This stuff worked for me and my assumption in sharing this information is that you're like me. It's possible you're not, but something tells me that you are based on getting to know other DP sufferers by reading posts. Please read this with an open mind.
I feel like the unfortunate thing is a lot of times when people no longer need to go to places like this, they vanish. Once you're cured you want to move on right away from the dark place you were previously stuck at. So I feel the need to share at least what worked for me because I know DP is like being in a darkness with no light in sight and how bad the suffering can get. I also know DP can fuck up your ability to focus and digest large chunks of information
So here are my best cliffs notes wisdom in bullet-point form:
1. modafinil + mirtazapine is a great drug combo bandaiding this illness. I am now off of this combo, but I don't know how I could've coped with life while actively going through DP without it.
2. propranolol was great for my panic attacks. I had them in social work situations that would be awkward to leave or when presenting. This drug at only 5-10mg was a life saver
3. Sleep apnea may be preventing your recovery by messing up some emotional/identity integration that happens while you sleep. Also, I was initially misdiagnised as only having "mild" sleep apnea and was told it's better not to treat it due to the inherent difficulties you trade off using CPAP. I don't think I reached deep sleep during an in-lab study and I suspect the at-home study I had showing that I had severe sleep apnea was more accurate, because getting surgery for sleep apnea changed everything
4. DP (for me) was probably caused by unprocessed trauma, denial, and some level of self-deception that I felt I wasn't strong enough to cope with as well as getting stuck in a nihilistic/solipsistic void
5. "Chronic inflammation" is probably a multiplier for the severity of DP as anything that lowers systemic inflammation seems to also treat DP
6. Look up 'lifespan integration therapy'. I think this works incredibly well for unprocessed trauma. Writing a personal auto-biography like Harris Harrington suggests also helps structure and integrate your unprocessed trauma into the narrative structure of your life which is important for self-concept
7. Self neglect makes things worse. Practice caring for yourself. Figure out a way to consistently practice this (especially going easy on yourself)
8. Find your inner-voice. Some point in having DP I lost my inner monologue and as crazy as it sounds it's useful to speak outloud, know what your voice sounds, then internally sub-vocalize using this voice. I feel like it's something I had to "re-train" myself to do
9. Have faith in yourself. You're probably pretty smart person and not only that, but if you let other people do your thinking and deciding for you you won't grow out of this. You have to learn to be strong enough to trust yourself. Trust your inner wisdom. Trust your intuition.
I suspect the root cause of the severity of my symptoms came fro severe sleep apnea (40+ events/hr), I suspect that chronic shitty sleep causes our emotional/identity integration systems while we're dreaming to shut down or significantly dysfunction - I've been in awe at the amount of dreams and emotional processing that I've had since I got a surgery that brought my sleep apnea down from 45 events/hour (tested) to 5 events/hour (tested). The insidious part of this condition is I think that it co-developed with DP and both exacerbated each other creating a positive feedback loop to hell. The second half of how insidious it is is I had previously ruled out sleep apnea due to the fact that I had "only" an AHI of 10 in an in-lab sleep study, but in a home study (pulse oximiter + chest belt + nasal cannula) I was able to actually achieve deep sleep where the apneas really showed themselves. I also was not significantly overweight when I believe sleep apnea got worse in my life (5'11" 180lbs), but eventually I gained 20 lbs which is also a positive feedback loop with sleep apnea making things even worse. It's also very hard to lose weight weight sleep apnea even without the addition of dealing with DP and anxiety.
I should also mention that coincidentally I am an HSP(https://hsperson.com/); credit again to Harris Harrington for figuring this connection out. I know mentioning this may trigger some as it sounds like some unscientific self-help categorizing somewhere on the spectrum of meyers-briggs to zodiac signs, but please approach this with an open mind as it may be just coincidence that you fit this category as well as I do. I think DP happens to people that are similar in a lot of ways and it may literally be the equation: interpersonal unprocessed trauma/codependent relationship + sleep apnea + high sensitivity. There may be other "types" of DP since I suspect there are other ways that emotional processing at a deep-brain level doesn't happen than being things being "stuck" with sleep apnea.
There are different "levels" I had to work on to deal with this psychological illness:
1. Practical - how to survive while dealing with these issues: DP, panic, anxiety, depression, and fatigue
2. Inter-personal - I had to go into my subconscious and do work, particularly trying to figure out what I was in denial about in regards to my identity and my relationships
3. Emotional strength - I had to become a stronger person so that I could cope with the parts of life some part of me felt I wasn't strong enough to face
4. Spiritual - I grew up Christian. As with many millennial stopped believing in my late teens and had to deal with the void by making my own "map" of reality and learning from the wisdom of others while figuring out a reason to live and have meaning
5. Health - sleep apnea, trying different medications for depression anxiety, fatigue & other issues that sleep apnea causes (blood pressure, low GABA; etc.)
7. Had to find the courage to face what I was in denial about
If you're looking for a drug band-aid, then I recommend mirtazapine + modafinil. At least for n=1, me, I think this combo helped me cope way more than the many many other psych drugs/supplements that I tried. Ideally, you get to the root cause, but I wasn't severely traumatized in my life and I am not ruling out the idea that some people have been through things that are too difficult to face. That said, I think people are way stronger than they think and the demands of life, if you choose to cope, while dealing with this condition make you a very strong person. I suspect I will be able to deal much better with the death of my parents or any other tragedy or coping with something like terminal cancer because of the growth that has been forced on me. I've simply have so many more tools in my toolbox now to cope with life.
A note on negativity:
People on here are suffering terribly. Sometimes people don't realize how they affect others when they are in catastrophic pain. As such, I've noticed that sometimes the tone of this forum can be very negative which I think people don't realize can turn into a self-fulfilling prophecy of not reaching a "cure" state. You HAVE to have an open mind to open doors you haven taken: if you keep doing what you've been doing you'll get what you got.
A note on faith:
An antidote to the above is having unwavering faith that you'll find your cure. You know this to be true because this the positive inverse of the above (people having "faith" that they're stuck in this illness). People want to think they're rational, but is it not logically equivalent to assume you'll find your cure as to assume that you won't.
Goals & Health
Even if you are a Taoist, I believe in the need for setting goals. Something to do with the rewards circuitry of the brain which seems to oppose depersonalization/drealization. It is humanizing and empowering to set goals, work towards them, and achieve them. And it's very self-empowering to be a success while coping with the heavy blanket of this illness. You feel really good about yourself when you see yourself making progress and then achieving your goals even with this illness.
1. Something gets lost when people go from religious to atheist. I am not anti-rationality, but I think if you watch Jordan Peterson's Bible Series he points out the baby we threw out with the bathwater. To the best of my knowledge I believe Jordan Peterson is an honest intellectual trying to understand the truth, so for people worried they won't gain something out of this please have an open mind because it is all about how religion is something self-selected by evolution and contains abstract truths that don't require blind faith. I think you need to fill the void. I originally did with Taoism/Buddhism, but in the end I've developed my own "map" of reality through piecing together truths from many different domains/perspectives
2. It's highly possible you're a codependant aka you had to mold your personality to adapt to one or both of your parent's pathologies and codepedency = self-neglect which can lead to DP since you dissociate from the "invisible" self-harm you're doing to yourself. Truly emancipate yourself from mental slavery. Read books, listen to audiobooks, watch youtubes on codependancy
3. Running/cardio seems to treat DP over time by 1. providing a meditative space for the subconscious to integrate with the conscious 2. through bringing balance to the endocannabinoid and kappa-opioid systems
Shame and Committing Evil
Just because you're an atheist doesn't mean your superego goes away and it's easy forget that you're carrying the burden of sin when you're an atheist. Meaning, you may have suppressed guilt which is aggravating DP because you've been in denial that you're a person that has done bad things. Apart from asking god for forgiveness sometimes you have to forgive yourself and the universe will forgive you if only to stop you from doing more evil. I suspect that there is religious circuitry in the brain so the equivalent thing to do would be to express silently your apologies for the things that you've done wrong to the people you've wronged and admit that you're a flawed person, which is true for everyone, and that you promise to be better over time.
The Machinist (movie - watch it!!) makes a great point about the above. It can also explain why even if you don't have sleep apnea you don't sleep well for the same reasons he does.
Remember, it's just a ride - https://www.youtube....h?v=KgzQuE1pR1w
I'm getting tired so I'm going to stop writing. Sorry if this is disorganized. I have so much more info so if people find value and want more in any specific area I am happy to write more, but I will only write more if it vibes with people.
Other important note: I did take LSD once while I was deep in DP. I figured that I was already fucked and my life was hell so why not try anything even if it's drastic. I think LSD permanently made me more open minded which helped me consider things that I hadn't previously considered which lead to me trying things, switching if they don't work, and trying some other random novel thing until I found my cure. So LSD overall did help. I also think marijuana/psychedelics can reveal the unconscious which can throw someone into a traumatic condition like DP or ... "when you're going through hell...keep going". I actually vape weed (1:1 THC/CBD) after my cure because I think it helps me heal even more. People may hate me for saying this and it may not work for you.