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Depersonalization rooted in developmental trauma? Books to read...


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#1 Billy D.P.

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Posted 02 December 2019 - 12:33 AM

I don't know how many people here have underlying emotional issues that they recognize as either deeply connected to their depersonalization or the root cause of it but I know this is certainly the case for me. It's taken me 31 years to realize this but I'm glad I'm at that point finally.

 

For me, depersonalization is deeply rooted in what's called "developmental trauma" which is trauma that occurs between the ages of 1 and 5 when 80 percent of brain development occurs. Scientists are also now realizing that "trauma" is not just something bad happening to you but can also occur when you don't get enough of something you need to survive. Essentially trauma is either too much of a bad thing or not enough of a good thing. The younger this occurs in childhood the more widespread the effects. 

 

What I've realized in dealing with two severe episodes of depersonalization in my life and recovering from both is that depersonalization is a nervous system disorder or disease. It's very much physiological. It has very specific symptoms and traits that align tightly with other central nervous system (CNS) diseases. Obviously this isn't anything revelatory but it's given me a solid foundation of knowledge and confidence to move forward in analyzing the root cause of my issues. I think it would greatly benefit our community across the globe to acknowledge this as well. Any pushback about how this is all in our heads or some kind of mood disorder only adds to the stigma and misunderstanding and prevents us from seeking the neurological support and research we need. 

 

As for the precise topic of this post, there've been two books I've read recently that have transformed my entire view of my life and how depersonalization fits into the larger story of my health issues. One is The Pocket Guide to the Polyvagal Theory by Stephen Porges and the other is Healing Developmental Trauma by Laurence Heller and Aline LaPierre. I cannot recommend these books highly enough for this community. They have utterly transformed the way I view depersonalization and my own personal narrative. 

 

The biggest takeaway as it relates to depersonalization from both these books is that the human nervous system basically develops a baseline view of the world as either safe or unsafe from an extremely young age and then wires the entire body to favor one or the other depending on how safe the child felt growing up. If for example you had a very loving family where nobody fought and you knew you were loved unconditionally and provided for and cared for then your nervous system developed in a healthy fashion. If however you experienced any sort of dysfunction or abuse or neglect or perhaps even a parent who didn't attend to your needs then what often results is an ongoing stress that prunes your neurons to favor a nervous system that's constantly prepared for fight, flight, freeze or feign. Essentially it's more advantageous from an evolutionary standpoint to remain prepared for danger and stress in order to survive than it is to remain calm and playful and thus offguard and prone to damage, disease or death.

 

As is the case with every aspect of the body, the more you use something the stronger it gets, and the nervous system is no different; however, because the brain is developing at such a rapid rate in infancy this is even more true than at any point in life. And so as children with early stress and trauma mature their nervous systems basically reflect whatever early view of the world they were bestowed being either mostly safe or dangerous, the paradox being that if you're programmed to view the world as dangerous you will grow up to constantly find threat even when there isn't any and thus continue strengthening an already overpowering "fight or flight" response. This is what many of us experience as anxiety. 

 

So how does this relate to depersonalization?  

 

This is where the polyvagal theory comes in. Basically polygaval theory says the main conduit of the CNS, known as the vagus nerve, is comprised of a few main systems that stem from different parts of the brain and all intermix to promote various levels of stimulus and relaxation depending on a vast array of environmental signals and social circumstances but that the root of everything is safety. As long as mammals get signals from their environment that their lives are not in danger they can really give their nervous system a go for all sorts of activities including sex, play, socialization, sleep, feeding, you name it. But if they feel threatened in some way a whole different set of nervous system wiring kicks in and won't let go until it again gets signals it's safe. But the key here is that though there's overlap with the wiring, these two systems cannot be fundamentally active at the same time in equal proportion. Evolution designed our nervous system to either heal, grow and thrive or channel all our biological recourses into staying alive and escaping danger via fight, flight, freeze or feign. So while you may be anxious as hell and still talk to people in an entirely safe environment, the fact remains your body feels unsafe and thus so does your nervous system, which is really all that matters. 

 

My hypothesis about the root cause of depersonalization, and one I'd argue is fairly well supported by the polyvagal theory, is that some aspect of the fight, flight, freeze or feign nervous system is essentially permanently frozen. To some degree either an event or a long string of powerful events were deemed by the body so dangerous that the "rest and digest" aspect of our nervous system was completely severed, perhaps through neuronal excitotoxicity, perhaps through some kind of hormonal flooding, who knows. All that matters is that we are essentially stuck in "fight of flight." This is also the case with those suffering from PTSD which is why the symptoms of both conditions are so similar in so many ways. 

 

I've corresponded with Dr. Porges about the precise biological mechanism by which this frozen state occurs and though he couldn't give me an exact explanation of what's going on at the cellular level what he did say is the nervous system has to get actual cues from the outside environment that it's once again safe so as to move away from being stuck in a state of anxiety. However this isn't quite as easy as it sounds. You can't, for example, just sit in your room where it's supposedly safe and expect your nervous system to recalibrate. There are actually specific sound and light frequencies that move your nervous system towards a state of safety and artificial light and sound from electronics actually trigger your nervous system to feel threat, which is why people with depersonalization can't stand fluorescent lighting for example. Things like talk therapy, singing, meditation, human touch, active listening, yoga and basic eye contact are all examples of environmental cues our nervous systems deem as safe and that can move you out of a frozen dissociated state. But to truly make the transition from being frozen in dissociation (as many here are) to a state of flow and health and normalcy seems to require lots and lots of little repeated cues of safety. In short, there's no single "cure" for depersonalization, though there may be in the future. 

 

Anyway, this is just a very basic outline of all this stuff. I'd really encourage anyone with this condition to read up on polyvagal theory and developmental trauma as they're both intricately related and cover extensive scientific ground on depersonalization and related dissociative states. Nobody has the precise mechanistic answers for depersonalization quite yet but in reading up on this material you should be able to get a pretty good grasp at the general direction this is moving towards. 



#2 Broken

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Posted 02 December 2019 - 07:03 AM

Yup agree with all that, have had that theory myself. I dont know how to get that vagus nerve activated though. I do have cold showers which supposedly activates it. I have been taking a lot of choline which presumably makes more acetylcholine in the body (but you probably piss a lot away lol). But that is the main neurotransmitter of the vagus nerve. And lots of eggs.

 

It most definitely feels like this is the root cause though, that spaced out, unrelaxed, tense and hypervigilant with a knot in my stomach. I have also been taking huperzine A which is a natural drug that they prescribe in japan for Alzheimers. It prevents the break down of acetylcholine.

 

The main clue is the things you listed:  "sex, play, socialization, sleep, feeding, you name it". Except sex maybe (lol) I struggle to get the energy to play or want to although love doing that with my nephew. Socialising is impossible and uncomfortable and I just shut down. Sleep is a but issue taking me at least an hour to drift off, being woken easily by any sound and waking up exhausted despite how long I slept. Eating is an issue, I dont eat enough or digest food well it just sits in my stomach if I overeat (again rest and digest doesnt activate well for me). And just relaxation in general.



#3 Mayer-Gross

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Posted 02 December 2019 - 08:05 AM

Stephen Porges ideas has been tested in depersonalisation disorder. Particularly disrupted heart rate variability. The origins of the disruptions seen in depersonalisation disorder was not found to be the vagus nerve.https://www.ncbi.nlm...les/PMC4374468/

 

We know that depersonalisation disorder is a disorder related to cognitive regulation of emotions. The prefrontal cortex regulates emotions in depersonalisation but also in states like depression. When you manipulate locations in the prefrontal cortex with rTMS the heart rate variability changes. There are trails where depressed are given rTMS while heart rate variability is measured. If there is seen changes they know it is the right location and if not the shift to other locations in the prefrontal cortex. So, there is a "Top-down" from the prefrontal cortex to the body. So, Stephen Porges is wrong. There is also a "bottom up" where the  CNS and the body can effect the brain. So, there he is right. Depersonalisation disorder do not come from lower parts of the CNS but the prefrontal cortex the projects to the body. https://www.scienced...935861X19303791

 

In the rTMS trail for depersonalisation at the right ventrolateral prefrontal cortex they measured the effect on skin conductance as a maker of parasympathetic tone and it changed in depersonalisation towards a fight and flight mobilisation. https://www.ncbi.nlm...les/PMC3968882/



#4 Billy D.P.

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Posted 02 December 2019 - 10:38 AM

Stephen Porges ideas has been tested in depersonalisation disorder. Particularly disrupted heart rate variability. The origins of the disruptions seen in depersonalisation disorder was not found to be the vagus nerve.https://www.ncbi.nlm...les/PMC4374468/

 

We know that depersonalisation disorder is a disorder related to cognitive regulation of emotions. The prefrontal cortex regulates emotions in depersonalisation but also in states like depression. When you manipulate locations in the prefrontal cortex with rTMS the heart rate variability changes. There are trails where depressed are given rTMS while heart rate variability is measured. If there is seen changes they know it is the right location and if not the shift to other locations in the prefrontal cortex. So, there is a "Top-down" from the prefrontal cortex to the body. So, Stephen Porges is wrong. There is also a "bottom up" where the  CNS and the body can effect the brain. So, there he is right. Depersonalisation disorder do not come from lower parts of the CNS but the prefrontal cortex the projects to the body. https://www.scienced...935861X19303791

 

In the rTMS trail for depersonalisation at the right ventrolateral prefrontal cortex they measured the effect on skin conductance as a maker of parasympathetic tone and it changed in depersonalisation towards a fight and flight mobilisation. https://www.ncbi.nlm...les/PMC3968882/

 

I never said it wasn't top-down. I highly doubt Porges would suggest the same given the cognitive symptoms of depersonalization. The vagus begins in the brain but has different regions where those nerves stem from and my suggestion is it's those areas where the actual symptoms of depersonalization could possibly manifest or at least play a small role. I'm also not suggesting the vagus is the entire story nor the cause. I'm simply trying to point out that anxiety is a major trigger in this community and even a cause of this condition and that if people are better able to understand fear and how their own nervous system operates that they then may be able to calm themselves or regulate their nervous system better. 

 

I would point out heartrate variability isn't the only biomarker for a dysfunctional vagus. In fact, if there was an issue in the CNS and with the vagus specifically for those suffering from depersonalization then heartrate variability would likely be either normal or even slowed given depersonalization falls more in line with the dorsal part of the vagus and the freeze and feign responses where heartrate is decreased. In fact, that's exactly what depersonalization is: a sort of permanently frozen, dorsal-dominated state. 

 

It's also worth noting there are plenty of stories on this site of depersonalization being triggered by bottom-up substances like antibiotics and other medications which begin in the enteric nervous system and make their way upward. Given the role we now know the microbiome plays in providing serotonin to the brain and executing all sorts of biological functions it wouldn't surprise me if some aspect of the communication between our gut bacteria and brain had something to do with all this as well...



#5 Billy D.P.

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Posted 02 December 2019 - 10:42 AM

This may sound conspiratorial, but I don't think feeling safe is a big priority in our society. Could that be why such a huge percentage of people classify as having an anxiety disorder? Could that be why suicide rates are significantly increasing among teens?

 

It absolutely is not. Porges talks about this concept called "neuroception" which is basically the signals you receive unconsciously from stimuli in the environment that either trigger safe or unsafe reactions from the nervous system. He says modern society is basically littered with low-frequency sounds that are constantly triggering anxious states. These are often even present in classrooms and he argues for a total reconstruction of learning environments to better attune our nervous systems to a calming state where we not only feel safe but are actually better suited to learn. There's a reason something like 30 percent of millennials identify as having anxiety.  



#6 Billy D.P.

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Posted 02 December 2019 - 11:02 AM

Yup agree with all that, have had that theory myself. I dont know how to get that vagus nerve activated though. I do have cold showers which supposedly activates it. I have been taking a lot of choline which presumably makes more acetylcholine in the body (but you probably piss a lot away lol). But that is the main neurotransmitter of the vagus nerve. And lots of eggs.

 

It most definitely feels like this is the root cause though, that spaced out, unrelaxed, tense and hypervigilant with a knot in my stomach. I have also been taking huperzine A which is a natural drug that they prescribe in japan for Alzheimers. It prevents the break down of acetylcholine.

 

The main clue is the things you listed:  "sex, play, socialization, sleep, feeding, you name it". Except sex maybe (lol) I struggle to get the energy to play or want to although love doing that with my nephew. Socialising is impossible and uncomfortable and I just shut down. Sleep is a but issue taking me at least an hour to drift off, being woken easily by any sound and waking up exhausted despite how long I slept. Eating is an issue, I dont eat enough or digest food well it just sits in my stomach if I overeat (again rest and digest doesnt activate well for me). And just relaxation in general.

 

This is interesting. You sound a lot like me. Huperzine is one of the only medications that's made me feel stimulated in a good way. I really can't handle coffee or other stimulants. I also have trouble with digestion and, as you say, food just sits in my stomach if I eat too much. Again, this could be a result of faulty communication between the top and bottom parts of the CNS. Have you seen a doctor about your stomach? I suspect I have SIBO but I'm seeing a doctor soon to find out.

 

What you say about choline is also true. It's extremely important to get proper nutrition in order for your body to heal. I've taken cold showers for years and it always makes me feel better, but again, I truly think there isn't a "cure" for this condition as it stands, but rather a series of small actions you take every day over the course of years that can slowly nudge the nervous system back into a state of parasympathetic dominance, at least this has certainly been the case for me both times I've overcome my depersonalization. 

 

It's interesting what you say about socialization because I think that probably applies to a lot of people with depersonalization and again fits into the theories put forth by both the books I recommend above. Porges talks about this concept called the Social Engagement System (SES), which is basically a social state humans evolved for purposes of communication, reproduction, culture and even to resolve intense disagreements while also remaining in a parasympathetically dominant state of the vagus -- essentially feeling safe even in moments of intense physical activity or political argumentation. He's told me specifically that if you're body is caught in a state of threat, which I suspect is part of depersonalization, then your SES is really unable to properly engage. Socialization is a huge part of this. If for example you have difficulty making eye contact, which many here seem to have, then that's a direct indication you're SES isn't activated while your threat center is. 



#7 Broken

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Posted 02 December 2019 - 11:57 AM

This is interesting. You sound a lot like me. Huperzine is one of the only medications that's made me feel stimulated in a good way. I really can't handle coffee or other stimulants. I also have trouble with digestion and, as you say, food just sits in my stomach if I eat too much. Again, this could be a result of faulty communication between the top and bottom parts of the CNS. Have you seen a doctor about your stomach? I suspect I have SIBO but I'm seeing a doctor soon to find out.

 

What you say about choline is also true. It's extremely important to get proper nutrition in order for your body to heal. I've taken cold showers for years and it always makes me feel better, but again, I truly think there isn't a "cure" for this condition as it stands, but rather a series of small actions you take every day over the course of years that can slowly nudge the nervous system back into a state of parasympathetic dominance, at least this has certainly been the case for me both times I've overcome my depersonalization. 

 

It's interesting what you say about socialization because I think that probably applies to a lot of people with depersonalization and again fits into the theories put forth by both the books I recommend above. Porges talks about this concept called the Social Engagement System (SES), which is basically a social state humans evolved for purposes of communication, reproduction, culture and even to resolve intense disagreements while also remaining in a parasympathetically dominant state of the vagus -- essentially feeling safe even in moments of intense physical activity or political argumentation. He's told me specifically that if you're body is caught in a state of threat, which I suspect is part of depersonalization, then your SES is really unable to properly engage. Socialization is a huge part of this. If for example you have difficulty making eye contact, which many here seem to have, then that's a direct indication you're SES isn't activated while your threat center is. 

Wow that is interesting to know. Not sure if it is the choline, tryptophan or huperzine A but I have been getting some muscle tremors this week. Not seeing it as a bad thing yet as neurogenic tremors are believed to be how the freeze response is released in animals and humans, the only problem being we are told not to tremble/shake from a young age as we look 'weak'. 

 

Haven't seen a dr regarding the stomach no, it isn't a huge issue that they would pay any notice. I just cant eat for the first few hours of the day and a big meal sits for ages in my stomach. 

 

I have been upping my meat and tryptophan intake of late as well. If the Serotonin theory has any truth, it makes more sense to increase your own stock than take an SSRI that only makes use of what you have. 

 

"I truly think there isn't a "cure" for this condition as it stands, but rather a series of small actions you take every day over the course of years that can slowly nudge the nervous system back into a state of parasympathetic dominance" I completely agree with this as well, we dont have a magic pill yet that targets this system specifically so it is a matter of doing lots of little things towards the PNS being activated. 

 

Yeh the SES makes perfect sense to me, and eye contact is an issue even though I try very hard to fight it and be engaged socially and make eye contact it is just extremely difficult. Weirdly on Sunday night I had dinner at my girlfriends parents and was engaging as usual but felt spacey in a way that I havent before. It was honestly hard to tell if the derealisation was becoming better or worse. Things looked more 3D and my field of vision was widening but it was also strange, unsure if this because social/visual parts of the brain that had been offline for so many years were becoming re engaged or what was going on lol... I am taking it as a positive though and as a sign that choline, tryptophan and more protein in general is helping me make those calming neurotransmitters serotonin, acetylcholine and GABA etc



#8 Billy D.P.

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Posted 02 December 2019 - 02:00 PM

Yeh the SES makes perfect sense to me, and eye contact is an issue even though I try very hard to fight it and be engaged socially and make eye contact it is just extremely difficult. Weirdly on Sunday night I had dinner at my girlfriends parents and was engaging as usual but felt spacey in a way that I havent before. It was honestly hard to tell if the derealisation was becoming better or worse. Things looked more 3D and my field of vision was widening but it was also strange, unsure if this because social/visual parts of the brain that had been offline for so many years were becoming re engaged or what was going on lol... I am taking it as a positive though and as a sign that choline, tryptophan and more protein in general is helping me make those calming neurotransmitters serotonin, acetylcholine and GABA etc

 

In my experience nutrition and healthy eating habits as well as natural medicinals have been probably my greatest ally in getting healthy again. I've just noticed such a substantial change in my overall mental health and depersonalization since eliminating fast food and learning to cook and targeting organic vegetables and proteins as well as herbs that promote neurogenesis.

 

That said, there's an increasing body of research that seems to point to human connection as vital as anything for health and recovery. I know it's scary but if everyone with depersonalization was enrolled in talk therapy and did yoga, massage and basic socialization on a frequent basis I really feel like we'd see more optimism on these boards than anything. 

 

One thing to keep in mind that both polyvagal theory and developmental psychology tells us is that for those who suffered early traumas and were raised in households that weren't always safe is that our nervous systems essentially can't tolerate stimulus. Whereas normally people who get excited in some way experience a rush of pleasure, childhood trauma actually wires the brain to shut down in fear. So for example if you find yourself struggling in social situations perhaps notice what's going on in your body, when you shut down, if you have any precise triggers, etc., and whether the shutting down or checking out or dissociating is occurring at the height of a need you may be fulfilling. I know this is certainly the case for me. I've always been prone to shutting down and dissociating when I should be most happy. Again, this is just a natural adaptation you had to make as a child to survive by essentially always being on guard and looking out for yourself because your needs weren't met. Not saying this is true for everyone here but it certainly could play a role for some of us. 



#9 Mayer-Gross

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Posted 02 December 2019 - 08:02 PM

 I'm simply trying to point out that anxiety is a major trigger in this community and even a cause of this condition and that if people are better able to understand fear and how their own nervous system operates that they then may be able to calm themselves or regulate their nervous system better. 

 

 

 

That anxiety is central in the development of depersonalisation, particularly panic, have been used for a model partly based on brain imaging studies of depersonalisation disorder for the last 20.years. They started with a model called "front-limbic" where parts of the prefrontal cortex suppresses the amygdala due to high levels of anxiety.In the model the cost of this suppression is inhibition of insula cortex and the sense of a lost self and emotional numbing They used to start with the medial prefrontal cortex as the prime suspect for this mechanism but later changed to the right ventrolateral prefrontal cortex. The medial prefrontal cortex can express dynorphins to inhibit the amygdala but also parts of the reward system and give a state of anhedonia. It might explain why some sees a benefit from opiopate antagonists. The ventral prefrontal cortex might not by itself regulate emotions but signals to the rest of the prefrontal cortex the need for emotional regulation- so it can activate the medial prefrontal cortex. I have Stephen Porges book. Used heart rate variability biofeedback for a long periode 5.years back. Porges is wrong and his model has been tested in depersonalisation disorder. I don't think this methods can be used in depersonalisation disorder to remove this suppression from the prefrontal cortex but if they are normalised with rTMS you can use them to establish more new networks that are not so defensive as depersonalisation is.https://www.ncbi.nlm...les/PMC4864622/



#10 forestx5

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Posted 02 December 2019 - 11:00 PM

"the "rest and digest" aspect of our nervous system was completely severed, perhaps through neuronal excitotoxicity, perhaps through some kind of hormonal flooding, who knows. "

I cast my vote for genetic switching.  Psychological trauma causes a gene or genes to turn on, or off.  This causes the loss of, or changes to, a neurological process.

One normally thinks of the body's reactions as being helpful to survival.  That's not always true.  If a plaque in a coronary artery ruptures, the body rushes clotting agents

to the site of the rupture, causing thrombosis.  What was once a minor issue, is now a fatal heart attack.  Thanks for nothing.



#11 Jason39

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Posted 06 December 2019 - 07:56 PM

28 years ago I has an emotional trauma that resulted in permanent dp and eventually depression and anxiety. However, I think I also have vestibular issues which either took over from that trauma  and cause my dp or just contribute to it, unless that trauma itself caused an inner ear problem.

 

When it first happened I was 12 and not knowing what panic attack and dp was it was so severe that I felt dysesthesia-like pain (electrical feeling) lasting for a long time. I still often experience it. I should have seen a good ENT/Neurologist long time ago. I did see a couple of quacks who put it all to my anxiety.

 

That feeling 9dysethesia) and dp would worsen from cigarette smoking, moving my eyes too far to the sides and especially gets extreme if I smoke weed or let's say if I stimulated inside of my right ear with my finger I would be debiliated and unable to function (would have to lie down all the time) for days due to 100% dp and extreme dysethesia feeling.

 

Lately I even avoid coffee. I found that amphetamines help a bit.



#12 forestx5

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Posted 06 December 2019 - 11:34 PM

Developmental trauma?  Hard to argue with that.  I don't believe one becomes healed from acknowledging it.  I relived my emotional trials many times, to no great benefit.

One cannot go back and undevelope and then develope differently. But you can spend a lot of money at $75 an hour trying. 

But who knows?  I battled it all of  my adult life, and age wasn't making it any easier.  I felt pretty sure I would die by my own hand when I could offer no more resistance.

Then I had ECT.  They don't know why it works, but it is the most efficient treatment for depression related disorders.  So I offer an analogy to the personal computer and

application software.  You are working along in your app, and you get hung up.  Things aren't responding and you've lost control of the program.  What do you do?

Pull the plug and wait a few.  Plug it back in and set the boot strap code in motion.  End the dysfunctional processes and begin processing anew. I feel like that is what happened to

me with ECT. But, if polyvagal theory is your bag, and your medical insurance covers it, and you can afford the co-pays, then have at it.






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