should say they did for me.  I also have a friend with OCD -- BAD OCD.  She started Zoloft whenever that came out after trying other SSRIs ... she has been on that since age 30.  She will never go off of it as when she does her OCD gets TERRIBLE, and I mean TERRIBLE.

I also find it notable that I have been on an anti-cancer medication for 4 years which is known to cause depression in individuals.  It is not uncommon.  Certain SSRIs can help -- others interfere with the workings of the anti-cancer med.  I was already on Celexa when I took Tamoxifen (the cancer med) which I was to stay on for 5 years.  I was sick of the side effects and recently stopped it.  Risk/benefit.

What is incredible is that I am LESS depressed OFF of the Tamoxifen.  It is very subtle.  After two months I feel "different" -- I have more motivation, I am less sad, and I have been suicidal a few times over the past 4 years as well.  Suicidal feelings I had for the past 6 months are gone.  (And I have been close to suicide 3 times in my life.)

At any rate, what is unfortunate is that an SSRI is NOT what should be used for bipolar depression. It is known (by psychiatrists who have any brains) that an SSRI can trigger serious depression or mania in someone with bipolar.  If a doctor sees only depression, does not get a family history, a good history from a patient, he/she may mistakenly prescribe the SSRI and cause a mess.  I consider that malpractice ... but that is another story.

True, an SSRI serves specific purposes, such as helping with anxiety/OCD and indeed with depression -- but not in ALL people.
A mood stabilizer -- originally Lithium and now many others -- Depakote, Neurontin, Lamictal are the drugs of choice for bipolar -- and there are quite a few types of bipolar -- some individuals are more depresed, others more manic, others cycle back and forth, etc. -- each case is unique.  And bipolar again is NOT clinical depression.

Also, Dr. Daphne Simeon did a very long study (too long IMHO) on Prozac and DP/DR.  She found no help for DP/DR.   Dr. Sierra has always gone in other directions.  His Klono-Combo theory and Lamictal theory has saved my life.  Klonopin combined with an SSRI (Celexa ... I couldn't tolerate Prozac and a few others) and Lamictal have saved my life.

No person here will necessrily respons to ANY medication in the same way.  The problem is there is no specific medication known to treat DP/DR.  It is trial and error.  Also, I am in DBT therapy, have a support group (depression and anxiety), and include exercise, yoga and other things which in combination help all of my symptoms. However I am not "cured."

It would seem all disorders have the ability to "go into remission" and are not necessarily cured.

One promising thing in research is that blood tests are being used to determine the best kind of anti-depressant for some people, and genetic testing can also help with figuring how to treat other psychiatric disorders.

No one has ever said that an SSRI is the proper treatment for DP/DR, but as someone else said -- it HAS helped people here on the board -- why, I have no idea.

Also, as noted by many here, no one can force ANY medication on you.  If they make a misdiagnosis -- well that is inexcusable. However many medications (though imperfect) do keep people functioning, and again improve quality of life.  Nothing is guaranteed re: any physical illness anymore than psychiatric illnesses which are FAR less understood.


Edited by *Dreamer*, 24 March 2015 - 07:47 PM.


#11 *Dreamer*

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Posted 24 March 2015 - 01:35 PM

I have been on Klonopin 6mg/day since 1987.  It still works.  My brain isn't fried.  I know if I ever go off of it my DP/DR could go through the roof.  But that means I would go back to the chronic condition I had for 25 years BEFORE I TRIED IT.  It was the ONLY thing that helped me.  Medicine has changed in certain ways over the past 50 years, and not much in other ways.

It is risk/benefit, quality of life, and my choice.  No one forced me to take any medication I have ever had.  Even pain medication after surgery.  If I REALLY need it, I'll take it.

Some people can not take aspirin as they are allergic to it.

When I last had surgery, I had a morphine drip I never used.  I never used the Oxycodone I was prescribed.  I tried the high level Acetominophin or something, and it made me puke.  I lived with the pain.  THAT was easier than living with severe DP/DR.


Edited by *Dreamer*, 24 March 2015 - 01:37 PM.


#12 Guest_Zed_*

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Posted 25 March 2015 - 05:22 PM

FreddyFred.. maybe you want to check out this video before you jump into the psych meds. It's always good to get the other side of the story. 

 






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