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Discussion Starter · #1 ·
Hi everyone, I hope you are all doing well, or at least as well as you can, considering the circumstances.
Following my last message in this forum, i fell into a deep depression. I had no intention of going back on medication, but it was getting really bad - I had continuous suicidal thoughts. I am sorry if what I wrote upsets you, I don't want to give any negative vibes.

Well now going to the slightly more positive news...
I was put on a low dose ssri (ecitilopram) and requested to try the lamictal again.
Previously I was on a dose of 50 mg when i stopped as i thought i was having bad side effects.
I also was diagnosed with having a lethargic type of depression, which seemed coexist with some ADD symptoms. I was diagnoed with ADD around half a year ago, and was prescribed ritalin/methylphenidate for it to help me with my focus/motivation and to help with especially the lethargy. I should mention that I am also suffering from mild-medium sleep apnea and haven't been able to find a fix for it yet, as it is impossible for me to sleep with the full mask on (I have congestion so can't just use the nose mask).

I am now up to 150mg lamictal and 10 mg ecitilopram. I started to feel a improvement on the derealization aspect but not so much of the depersonalization, and ritalin would help take the focus away from the DP but after it wore off the anxiety and adrenalin made things very worse, but it has been a great help for my lethargy, although it has less of an effect now in that regards and more of a focus/concentration help.

In the last couple weeks I felt very bad and just sick everytime i woke up. I have had this feeling before and it lasts for a very long time before it subdues for a while then starts again. This has a terrible affect on my daily life and ability to function. I realized that in some way i am still feeling depressed. For some people that is a great sadness but for me i just feel even more flat and what it really does is it makes me withdraw and speak in a very low manner when interacting with others. I have tried a variety of SSRI and SNRI's before and they seem to have the same effect on me everytime. They don't really help with my mood but just numb me out which doesn't help at all.

My psychiatrist suggested nortriptyline which is a TCA. I have extreme tension headaches and dizziness when I feel very bad so in regards to the headaches it seemed like a good fit. I was asked to continue with the SSRI incase I couldn't handle the TCA then i would be able to fall back on the SSRI. I asked if there was a rick os Seretonin syndrome and my physciatrist assured me that the dose that i am taking is very low and that i should not be worried.

After a couple days of taking the TCA i felt like even my depersonalization was getting better. I still woke up feeling sick sometimes but it felt better then what i was just on the SSRI. I seemed to be able to get out of bed a little easier and some of my tension was gone. I noticed however that after a week i gained weight and that is very unfortunate as I am trying to lose weight at the moment. The TCA also makes my libido non-existent, and makes my heart beat faster sometimes, and i have read that it can cause tachycardia in the long term, and therefor im also thinking it cant be good taking it in combination with ritalin.

I stopped taking the TCA and in around 2 days i took my normal dose of ritalin and it seemed to last forever and gave me intense anxiety. I also felt like i felt before, just total shit with fever like symptoms (without having it) and dizzy all the time. My DP/DR also got worse. I am now facing a double edged sword and i am thinking to call my physicatrist tomorrow and ask perhaps for a dose reduction for the TCA. I was taking a very low dose of 25 mg but there is also a lower dose of 10 mg available. Hopefully it will help me and it would cause fewer side effects.

Now back to DP/DR when i took TCA + SSRI + Lamictal (at night) when i woke up i felt different. DP / DR was less pronounced. Unfortunately 30 minutes later i would start dissociating back to my 'normal' state but still less then usual. I also noticed another 'type' of dizziness. When i am really trying hard to focus on an object ahead of me, which directly is an attempt for me to disscociate less, I would feel a pain in my head a different dizziness then before. It seemed like by brain/mind new what I was trying to do.

Anyhow today i feel shit again as i haven't taken the TCA and have to wait till tomorrow to get a lower dose prescription, but i really hope that things are moving in the right direction. I also want to talk about how i have come to percieve my DP/DR. I have to state that i am in no shape or form qualified, or licensed to make any claims in regards to this condition, so don't take my word for this as i am just sharing my own thoughts and my own perception on the condition.

First of all I believe that my DP/DR stems from great trauma and stress, and has then been exacterbated by my inability to properly feels these nasty emotions. I have trouble with Alexithymia even before my DP started. I believe that neglecting to feel these emotions has cause a great distress in me and my body/mind has been forced to deal with it by dissacoiating. Now you might say, well it seems very simple, just feel these emotions and your DP will stop. Well it's exactly that which is so difficult. Imagine having Alexithymia, and trauma cause in early childhood, it will be extremely difficult and of course uncomfortable to resolve. It also requires a very skilled and proeficient therapist, which i have yet to find. Having said that, i am fully commited to go through this journey and to begin healing, however, this could even take decades of work.

I am hoping that through medication, it can improve my life to the point where i can be rather functional, and where I am not as distressed everyday, as going through a decades worth of work when you are feeling like absoloute shit can make it much harder and also I have to live my life in the present as well.

Now I have read allot about people talking about the notion about acceptance and not thinking about your DP. I do believe that this is important, especially because when feeling physical sensations, we usually seem to think that there is something wrong with us and that its not just DP which in turn makes things worse. I however also believe, that in my case, and with other cases of trauma induced DP, that this will not be enough to fully recover from the disorder. I may be wrong however that is how i feel it is in my case. It seems like the majority of cases where the individual has suffered from drug induced DP or panic/anxiety attacks which has then resulted in DP, this method has helped individuals in great degree and with complete remission of the disorder.

Anyhow, sorry if this got long, just thought i'd share my thoughts, and i hope to get better and keep you all updated.
Merry christmas and Happy new year!
 

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Discussion Starter · #2 ·
Well it seems like there is no-one that is interested in this thread, which i feel is a bit surprising.

Just another update i want to give to those that are interested:

- The co-incidental addition of nortrypline (together with sertraline - although i do not know if taking it together has made this effect) and lamictal has greatly reduced my dp/dr symptoms.
On lamictal 150 mg i felt my DR reduced but not my DP. Now i feel both of them reduced and I am at the lowerst dose of sertraline and nortrypline however i do not plan to take more nortrypline because of the side effects and because i take methylphenidate for my ADD and neither do i want to take more sertraline because it has creates more apathy for me. I am also on a relatively low dose of lamictal (London research unit suggests UP to 400 mg.)

When i was on the lamictal i was hoping that i could get 70 percent better with an increase and maybe with therapy possibly and hopefully become 90 percent better but 100 percent was even out of the equation for me.
Now i feel 50-60 percent better and I'm sure that i can get to 90-100.

This is an amazing turn of events as just 4-5 months ago i had allot of suicidal thoughts and couldn't bare living with this disorder.
I feel so weird now in my body, the DR got reduced before but never the DP. I feel like more lightly i dont know how to say it but i can feel my body better.

BTW I have had CHRONIC dp/dr for 6 and a half years now.

I am 26 years old.
 

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Hey,

I'm sorry to hear you've been suffering for so long at such a young age. You've been robbed.

I've also had a trauma-induced DP/DR for about the same length of time as you. I have two young children, and it feels like I'm missing their childhood because I never feel PRESENT. When I've talked to doctors or therapists about it, they never seem to understand my problem and therefore only get prescribed medication for depression and anxiety. There's nothing worse than experiencing these symptoms and not being understood or having them diminished by loved ones.

What dosage of Lamictal/Sertraline/Nortriptyline are you taking now? I'm currently taking Citalopram (SSRI). You think if I continued with Citalopram and added Lamictal that might help?

For what it's worth, I truly hope you're feeling better and achieve full recovery someday.

Best of luck to you.

Brie
 

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Discussion Starter · #5 ·
In regards to citalopram, its actually practically the same i take, which is ecitilopram. I mistakingly wrote sertraline throughout both of my posts, which is wrong.
As I said i can only comment on my personal experience. With Lamictal i saw a gradual reduction in DR, but with Nortrypline the reduction of DR became slightly greater and a slight decrease in depersonalization as well.
 

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Discussion Starter · #6 ·
Down to 20 mg nortrypline due to massive weight gain. Will further reduce to 10 mg in the comming weeks.
Currently taking 40-70 mg ritalin (concerta+methylphenidate) during the day. 10 mg ecitilopram, 20 mg norttypline and 200 mg lamictal/lamotragine.

60% Recovered.

I have been emotionally numb before my DP DR, which i have had for 6 and a half years now. 3 therapists have said they believe i have C-PTSD. I have cried a bit the last 2 weeks, every once in a while which i haven't dont in a long long time.

Still have severe depression in the form of fatigue and emotional numbness, but it's a start.
Although my current class in college is tearing me apart, I hope to move to my native city after this semester. After 1 year in Denmark you can move to a different location continuing your same study. Will have to see about accommodation and what not soon.

EDIT: Also some past memories has returned.
 

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Discussion Starter · #7 ·
Update:

Still on 200 mg Lamictal - Actually just started 225 mg today.

I am now on 10 mg Nortrypline as opposed to the 25 mg i was before.
I have noticed that this has had a negative effect on my ability to feel my emotions.
Before i was sobbing, I was able to feel past trauma, I literally faced my inner child. Now nothing - It is so hard for me to access it.
I am not sure what to do. On one hand i reduced my dose because i gained an extraordinary amount of weight.
On the other hand, it is hindering my ability to heal and recover. Stuck in a dilemma.
 

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Discussion Starter · #8 ·
Still on 225 lamictal - 10 mg nortrypine - ecitilopram bumped to 20 mg. On concerta/ritalin xr as well but not relevant to DP.
Going to maybe start tapering off nortrypline although it still seems to help with my dp even when reduced from 25 to 10 just to a lesser extent.
Still not close to being recovered.
Maybe 70% on a good day but still probably in 60-65 % range.

I guess the good news is that everytime i increased the lamictal i saw improvement, but i dont know how much that was DP, mostly DR but we will see.
Everytime i increase lamictal i get really tired and fatigued for 1-2 weeks so im waiting for maybe the break, i have 1 week off in a few weeks so i will increase it to 250 there and hope to see a increase. I am confident i will see a difference but not sure if it will be more reduction of DR or also bit more of DP.

When i try to focus very hard i can see through my DP DR but only for few seconds and my head hurts, its as if my brain is slightly fatigued and not there yet to fully connect me with myself again.
I just dont know what to do even if i do recover (Hopefully fuck, really hopefully) what will happen when i reduce my medication and remove them all together. I dont wan't to be on this stuff forever i want to get off them as soon as possible, but as im not even close to being fully recovered, thats probably going to take a really long time.. maybe even 7-10 years. And then what will happen if the DP comes back i have no idea.
 

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Discussion Starter · #9 ·
Lamictal increased to 250 mg. Seen an improvement again, for the first time was really able to feel my arms and legs.
However all this antidepressants and medication has made me numb, even though ive always kind of been numb.
I am just physically depressed and im just waiting to be able to see a competent psychologist that can help me get past my childhood trauma and the last 10 years as well.
Feel so hopeless sometimes when i cant get close to anyone, and don't know who i am.
 

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Discussion Starter · #10 ·
Update:

Lamictal increased to 300mg.
Decreased my ecitilopram cause i was feeling too numb and am feeling better now.
The jump from 200/225 to 250 was much more noticable. Fortunately the jump to 300 has shown slight improvement too.
On the other hand i had hoped to be 90% recovered by the time i hit 300mg, which is not the case. I will move up to 400 and im confident that i will continue to see a improvement but i have to go up very slowly now as i am afraid i will relapse. By that i mean, i am kinda scared to be fully dp dr free, i feel more 'vulnerable' idk how to explain it, or i fear i cannot handle it.

I really didnt want to go all the way up to 400 mg but it seems like thats what i will do. I have an inclination that by 400mg i will only be 80% recovered, but i am not going to go higher. I am already at a pretty high dose. Long-term trauma work and therapy will have to pave the way from 80% to 100% with a little bit of hope.

Summer is coming up thankfully which will give me the motivation to go swimming. I used to go swimming when i was a teen and found it oddly therapeautic. Much more satisfying then running (which i can't stand). I also want to get a massage/physiotherapist once a week. Will need to practice some yoga and mindfullness too to calm my body down and relax a little more, i feel my muscles are tense sometimes.Therapy work will be really difficult because i have allot of repressed emotions which i have only minutely been able to connect to recently. But when i did connect, there was a incredible amount of pain and agony.

I also feed sad that there are others who are still struggling. I know that swimming, excercise or anything of the sorts, would not have helped me, as i was in such a deep state of dissasociation, depression and despair, that i felt like nothing would help me. With how i am currently feeling, it has given me, at least the opportunity, and willingness to fight through this, which was not present before. My heart goes out to all of you.
 

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Discussion Starter · #11 ·
Update:

I have been pretty numb way before my dp dr because of past trauma - So thats a given. I am still numb but have periods where i feel my emotions. But the real good news is that i started intermittent fasting and its helped clear my head a little bit which is nice.
Still on 300 mg Lamictal. Not going to increase until after my exams which should be done in a month.
I hope that i will be 80-85% recovered once i hit the 400, which im not too worried about, as everytime i increased the dose i felt improvement.
Personally my life was still shit before dp dr, so i have allot of trouble with intimacy and relationships and all of that stuff. But got to look at the bright side, im much better then i was before, however the DP is still not completely gone, its really holding on. As i mentioned before apart of me is also scared to fully recover. It doesnt make any sense because thats all i want but im just afraid.
 

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Discussion Starter · #13 ·
Update: Still on 400 mg Lamictal
A couple days ago i accidentely took 2 ecitilopram 10 mg instead of just 1 10 mg.
The next day i felt like the dp was even more reduced. But im not going to take more than 10 mg because it makes me feel numb.
Yesterday i had exams and i got a top grade - I had taken 1 propranalol pill, which i got from my local doctor, he gave me 3, because i told him i have exam anxiety.
propranolol is a blood pressure medication and it also helps to get rid of adrenalise and stuff.When i took it my DP was reduced even more so when i took 2 ecitilopram pills. I might try to talk with my psychatriset if its something we could incorporate
 

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Discussion Starter · #14 ·
I said that i wouldn't increase the Lamictal, but as i have no serious side effects thus far, at all - And with the improvement seen every time when increasing the dose - I have decided to go up to 600. Currently i took my first 500 mg today. Again seen improvement and reduction of disassociation. The remaining factor seems to be the adrenaline, cortisol levels that i need to manage. As i also take methylphenidate as part of my ADD treatment, it seems to exacerbate stress hormones. I have tried to take less, 1 pill instead of the usual 2. Other options are to take more escitalopram from 10 mg to 20 mg - But I will not do this. Another option is to take propranolol which helped immensely, but adding another medication to the mix does not seem like a good choice. Third option and most logical option is to do some sort of exercise every day - Doesn't always have to be heavy but just everyday to flush those toxins out.
Will update in a couple weeks or so.
 

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Discussion Starter · #16 ·
mini-update

Lamictal still 500mg
10 mg Nortriptyline removed, and i felt crappy for a few days but now i feel reduced DP. So its weird initially it helped with DP, at least thats what i felt, but now removing it i feel like my brain is much more clear and less foggy. I also used to wake up with heart pounding and was told my pulse was too high and now its better.

Current regimen:
500mg Lamictal (night), 10mg ecitilopram (night), 36mg concerta (once or twice a day)

Unfortunately i haven't been able to exercise as much as i wanted to.
Football resumes in a couple weeks and so does swimming.
Then i will really put a full effort and lets see what happens.

Its pointless to talk about recovery in percentage - Its probably now the best i have felt. But i disassociate more when outside, but yes, it has gotten better than before, i guess i should appreciate that.

Im going to purchase a book on trauma related disassociation (since i suffer from C-PTSD). The thing is, my life was pretty shitty even pre-DP and although i didn't experience dp/dr, at that time, i was very numb to my feelings. I still am but i have got some memories from the past that i didn't have.

Have to find a competent therapist though, and its quite expensive.
Only a few work on C-PTSD, official framework for diagnosis comes next year on the ICD.
Still not recognized on DSM (US, Australia)
 

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Hello Cray. I am a bit surprised to hear your psychiatrist accepts that you are on so many medications at one time.
I will have to recommend something to you - Dont combine this many medications. You will not be able to tell what is what. And remember that days differ generally for everyone - there are a lot of other factors such as blood sugar, sleep, diet, exercise, social / work wellbing etc. etc So combining medications and interprating all symptoms variations as a direct result of medications will not give you a constructive / realistic picture of your treatment. I am saying this out of personal experience as I have also been overfocused on medications for quite some time earlier.
 

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Discussion Starter · #19 ·
Hello Cray. I am a bit surprised to hear your psychiatrist accepts that you are on so many medications at one time.
I will have to recommend something to you - Dont combine this many medications. You will not be able to tell what is what. And remember that days differ generally for everyone - there are a lot of other factors such as blood sugar, sleep, diet, exercise, social / work wellbing etc. etc So combining medications and interprating all symptoms variations as a direct result of medications will not give you a constructive / realistic picture of your treatment. I am saying this out of personal experience as I have also been overfocused on medications for quite some time earlier.
I guess 3 different medications is quite hefty. But remember that the ecitilopram is at the lowest possible dose, and the concerta is for ADHD.
I am aware of the realistic picture of treatment, but i think i got very good benefits from it.
I probably wouldn't be alive now if it weren't for it. I am going to start see a therapist next month for C-PTSD.

BTW i wanted to say something im kind of ashamed of.
But with C-PTSD i can get emotional triggers all the time.
Sometimes i want to be a little disassociated so i dont feel the triggers all day.
I guess theres a part of me that feels that i need to be a little disassociated .

Well the hard work starts now with the therapist, but i can assure you that the medication helped massively. But i really dont even want to be on it. Really. But for now it's doable. Hopefully in a few years or the near future, i can begin to cut down and stop taking medication.
 
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