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DR not really correlated with anxiety

obsessive thinking derealization SSRI

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#1 Trith


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Posted 01 January 2020 - 08:36 AM



I have been having derealization for 20 years now, and some depersonalization mostly in the first 10 years and it tended to fade away.


What is puzzling me is that the vast majority of people say that their symptoms are correlated with anxiety or terrible panic attacks, and it doesn't seem to be the case for me. I do have a tendency to be anxious, and at times I have had really bad anxiety, like a few years ago when it was so bad that my immune system shut down, my digestion stopped completely for 2 days, I felt cold non-stop or some times I was so anxious that I thought I could  not survive this. And at other times I felt no anxiety at all, everything was manageable, I felt very ok. And in both these kind of circumstances my derealization was absolutely constant. Anxiety did not make it worse, and absence of anxiety did not make it better.


But some things have helped me recently. I have been on Sertraline (SSRI) for 4 days, and I felt like my derealization was almost completely gone. I had to stop because of too strong side effects though, and some mild auditory hallucinations. And so the derealization came back. I am now on a low dose of Risperidone and Lithium, and the derealization is just slightly lower than normal, but barely noticeable difference.


I realized I have a kind of obsessive way of thinking, where every thought I have comes as a form of imaginary conversation with someone. Every thought I have, all the time. I realized this was a kind of way to imagine having acknowledgment (or recognition is the right word?), and one day I tried to take each thought that I was having and just put it back in context of this need of acknowledgment, that this was all imaginary, that the real meaning of the thought is a need of acknowledgment. As I did this, I felt a very strong rush of "re-realization", like a flash. I have never had this before in all this time. But then it was gone and impossible to make it happen again. I had another rush like this in another similar circumstance but it is maybe a story for another time.


I am kind of annoyed that I don't have obvious anxiety reasons to focus on to get rid of the DR. I was wondering if anybody had something similar (no correlation with anxiety) and I would be interested to know if you too have some kind of obsessive thinking patterns, and what helped you.

#2 seven


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Posted 01 January 2020 - 12:21 PM

Yeah same. It may be related to serotonin. Could be low or just synapses doesnt work right and fe feel disconnected.

#3 Midnight


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Posted 04 January 2020 - 07:57 AM

I find it very hard to accept that DP/DR is not correlated with having an anxious disposition. 


I've never seen a very confident extroverted person with little to no social anxiety who had depersonalisation. 


In fact there tends to be a strong correlation between these phenomena: 




^ That's not the only place that I've read about this connection. 

#4 Aridity


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Posted 04 January 2020 - 08:10 AM

That you don't experience Anxiety now does not mean it's not caused by anxiety. I believe it is,if only you have experienced immense amounts of anxiety stress panic the switch can be turned on.. only to never be switched off...

#5 Trith


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Posted 04 January 2020 - 09:47 AM

You are right. In general there is a strong correlation between DP/DR and anxiety, and it is hard to think that the fact I have had anxiety too in the past is just a coincidence. A few months ago a therapist told me that I could have anxiety and not really recognize it as anxiety because I have been having it for so long that I adjusted my standards. This could be true but at the same time it is impossible to verify.


Where, what is this pill that can start digestion again? I haven't had this problem in years, and I hope I will never reach that point again, but I am just curious. Last time I had that I relied on a big glass of vodka and it seemed to work.

Also you say you have imaginary conversation, I am very interested (or if anybody else has the same), is it something constant too or is it just in some circumstances? And what kind of thought is it, back and forth argument, explaining something, trying to prove something? Do you know what do you "look for", in general, with these thoughts?

#6 Phantasm



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Posted 04 January 2020 - 10:20 AM

I think it would be unusual to have obsessive thoughts that didn't at least begin with stress and anxiety, and I agree that you can become so used to stress you no longer recognize it as abnormal, but I also think obsessive thinking can take hold, and it then continues to generate stress by itself.


So we might not even be thinking about DP/DR or anything anxiety related as such, but because we are obsessing about something, it keeps our minds over-worked. This might explain why some people no longer think about it but still feel unwell.


For me it was always like I had this proviso, this one or two issues, that if I can just figure them out then I'd be able to move on, not realizing that it was only the obsessing itself that was keeping my issues alive.


If we once felt under threat, it's understandable why we would be reluctant to let go of all obsession (just in case) but when you become aware that it might be obsession itself - any obsession - that might be the cause, we can hopefully let go more and more of those attempts to control everything with our minds. I certainly recognize that conversation with yourself you described! That revelation you had I also identified with, as I had one similar with the thought, "Don't let anyone ever tell you you don't matter," as I think they both relate to self-worth, which can be very core to mental health matters because people with healthy self-esteem tend not to constantly question themselves.

#7 Trith


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Posted 07 January 2020 - 05:02 AM

Thank you for your answers. I have already heard a therapist tell me that, that she couldn't see any other origin in obsessive thinking than anxiety. It might be true, but I would tend to think that any emotion could cause obsessive thinking. I could think obsessively out of anger, for example, or excitement, loneliness, lust, mania... I have a friend who is obsessively thinking about his ex because he wants to figure out the reason why it didn't work. This feels to me more like a grieving stage and not really anxiety. Although it could be a bit of a self worth problem, which in a sense would be related to anxiety.

But anyway, I watched the following video a few days ago:



Where this little guy explains how for him DPDR is part of anxiety and cannot be an independent disease. I did not feel any anxiety at the time, but I tried to imagine that because I have derealization right now it must mean I have anxiety, and I tried to actively look for anxiety. This caused me to become anxious (anxiety without any obvious object) and at the same time it reduced my derealization. It was very interesting to find this out. As if part of my derealization was anxiety in disguise, or part of my derealization was hiding anxiety. It would make sense, because derealization is often explained as a way to avoid anxiety and still function in emergency situations. But I think I prefer anxiety.


And about self worth, I am exploring in therapy how I have dissociation in my life in different situation, how I can sometimes have imposter syndrome at work (so I act like an adult outside, but feel like a child inside), or how I try to please others instead of relying on what I truly want (which I sometimes can't even see) so it is like giving the controls to others and disembodying myself. I don't know if this has been helping with respect to derealization so far, but I hope it will.


And same with the obsessive inner conversations. I also voice them a little sometimes, or I make some facial expressions that go with the fantasized conversation. I like to think that I do this mostly when I am alone and I hope it is true. Right now the obsessive thoughts are quite strong for me, and it is almost like voices in my head, that I can't control, although I know it is in my thoughts only. Some recovered people often advise to "stop thinking about it", but for me it happens on its own, constantly. It is really difficult to redirect my attention away from it over and over. All the more that I am usually too out of touch with reality to have anything to redirect my attention to, everything seems like a thought.

#8 axegrinder



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Posted 08 January 2020 - 06:02 PM

I think DP is absolutely correlated with anxiety, but for me at least, DR seems to be something on its own. Its almost a pseudo hallucination state. I've had DR before without any anxiety whatsoever. 

#9 Trith


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Posted 10 January 2020 - 11:45 AM

... I don't understand the lack of skepticism in that video. Maybe it's emotionally based.....


I relate very much. This is something that tends to get on my nerves everywhere people talk about DP. It looks like more than half of the people who recover have zero doubt that absolutely all people who have DPDR have the exact same thing as them and should use the same solution. Then there is the fact that they consider themselves as teachers who's job is to kick people's butts to help them recover by telling them the "truth" about DPDR. It almost sounds like they consider themselves as grown ups while people still struggling are (stupid) children. I don't think I see this happening with anxiety or depression, for instance. And it is so frequent around DPDR that I think it might be related to the personality type who is prone to get this disorder. It certainly happens to me sometimes that I think I came up with the brightest idea/project that changes the world, only to dismiss it some weeks later. It is like believing too much in the power of my mind.


Anyway, I try to still listen to these people, as they often say things that help me, but it is often hard to put the problem aside.

#10 Cedric


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Posted 10 January 2020 - 02:39 PM



I think that, at least in the cases I'm familiar with, DPDR is caused by very strong or persistent anxiety. This makes sense because biologically it's just a defense mechanism, to make you endure and get through dangerous situations well.

But I also think that in some cases of persistent DPDR the cause can be something physical, like low testosterone or epileptic attacks. This of course requires a different approach, but I think it's more rare.


For anxiety based DPDR the generally accepted solution is to lower the anxiety, either trough therapy and/or medication, though it also seems to be strongly influenced and maintained by obsessive thinking (which is something common in most people here)... which makes things complicated because even without acute stress the symptoms stay for a long time, either real or placebo, because of obsessions. For some reason.


Still, the solution is to lower and get rid of anxiety. If that doesn't solve it, it might be something other than an anxiety response.

Also tagged with one or more of these keywords: obsessive thinking, derealization, SSRI

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