maria said:
Having been reading this forum for over a year now I should probably know the answer to my question but I'm a slow learner. So I visited a new doctor. She stated I'm depressed and have dp/dr. I asked her if she thought the last two are symptoms of the first, or symptom of anykind, but she said that my dissociation is an illness of it's own. And that's the total opposite of what I've been reading from this forum. So should I know think I'm having the actual Depersonalization Disorder and not just for example depression/anxiety symptomized with depersonalization and derealization?
Well, this is the million dollar question again, and I think different psychiatrists/therapists might see dissociative disorders in different ways.
In saying Dissociation, I'd say she means your symptoms of DP/DR. You also have Depression.
From what it says in the DSM-IV, Depersonalization Disorder is pretty specific and exists
without any other co-morbid mental illness. And as Mauricio Sierra at the IoP seems to have found, Primary DP/DR is rare. I think the DP/DR patients he sees (same with Dr. Simeon in NYC) have co-morbid disorders, the DP/DR is never in a vacuum.
I have read in various places that the mass of researchers trying to update the DSM-IV (which came out in 1994 -- the text revision has minor changes as I see it) there is much argument as to where to put "Depersonalization Disorder" -- the 100% Primary Disorder. It may very well be strictly neurological, like Capgras and Cotard's.
In my case, since seeing psychiatrists starting in 1975 at the age of 15, I've received the following diagnoses:
Note, my primary complaint, my most disabling SYMPTOMS were chronic DP/DR. Anxiety was second on my list, and I didn't even realize I was depressed. I thought it was normal to feel miserable, but I was also miserable about the DP/DR.
1975: Depression - Primary Disorder with accompanying anxiety and DP/DR. For insurance purposes Depersonaliazation Disorder was used as the primary diagnosis.
1982: or thereabouts... I always forget the details without looking at notes
Depression, DP/DR, Anxiety. For insurance purposes Depersonalization Disorder was used as the primary diagnosis.
1984 or therabouts: Depersonalization Disorder.
At that time I was REALLY Borderline in many respects.
1994: Generalized Anxiety Disorder (this seemed to make most sense as I have EVERY symptom -- about 100 of them, LOL), with chronic DP/DR as a secondary symptom. But later the psychiatrist and I noted the Borderline charcteristics. DP/DR is a symptom of Borderline/Mood Dysregulation.
2001: Back to Depersonalization Disorder
I believe there is Primary Depersonalization Disorder which is ONE of a group of Dissociative Disorders such as Amnestic Fugue States, DID, and I forget the others. I think only a few people on this Board have Primary.
I believe no mental illness exists in a vacuum however. There always seem to be comorbid problems.
The process of diagnosis in psychiatry isn't cut and dried. I used to pidgeonhole myself and others, but I don't think it works that way.
I believe DP/DR are symptoms in most cases. I think I am difficult to categorize as my DP/DR is chronic 24/7. I believe these symptoms are clearly secondary to Mood Dysregulation (a new diagnosis that may replace Borderline, but I'm not clear on that either), and Anxiety. And my Mood tends towards depression which cycles slowly in and out. It is not dramatic like bipolar. I have no mania or psychosis. It is perhaps on the bipolar spectrum.
I don't think I've met a mentally ill person who didn't have more than one symptom. They have a disorder or disorders which manifest themselves in a variety of symptoms that change over time.
Meds/treatment have to be tailored to the individual. And the illness (as mine has) changes over time.
This is like say Cancer. They keep finding more and more "subtypes" of cancer -- different variations of tumors, etc. They can be more specific in diagnosis and hence treatment.
AIDS is interesting in this respect, and treatment for that has changed over time. I just read that the HIV virus itself may be weakening. I don't know what that means, but virus' mutate as well.
We are infinitely complex. There is no ONE answer really. We are so unique, each and every one of us.
Best,
D
IMHO
