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#619862 Review of brain imaging studies and dissociation published until today.

Posted by curiousmind on 24 July 2020 - 08:47 AM

A well written, refreshing and much needed study indeed. The most important highlight perhaps being the conclusion that "dissociative processing cannot be localized to a few distinctive brain regions but rather corresponds to differential neural signatures depending on the symptom constellation." There is much talk on this forum among us about whether or not our experiences are uniform. According to this study to some extent it is true that we share similarities in our experience and accordingly in our neurophysiological alterations from before-DPD, but indeed it may be the case that we also share striking dissimilarities and peculiarities in both our experience and correspondingly our neurophysiology. Admittedly in the past I have been outspoken about the uniform experience/neurophysiology hypothesis, but in the wake of new evidence I must adjust my stance and shift my understanding. But amidst the wake of this new information, the authors of the study still uphold the uniformity and relevance of the fronto-limbic dysregulation theory—a similarity that based on current findings we do share.

#616462 Modafinil Experience

Posted by curiousmind on 26 March 2020 - 08:52 AM

TLDR: Modafinil does something for my DP. 


I don't intend to write up a detailed review about modafinil, but I will say a couple of things.


So, I recently had the opportunity to meet a couple fellow DP-ers from this forum (wonderful people), and one of them happened to have prescription MODIODAL pills on them, he was prescribed the substance by a doctor. I do not condone my following action, don't do this but I'm stubborn so I asked if I could give it a try. (you guys are aware how experimental treating DPDR can be, and psychiatrists in my vicinity do not know much about this condition, and laws here are pretty strict, not much leeway in what they can prescribe you). But anyways, he said sure, he doesn't intend to use it any longer so he gave me whatever he had left, so 8 pills in total (pls don't take drugs from strangers tho). 


Disclaimer: I do not condone the use of illegal or legal substances that were not perscribed, this is very stupid. That being said I have done a lot of research into this compound, I will link the relevant studies below for information purposes. I informed myself as to the appropriate dosing, the less-well-understood mechanism of action, pharmacology and followed the necessary safety precautions. 


Anyways, I gave it a shot, first carefully upping my dose starting at 50mg the first day. I did this to test whether or not I was allergic to the substance, or whether or not I would develop a rash from it (one that could be fatal). After day 1 I felt nothing, no effect whatsover from 50mg, positive or negative. So I decided to up my dose, at 100mg I still felt nothing. 


It was when I tried 150mg that I could notice something happen to me. I sat down to read a book, and the first thing I noticed ~1 hour after taking 150mg, is a profound sense of euphoria, felt like a come up. Soon after I started feeling very on edge, everything began to look more sharp, lazer focussed feeling. I was a bit overwhelmed initially, but tried to keep my calm. It wasn't a bad feeling per se, most definitely tolerable, but I just experienced a shift in my state of consciousness that I was not expecting. The day went on, and it passed by really fast actually. Whatever I put my mind to, I felt more focussed and engaged. Things like reading were more engaging, and getting work done didn't feel like a huge chore. I stayed on this 150mg dose for a couple of days, and I haven't been as productive as I was on modafinil since getting a DPD diagnosis. Also, the jittery anxious feeling didn't happen anymore after my first dose of 150mg.


I had 250mg left yesterday, and I decided to take it all in one go. I took it on an empty stomach as usual, and as I expected, in about an hour I could feel the effects, and like the first time, a profound sense of euphoria hit me. I was super motivated all of a sudden and so started doing my work. The energy this thing gives you is fascinating, the focus you get from it is truly astounding, and a mental clarity is also felt. I did however stay up until 3 am last night, but this is because I woke up late, I took my dose at 9:30. It was as if I drank 15 cups of coffee that day, but without the physical jittery side effect. 


Conclusion: what does modafinil do to my DP?

The main benefit of modafanil for me is increased concentration and focus. It is hard to assess this one, but I did feel that my working memory was better as well. I don't usually like to think of my DP state as one related to brain fog, but if I have any brain fog at all, then the modafinil definitely seems to help with that.

The aforementioned effects are pretty much expected, this is what the drug is supposed to do and does do in even healthy patients, but modafinil seems to affect my DP in some incomprehensible sense, it is difficult to put into words. It is not a cure for me, it doesn't fix my sense of unreality, but it does do something to it. Visually things look more sharp, I had a better sense of spacial awareness and things of that nature. That being said, I was not as self-conscious and self-reflective while on this drug, so I barely noticed my DP at all, especially on 250mg. I only saw the task that was ahead of me, my mind didn't wonder off at all to check in on how I feel.

Interestingly, I also felt more negative emotions during my experience, especially at the higher dose––which is inherently a good sign if you ask me. I do believe that behind the layer of my DP I am emotionally exhausted and so these negative emotions were sort of surfacing during my experience. For example, I felt embarrassed in front of some people I was talking to yesterday, and I could feel the shame/shyness in my body––something that I do not sense at all in the midst of my DP. 

In terms of side effects, I didn't feel any, though I did lose all interest in sex. This is likely just because I was so immersed in other activities. 



One thing to keep in mind is that I took the modafinil intermittently, not continuously one day after the other. It was more like whenever I felt like it, or when I felt that I woke up early enough. If I woke up after 9am I would be reluctant to take it, because this thing has a long half-life, it has its effect on me for 10-15 hours depending on the dose. True enough, the 250mg kept me up reasonably late. Moreover I only had 8 pills at my disposal, so I cannot say how this thing would affect me long-term, I do think though that this is a drug that is to my benefit, and it is a pill I would take if I was prescribed it. In the studies where modafinil helped with DP symptoms, it was used in a long-term window [1, 2]. 


The research

The research is scare, there is no large studies testing modafinil's effect on DPDR, in fact, there are no published trials, only reviews [12]. As such, we are left with mostly anecdotes, and my testimony likewise fits into this category. 

There is a scarcity of studies concerning modafinil in general. There is some indication that it affects mechanisms in the frontal lobe and the hippocampus that are involved in reinforcement learning (norepinephrine and dopamine are somehow involved, yet the substance is said to have a fairly distinct mechanism of action from other stimulant drugs such as amphetamines like methylphenidate [5] and we know that when used, patients with depression make decisions more efficiently and effectively [3]. 

Based on the research and my personal experience I would say that if you are struggling with attentional issues or are hypo-aroused, then this could do something for you, but don't take my word for it, of course, always consult a professional about whether or not this is something you could/should be taking. 

One last question that remained in me was why did I feel closer to my emotions on a cognition-enhancing substance? There was a study recently published that said in relation to modafinil that "cognitive enhancing effects in the absence of effects on affective processing suggests a promising potential to enhance cognitive control in clinical populations" [4, underlining added].  So somehow, it is presumed that the substance affects prefrontal regions in relation to emotion regulation, and as suggested by the DPDR literature this condition is very much related to over-regulation of emotions (overactivity of prefrontal regions). 

#616074 London interview request - MA project to raise awareness for DPDR

Posted by curiousmind on 14 March 2020 - 04:47 AM

I would love to volunteer, unfortunately I do not live in the UK. Maybe we can have a skype/facetime interview, if you are open to it.

#615072 Mark Huddon on psychadelics and the youth

Posted by curiousmind on 20 February 2020 - 02:39 PM

"I ask Mark Haddon, the executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS) Canada whether kids and teens can safely experience psychedelics. And if so, then what would the minimum age be?"

#614932 My recovery story after 7 long years thanks to john of god Faith Healer

Posted by curiousmind on 17 February 2020 - 12:02 PM

Brazil 'spiritual healer' known as John of God jailed for 19 years for raping four women


#614878 The No-Cure Model

Posted by curiousmind on 16 February 2020 - 02:57 PM

Very well put, I have had this idea many times throughout DPD only to go back to finding the magic supplement. Recently I have been tried meditation again, as a method to tune down the task positive network. I think in that there is a sense that something needs to be done, understood, fixed and changed. I have hypothesised that this network may be overactive, particularly in my form of DPD. I am constantly fixated on understanding and finding the cure, and constantly interacting with objects in my reality with that negative premise.

I don't think this is a "you thing", rather that this is very much so a DPDR thing; my experience has been that what you just described is in and of itself a symptom of this condition, or the barrier, if you will. We are looking for an answer that doesn't exist; we are looking for something that we will not find. This state of stress (and though you may not feel it, this is definitely is a state of stress) is perpetuated in the knowledge that we feel something is not right, therefore we keep going back to find the cure, to find our way out of our demise. We are symptom-focussed. The research paper by Hunter et al I think really did hit the jackpot. Why do I think this? Because those who recovered and come back to share their stories all say the same thing over and over again (I have studied this extensively). They all say they accepted the condition first and foremost, allowed it to exist, moved on with their lives, tried doing all the things they did before without an obsessive watch over their symptoms, and after some time they felt back to normal. They didn't do anything, there is nothing we can do, its a subconscious disorder, we can't do anything consciously to "redeem" us. "But how do we really know they really recovered"; "but how do we know they even had this disorder"; "but how do we know they had what I have"; "but what if we had different symptoms"; "what if I don't even have DPDR"; "but my brain is damaged" --> these sentences are the blocks, the veils, the dams between us and recovery. Just listen to those phrases, they come from a place of doubt, a place of uncertainty, a place of fear/anxiety. 

#614870 The No-Cure Model

Posted by curiousmind on 16 February 2020 - 08:46 AM

There are many ways of knowing. A branch within philosophy, epistemology (theory of knowledge) is a discipline that deals with the question of knowing, and how it is that we as humans can come to "know things" about the world and ourselves, to put it simply. It is very easy for many of us who come from a well-educated background to only believe hard-facts, scientific studies based on "conclusive" findings. However, if you look at it from the branch of epistemology, a scientific way of knowing is not much different than a religious or spiritual way of knowing—in essence both require faith and both are belief systems at the core, never-mind the substantive component of these beliefs. In the latter you have faith in that a higher-being, a metaphysical force, a God is taking care of you and the universe around you, and you use this belief to explain certain things around you in your life, whereas in the former, you have faith in that a.) the scientific methodology is legitimate, that b.) the conclusions of scientists, researchers and scholars is valid and true (whatever these things really mean) and c.) faith in that those who are in the authority to teach us things about the world are indefinitely right. Many like to radicalise the two ways of thinking, one is usually thought of as the rational way, and the other is thought of as nonsensical by many of us today. However this polarisation is just an illusion, the receiver of either ways of knowing is subject to the same biological process in the brain when it comes down to that knowledge becoming stored in the mind and filed to enhance the way he/she sees the world.


Many of us with Depersonalization-Derealization Disorder (DPD) are trapped in the belief system that there is no way out, and that we have this condition forever because the scientific studies are inconclusive and they have not yet found "The Pill". I would like to refer you to the following (recently uploaded) video by Julian Cowan Hill who is a psychotherapist and tinnitus expert. In this video Dr. Hill introduces us to- and demonstrates to us the "No-Cure Model", and how this way of interpreting our experience is hindering our well-being and recovery. Julian Cowan Hill is a psychotherapist in London but primarily deals with patients who have tinnitus—a neurological condition—and he makes the sound argument that tinnitus is perpetuated by a loop of anxiety, more specifically the fear of permanence, the fear that you can never get better and that you will have this condition for the rest of you life. This unfounded belief system is what is thought to be perpetuating DPD as well as theorised in a 2003 study by Hunter et al. Many of us experience these symptoms, are terribly frightened by them initially, and then we come online only to find that "there is no cure", which falsely enforces the idea that there is no way out. Now, many of us have had this condition for years..."and I don't feel anxiety". It is the very veil of DPD, the very nature of this condition to mask and push-out of our conscious awareness the fears that we have been consumed by for so long (reference). I would encourage you to listen to what Dr. Hill has to say. 


Let me finish off by saying that thoughts are dangerously confused with reality. Thinking that something is true, even being convinced by our internal compass that something is true, does not make the substance of that thought true. I encourage you to question your belief systems, I encourage you to rethink how you view this condition, and I wish you all the best for recovery. It is possible, many have come out of this condition, what is your evidence that you won't too?

#614786 Question. Theories?

Posted by curiousmind on 15 February 2020 - 05:34 AM

"CONCLUSIONS: These results suggest altered cortical representation of afferent signals originating from the cardiovascular system in patients with DPD, which may be associated with higher sympathetic tone. These findings may reflect difficulties of patients with DPD to attend to their actual bodily experiences."


^This statement is key from this study, and I wish many more people on this forum read this study. A higher sympathetic tone corresponds to what some would call an elevated nervous system response, or anxiety, yet in DPD patients still feel hypo-aroused because they cannot "attend to their actual bodily experiences". This means that though you may not feet it, you are actually in an anxious state. This is also to say that many on this forum say that they "do not feel anxiety, therefore they are not anxious", yet it is the very veil of DPD to not bring feelings which are interpreted in the insula (like anxiety, and any other feelings) into conscious awareness. I really like this study. There are other studies that build on the idea that anxiety is perpetuating DPD symptoms.


More pertinent to your enquiry however, your reaction to medicines/supplements is likely related to anxiety or suspicion of them; discomfort in the knowledge that you have put something in your body not knowing what they will do to you. This makes sense based on what you're saying about your symptoms getting worse: "even trying to speak or communicate to someone becomes harder, as I struggle to put together a coherent sentence." Supplements should not have such an effect on you, and if you have an adverse reaction to medication then you should consult your health care professional on what he thinks you should do. Ultimately, if you feel better without meds, then don't take them. Most people who report full recovery actually didn't use medications, but then many also recover with medication, or report feeling significantly better with their support. It's really individual based on what you feel works best for you.

#614746 zyprexa/olanzapine is awesome (at least for me)

Posted by curiousmind on 14 February 2020 - 10:41 AM

I am always upset when people say that "you have DP/DR because of anxiety, trust me, you don't have schizophrenia"

I get where you are coming from, but if you have primary DPD then you do not overlap with schizophrenia. This isn't an opinion, rather this is well established taxonomically in the clinical literature. The medical sciences are not perfect (no academic discipline is), however mental health has been a topic of clinical analysis for centuries, and there are old folks in their labs and offices researching, reading, writing, testing and debating clinical phenomena. If you do a bit of reading into it, you will find a long history of literature about DPD that started in the late 1800s. These "old folks" are professionals who have made a clear distinction between schizophrenia and DPD in terms of formal classification but also the implicated brain structures as a result of investigation and debate that took more than a hundred years long. They emphasise that there are many differences, but a key differentiator between the two disorders is reality-testing, that of which is impaired in schizophrenia but functional in the DPD.


Now, this isn't to say that you cannot develop schizophrenia just because you have primary DPD, because I agree with you in that you potentially could just like anybody else including currently healthy people. But it is very likely that you will not.  This is clear from the epidemiological research. Your chances are the same as a healthy person, and thats the point. Just like with anything in life that becomes subject to analysis there are always outliers, there always exist abnormalities and cases that don't lay on the trend-line, but it is very unlikely that if you have primary DPD that you will develop schizophrenia. "But what if I am that outlier" --> this is anxiety. Just because we think something in our mind and worry about it, it doesn't necessarily become true. If we suspect psychotic symptoms then we should refer to a psychiatrist who can help diagnose us. If the clinician says theres no problem, and the people around you do not suspect anything odd about you, then you do not have a problem. You may think you do and worry about it, but thats not necessarily reality. 


"because you have DP/DR it means you cannot have schizophrenia" as if DPDR was a protection against psychosis.... No, you always can have schizophrenia, and DPDR is even a symptom of it. Some people also say that that "if you worry about having schizophrenia it means you don't have it, because people who have schizophrenia don't know about it", it is just a misconception about psychosis. As a matter of fact you can have some form of schizophrenia without anosognosia

Yes, if you have schizophrenia or a psychotic disorder you may present with symptoms of DPD, but this is not a "schizophrenia-thing". People with depression, anxiety, bipolar, even OCD can have secondary symptoms of depersonalization, same goes for schizophrenia. I don't think anyone is arguing that DPDR is a protection against psychosis, rather that if you are worrying about developing psychosis, then you should acknowledge that you are worried. Worrying about something and actually experiencing something is two separate things.


It is dangerous to assume that everyone on this forum has primary DPD, this diagnosis is very hard to claim. For this reason, it is very important to get an accurate diagnosis from a mental health professional. You should never self-diagnose yourself with any condition, we are not capable of doing so on our own, we need the assessment of someone from the outside. This is especially the case if you have a psychosis-spectrum disorder. 


Agree 100%

How so? I do not see any overlap, and the clinicians don't either. 

#614606 zyprexa/olanzapine is awesome (at least for me)

Posted by curiousmind on 11 February 2020 - 08:47 AM

Someone else I know with DPDR is also on an olanzapine regimen and she says it improves her symptoms too. If I may ask, which symptoms of yours has improved with this medication? 

#614536 Phobia for alcohol or drugs due to DP/DR?

Posted by curiousmind on 10 February 2020 - 03:05 PM

If your DPDR was drug-induced then you will likely have developed a passion for disliking such substances, or whats more, you have come to fear mind-altering substances all together. My DPDR was induced by ecstasy and for the longest time I swore to never touch drugs, alcohol, caffeine or any mind-altering substance ever again. It is generally not a bad thing to want to stay away from such substances that you would use to arbitrarily make you happier (or to cover up some deeper, underlying, unresolved issue), however, I came to realise that my motivation for staying away from these substances was out of fear of what "they have done to me", which lead to avoidance behaviours and an underlying source of anxiety: not a psychologically sound way to live. The logic was: I took the drug, something bad happened to me, therefore the drug is evil. However, overtime I processed my traumatic experience and returned to my previous mindset that the drugs are not malevolent in and of themselves, they are purely chemicals just like food or particulate matter in the air or pharmaceuticals or what have you. That being said, I stay away from these substances nevertheless, because I don't need them to be happy, I am finding solace and joy in other things such as exercise, family relationships and friendships. But that is to say that I also don't fear substances, in fact, I have since my onset revisited some of my older acquaintances. 


It is probably a good thing to stay away from drugs and alcohol no matter who you are (in my opinion, because you are likely using them to fill a void in your life), but you shouldn't be fearing these substances, they are not inherently harmful. If your DPD was induced by ecstacy, think about how MDMA is being used in clinical settings to treat PTSD. If your DPD was induced by weed, think about how it is being used in a therapeutic context for those with cancer. If your DPD was induced by a psychadelic like LSD, then think about how psychadelic research is progressing, and how such mind-altering substances (ayahuasca and psilocybin mushrooms as well) are being used in the treatment of severe depression. Drugs are not evil, forget all the fear-mongering that you were subjected to in your childhood. In the just-mentioned scenarios, drugs are actually benevolent


If your DPD was induced by drugs, just know that it wasn't the drugs' fault per se, rather you are predisposed to a certain reaction to them, and you were probably in the wrong place at the wrong time. Don't blame yourself because you didn't know this about yourself, and don't blame the substance either because it didn't intend to harm you either. Blame your rVLPFC if anything haha. That is also to say that you would have likely developed this condition anyway at some point during your development. That night when I took ecstacy, I took the same type of pill that a couple of my other friends took as well. I developed DPD, they didn't, it wasn't the drugs fault. 

#614534 Slide Show memories

Posted by curiousmind on 10 February 2020 - 02:38 PM

Depersonalization-derealization disorder is essentially a disorder of "self-awareness" as Mauricio Sierra put it, one of the leading contemporary (though currently retired) researchers of the condition. What this means is that the individual finds his/her own existence strange and uncanny to put it simply. So, though many of the phenomena that which a depersonlized experiences is normal, it seems distant and unfamiliar and "weird" to the person with the condition. The illusion of DPD is that you feel like you become an observer of the outside world, but also the inside world which includes your memories as well. Please read my thread to find out why your experiences seem odd: https://www.dpselfhe...ow/#entry614462


I can myself attest to what you are saying though, I have also experienced the phenomena which you speak of on a regular basis, but over time you learn to not care about it, just like most of the other very subjective symptoms of this condition.

#614466 The only important thing to know

Posted by curiousmind on 09 February 2020 - 03:03 PM

"Recent research using psychopshyisiological as well as functional neuroimaging approaches are revealing distinct abnormalities, which supports the idea that the condition is firmly grounded on neurobiological mechanisms. The significance of such objective findings is particularly relevant for a condition like depersonalization, the clinical manifestions of which are entirely subjective, and mostly confined to the experiential domain of self-awareness."


^Taken from Depersonalization: A New Look at a Neglected Syndrome by Mauricio Sierra 


Our disorder is a disorder of self-awareness, our ability to describe our current states through interoception/exteroception is impaired. This is why we cannot allow ourselves to be fooled by our own thoughts and subjective symptoms, we must listen to those who understand this condition, which is why I encourage anyone with this condition to read into it. Find out what is happening, don't try to figure it out for yourself, you won't be able to, but thankfully the research can. 

#614464 The only important thing to know

Posted by curiousmind on 09 February 2020 - 02:30 PM

An overactive VLPFC might be suppressing emotional responses in depersonalization. 

And this is why rTMS therapy research is so exciting. 

#614462 The only important thing to know

Posted by curiousmind on 09 February 2020 - 02:26 PM

"Why do I feel like this?" --> your experience may seem to be, but is not at all inconceivable. Despite the commonly repeated heresy, it is not true that we don't know what is happening in the brain of a depersonalized person, this is a false doctrine. And no, if you have this condition (and are accurately diagnosed with DPDR), your brain is no different. Symptoms differ, it's a subjective discussion time and time again. "But do you have this symptom?", but the mechanism in the brain is the same for everyone, this has been studied for decades, and technology allows us now to see into what is happening into the patient's brain, to the best of our ability granted by most recent technologies. Please read the following, it is very well explained, easy to understand, don't get discouraged by the fancy brain terminology, whenever you come across one, just say to yourself: "a part of my brain", only two regions are important to really understand the basics.


"Medford and his colleagues have studied the emotional response of patients while they lay inside a scanner. If a person with an intact emotional system is shown emotionally positive, neutral, or negative images, the scanner shows brain activations appropriate to each type of stimulus. One of the brain regions that is activated when viewing emotionally salient images is the insula. Activity in the insula is correlated with "every conceivable kind of feeling," writes Damasia in Self Comes to Mind, "from those that are associated with emotions to those that correspond to any shade of pleasure or pain, induced by a wide range of stimuli: hearing music one likes or hates; viewing pictures one loves, including erotic material, or pictures that cause disgust; drinking wine; having sex; being high on drugs; being low on drugs and experiencing withdrawal; and so forth". [...] In depersonalization, Medford's team found that there is distinctly less activity in the left anterior insula while viewing aversive images when compared with healthy controls. "The emotional circuitry, emotional responses, seem to be switched off somehow," Medford told me. The switch lies elsewhere in the brain. Another brain region that has been regularly implicated in depersonalization is the ventrolateral prefrontal cortex (VLPFC)—an area of the brain thats involved in top-down control of emotions. Medford's study (on of the largest ever done [...]) found that the VLPFC was overactive in these patients when compared with controls. An overactive VLPFC might be suppressing emotional responses in depersonalization.       


The team took the study one step further. While there are no known medications for depersonalization, some people have reported improvements when they have taken lamotrigine, an anticonvulsant prescribed for epilepsy. Ten of the fourteen patients in Medford's study took lamotrigine for four to eight months, after which they agreed to be scanned again. Some patients reported that their condition had improved, while in others there was no change. Those whose symptoms had abated showed increased activity in the left anterior insula and decreased activity in the VLPFC when compared to the scans from before they began taking lamotrigine and when compared to the scans of those who were not feeling better despite the pharmacotherapy. "Whereas the people that hadn't improved at all, they were still very flat in terms of neural responses," said Medford, of the activity in the insula. The left anterior insula is involved in intergrating sensations from both inside the body (interoceptive) and outside (exteroceptive), and is thought to be crucial for creating a subjective sense of our own body and indeed for the sense of self. [...] while the VLPFC in people with depersonalization can be said to be "switching off" the left anterior insula, it's not under conscious control. "it's not a willed thing," said medford. "It's just happening. Things are being switched off."    


If so, this switching off should become apparent in how autonomic nervous system responses (which are not under conscious control) operate in people with depersonalization. And in fact, thats exactly what researchers have seen: if you measure skin conductance of the hand (an autonomic response) in reaction to unpleasant stimuli, people with depersonalization show very little activity."


Taken from The Man Who Wasn't There by Anil Ananthaswamy, bold and underlining was added by me.