Joined
·
1 Posts
Getting over Depersonalization
Let me begin by saying that I am not a mental health practitioner, nor do I claim expertise of any kind in the sphere of depersonalization. Rather, reading other people’s success stories in “conquering” depersonalization helped me immensely when I was in the throes of it myself. I always promised myself that when the time came, I would share my own story.As is apparently very common, I can distinctly recall not just the day, but the exact moment that my depersonalization began. It was about 10 years ago, while I was a senior in college. (In hindsight, this was a time of deep uncertainty in my life, as I felt pressure to figure out how I would apply myself immediately after graduation, and beyond). I was watching TV, when I suddenly became conscious of my own thoughts and sensory experience in a way that seemed to imply that I was separate from them. It felt as if nothing was real. The world was spinning, and I was filled with apprehension. The sensations were similar to those I had experienced during bad highs from smoking pot, except that I wasn’t stoned, which meant that I couldn’t simply expect for the feelings to resolve when the drug wore off. I took a few ibuprofen thinking that it was probably just a headache, but obviously, that accomplished nothing. As many of you have similarly experienced, I was stuck in the DP/DR feedback loop, in which I was hoping that the sensation would suddenly end, and when that failed to happen, I became increasingly anxious, which only made the depersonalization worse. Having never had any real experience with mental illness previously (I had my fair share of neuroses, but never anything that I ever thought of as limiting or disabling), I had no framework for making sense of what was happening.
The anxiety continued to escalate over the next few hours, until my heart felt like it was going to explode out of my chest. I wasn’t sure what else to do, so I asked a friend to take me to the emergency room. They conducted a full battery of pointless tests (EKG, chest X-ray) and kept me overnight for observation, never even mentioning the possibility that what I was experiencing was probably mental in origin. Over the next couple of days, I tried my best to forget about how I was feeling, but it was impossible. Still overcome with anxiety and not sure what else to do, I asked a different friend to again drive me to the ER. This time, the doctor suggested that it was all in my head, and gave me a pill to calm me down.
The tightness in my chest remained unbearable, and I called my parents. They suggested the problem might be acid reflux, which ran in the family and certainly plagued me from time to time. I had an endoscopy performed, which revealed that reflux had indeed scarred my esophagus. I was given a prescription for Nexium and immediately felt better with the (false) knowledge that my problem was a physical one, and one that was apparently very easy to cure!
While less intense than before, the anxiety persisted. I began to actively fear that the sensations of panic and depersonalization would return, and worked to suppress any memory of them (an approach that I later learned made them infinitely more likely to return). I visited the mental health center at my university, got a prescription for Ativan (to be taken only in the event of an acute episode of anxiety/panic), and tried to continue on with life, to the extent possible. I threw myself into an existentialism class and some other activities, but was consumed with a near-constant dread that the panic would return. I began to carry the Ativan around with me. I only took it a handful of times over the following two years, believing that by not taking it, I could somehow prove that I was stronger than whatever it was that was plaguing me. In hindsight, it didn’t matter, as the Ativan could only ever be helpful in temporarily alleviating the symptoms, rather than in curing the disease.
I had regular panic attacks and anticipatory attacks throughout the rest of the school year, but somehow I made it to graduation, and was even offered a prestigious job. I thought that what I was experiencing was merely a philosophical crisis, so-to-speak, and that it would subside as soon as I achieved some certainty in my plans. I spent the summer traveling around Asia, and my DP vanished mysteriously, such that it seemed like a distant memory.
Shortly after returning to the US, and less than a month into a high-pressure job in New York City, the panic<->depersonalization spiral returned in full force. I began to have irrational thoughts and fears- that I would spontaneously lose my mind and need to be committed to a mental hospital or that I would suddenly forget important details about my own life (such as where I lived) that I would suddenly disappear- cease to exist! It seems funny to think about in hindsight, but at the time, these thoughts were beyond terrifying, and their sudden intrusion into my mind was enough to make my heart race and my palms sweat. I became paranoid about the way I behaved and projected myself, lest anyone accuse me of being crazy. (In hindsight, rarely has anyone ever commented on my outward appearance, even during times of extreme mental turmoil, proving that it really was/is just in my head!) I began to think that something must be physically wrong with me- I must have a brain tumor! I began spending time online researching neurological disorders, but never managed to persuade myself that I actually had one. Sometimes, the symptoms would abate for a few hours or even a few days (typically when I was especially busy at work engrossed in a specific project), and I would temporarily forget that I was living in a mental prison.
Somehow I was holding my life together, but my grasp on reality felt increasingly tenuous and my fear of panic was sometimes unbearable. Every day had become excruciating, and it took all of the energy and willpower I had to simply abide, all the while inching closer to escape. I realized that I needed to deal aggressively with whatever was going on in my mind, and began formulating a plan that involved quitting my job and moving to Asia.
After one year in New York, my lease on my apartment expired, I gave two weeks’ notice, and bought a one-way plane ticket to Thailand. I had decided to put all of my eggs in one basket, betting that a 10-day silent mediation course would cure me of whatever it was that was making my life a living hell. The course was extremely difficult, and there were many moments where I thought that I wouldn’t make it. In hindsight, it is clear to me that I misunderstood the entire purpose of meditation (I thought it would bring bliss directly rather than increase awareness of the nature of existence…more on this later), but somehow, I achieved a level of mental stability from the course that I hadn’t known in years, and was able to move forward with my life.
The next five years saw a great number of positive changes. I started a successful business, got married, had a son, and managed to keep busy and be relatively happy. Of course, I had occasional bouts of depression and anxiety and panic and irrational thoughts and maybe even depersonalization, but for the most part, these things didn’t seem to bother me that much. Every so often, I would experience an intense panic attack out-of-the-blue. Even though I always managed to calm myself down, these were not-so-subtle reminders that I was still carrying with me a tremendous amount of mental baggage, and the demon surely could not be kept at bay forever.
As I began traveling more for work, my stress/anxiety levels crept up, ever-so-slightly , culminating in a sudden and horrific bout of panic and depersonalization right before I was about to board an airplane, which was so intense that it almost kept me from flying. I spent the next few days trying to reassure myself that it was just a fluke, but deep down, I think I realized that things were about to change for the worse.
This was about three years ago, and from then on, the panic attacks began to occur with increasing regularity. Initially, they only involved airplanes. The anxiety would build for a few hours before each flight, and then the panic attack would hit me almost as soon as I sat down in my seat. Throughout the entire flight, I would be filled with dread. What if I suddenly start acting crazy? What if my brain abandons me and compels me to open the emergency exit door and jump out of the plane? What if the other passengers sense that there is something wrong with me, and they decide that I am a danger to the flight and need to be physically subdued? I began the self-defeating process of trying to repress, alter, or rationalize-out-of-existence my thoughts, which of course, only ensured that these ridiculous thoughts would become further entrenched and frightening.
And sure enough, it wasn’t long before the panic attacks – or anticipatory attacks – began to occur in every situation that didn’t offer a clear escape. Boats, tunnels, elevators, high buildings – pretty much any situation in which I felt trapped filled me with actual and anticipatory dread, and I even began avoiding certain situations that I felt would be more likely to bring on the panic. Still, for whatever reason, I felt like I was still in control of my life, and as long as I avoided these “triggers,” everything would be just fine.
Meanwhile, work was both a source of increasing stress and a source of escape from the feelings of dread. As long as I immersed myself in working, I could surely “keep it together” and not lose my mind. For the most part, this approach worked. Except for one little problem: business was highly seasonal, such that I worked 24/7 in the fall and much of the spring, but was more or less idle 24/7 for most of the winter and much of the summer. As our busy fall season was winding down at the end of 2014, I began to experience the same horrible sensations that I had surely vanquished many years earlier. It began with depersonalization and anxiety, and then quickly morphed into a depression that was more intense than anything I had ever experienced. The depression soon took over my mind, and I felt myself battling with it constantly, wondering when it would “break.” It was at this time that I also began to have suicidal thoughts. I had experienced such thoughts on a few occasions in the past, and while I invariably found them terrifying, they always vanished shortly thereafter, seemingly without cause. This time around, it seemed that I was powerless against them. I tried meditating intensively, but this seemed to only make them stronger. I tried diverting my attention to other activities, and while I achieved some success with this approach, the horrible thoughts and feelings always returned, stronger than before.
I was struggling to make sense of what was happening in my mind, but for some reason felt that I could somehow out-think whatever was happening to me, or could continuously distract myself. Or maybe if I moved back to the US, that would bring an end to my psychological travails. Or maybe I just needed more sun. Or needed to spend more time working. I somehow made it through the winter, and threw myself into my business in the spring with renewed vigor. It worked to quell the worst of the symptoms, but the dread was always there. The irrational thoughts began spilling into my work, always involving some kind of scenario in which I embarrassed myself in front of our clients. What if I peed in my pants while on a long bus ride? What if I had a panic attack, and was forced to ask the clients for help. What if I blurted out something really stupid or inappropriate or offensive for no reason? And yet through all of this, I always managed to keep it together, never intentionally letting on that I was falling apart, even to my own wife. It seems crazy in hindsight, but I continued to believe that I could simply outlast whatever was happening, and it would be gone just as suddenly as it had arrived.
The next 6 months were a fairly busy period for me in work and in life, and despite frequent panic attacks and anticipatory attacks, it seemed that if I simply stayed busy forever, I would be just fine. Still, I felt myself being drawn deeper and deeper into my own neuroses, such that it seemed like everything I was doing externally (i.e. in reality) was merely a lever that I was pulling to maintain my internal sanity. Rather than doing things for the sake of doing things or because they were things that needed to be done, I started directing my efforts towards tasks and situations that were most likely to lessen my anxiety and/or keep the depression at bay.
On the last day of our busy fall season in 2015, I distinctly recall a thought popping into my head: I wish I could simply have a break from myself. What if there was a way in which I could be sedated for a short period of time and simply escape my own mind? Shortly thereafter, following an endless succession of empty days filled with free time to do nothing, I became stuck in my head, pretty much semi-permanently. I felt depressed and disconnected from my self. I began to have sensations that my limbs were somehow separate from me and outside of my control. While driving across bridges, I began to fear that I would suddenly drive the car into the water. When socializing with those that I wasn’t completely comfortable with, I became excessively self-conscious and also hyper-aware of others, such that socializing was becoming increasingly unpleasant. I began experiencing intense anxiety before I fell asleep, and after a few weeks of this, it prevented me from falling asleep all together. I figured that it was only a matter of time before I would have to insist that I be taken to a mental hospital.
I was still experiencing intense suicidal thoughts on a daily basis, and even though I knew that I didn’t actually want to kill myself, it had started to seem almost inevitable. I finally confided to my wife that I was depressed, and she was very supportive. I had become short-tempered with her and our son, and was increasingly an unpleasant person to be around. We both decided that I needed to actively take steps to heal myself. I began practicing Tai Qi daily with a local teacher and meditating frequently. This certainly helped, but I still was not addressing my problems directly. I was sleeping very little – perhaps only 2-3 hours a night – and for days on end was so mentally uncomfortable that it felt as if I was counting the seconds until the day was over. I would literally sit around trying to will the depression and anxiety away, obviously to no avail. I began telling myself that I only had to persevere for another 50 years or so, and then the struggle would finally be relieved with death. What a way to live!
My family and I had planned a trip to Thailand in early 2016, and I decided that another 10-day silent meditation retreat would cure me of my psychic turmoil. After all, it had worked in the past; how could it not work this time around? After a nice vacation, my family members returned home, and I checked into the monastery to begin the retreat. By this point, I was suffering panic attacks multiple times per day, felt continuously disconnected from myself and from reality, hadn’t fallen asleep for several nights in a row, was having obsessive suicidal thoughts, and felt stuck in a vortex of anxiety and depression and existential insecurity. And yet I was committed to 10 days in a foreign environment with nothing to do and nothing to accompany me except for my own increasingly bizarre and frightening mind. What could go wrong?!
Every day followed the same routine. All of us meditators woke to the clanging of the monastery bells at 4am, meditated until 6am, ate breakfast, meditated until 10am, ate lunch, and spent the rest of the day meditating – except for a brief nightly meeting with the temple abbot or head nun – with bed time at 10pm. Even though I was hardly sleeping (due to the rigid schedule and worsening anxiety), I managed to make it through the first half of each day with little trouble. However, the afternoons were becoming hellish, evenings were becoming nightmarish, and nights alone in my bed trying in vain to fall asleep were of the purest kind of anguish I have ever experienced, where it seemed like passing even one more second was going to be impossible. I tried to convey this to the abbot during our nightly conversations, as well to the monk that was in charge of the meditation retreat, but their response was invariably, “That’s normal. Tomorrow, you should try harder.” It felt as though I was close to a nervous breakdown and/or suicide, and all they could muster was this pathetic advice. Given the imposed silence and the fact that our phones had been confiscated at the start of the retreat, I had no one to confide in and no one to comfort me in my despair. I would walk in circles around the monastery like a caged animal, hoping that I would somehow achieve sudden enlightenment, or at least be given a respite from the constant mental pain that seemed destined to break me. On the 5th day of the retreat, I finally broke down. I was so emotionally overwhelmed that I cried. Not just cried but sobbed. This might not seem like such a big deal, unless you realize that this was the first time I had cried in perhaps 15 years and that most people who knew me well would say that I was as stoic as they come. Afterwards, I lay in my bed, almost too weak to move, just wanting out. Out of this temple, out of my mind, out of this life. I found the head monk, and practically demanded that he return my cell phone. I called my wife and informed her what I was dealing with, and we decided that I should leave the monastery as soon as possible.
The trouble was that my flight home wasn’t scheduled to depart for another 5 days (originally booked to coincide with the end of the retreat), and it wasn’t possible to change my ticket. Now, it might not seem like such a big deal to spend 5 more days in a country as warm, beautiful, and friendly as Thailand, until you remember the extremely fragile state that I was in. Fortunately, a friend of mine was in the area, and he graciously offered some much-needed social and emotional support. At this point, I still wasn’t really sure what was happening to me. As I said, I felt depressed and anxious, but it was more than that. I was stuck in my own head 24 hours a day (literally, as sleeping was almost impossible by that point), and yet paradoxically, I also felt disconnected from my sense of self. This combination of disconnection and hyperawareness was palpable, almost tangible, and yet I couldn’t make sense of it myself, let alone explain how it felt to other people. I began spending increasing amounts of time googling symptoms and “researching” various psychological ailments. Maybe I was just depressed? Or maybe it was actually bipolar disorder? Maybe it was multiple personalities disorder? Maybe it was PTSD (from some undiagnosed trauma)? Chronic Fatigue Syndrome from a virus I had contracted the previous year? Maybe the latent brain tumor was acting up again? Maybe it was from being too idle? I called my parents, and for the first time, I opened up to them about all that I was experiencing. My mom seemed to believe that it was anxiety, while my dad seemed to think that I just needed to change my perspective on my life and find some relaxing hobbies.
The next day, I went to the local hospital to get a checkup. I was hoping they would discover a parasite or something else that would explain everything. When that didn’t happen, I decided to get a prescription for sleeping pills. I was given a packet of Xanax, and then spent the next few hours obsessively researching it. Would it knock me out? Make me sleep-walk? Have horrible nightmares? Would I become addicted to it? The most frightening thought was that in a moment of panic, my brain would overcome me and I would accidentally-intentionally overdose it. I kept one pill for myself and gave the rest to my friend to hold on to, and promptly fell asleep. On the day of my flight home, I was still in a bad state. I felt foggy as hell, and the world felt fuzzy. It seemed like my self was just a bunch of weird perceptions with no meaning, and reality seemed as if it would vanish in an instant! With the help of a Xanax, I managed to board the flight and was soon reunited with my family.
Back home, things failed to improve (I was already at rock bottom, and my situation couldn’t get any worse). I couldn’t focus on anything, spent hours each day trapped in my thoughts, and more hours googling symptoms. During one of these internet binges, I stumbled upon “Pure-O OCD.” Short for the Purely Obsessive form of Obsessive Compulsive Disorder, Pure-O refers to the condition in which one is plagued by irrational, horrible, intrusive thoughts. Unlike the traditional form of OCD, Pure-O doesn’t necessarily compel one to engage in outward compulsive behaviors (like washing hands repeatedly or counting things), but instead is accompanied by rituals which take place purely in one’s mind, like trying to block thoughts or rationalize them away. This seemed to explain the intense discomfort with suicidal thoughts that I was experiencing, and I decided to latch on to this self-diagnosis. In the next couple of days, I was handed some degree of confirmation from a family friend that was a psychiatrist. She recommended that I begin taking a daily regimen of sertraline (Zoloft). As I was very much opposed to taking antidepressants, this took a lot of persuading from my self and from my family members. I was still naïve enough to think that I could outwit my disorder armed with only patience (which I actually lacked) and a few self-help books. Anyway, a few days later, I began taking the medication.
Based on the advice of a friend, I decided to supplement this with weekly counseling sessions with a therapist that specialized in CBT (Cognitive-Behavioral Therapy), conducted via Skype. The therapist was skeptical of my OCD diagnosis and by the end of the first session, she had supplied an alternative: panic disorder, and prescribed a treatment regimen of daily behavioral exercises. These involved confronting my fears head-on. I was told to deliberately put myself in panic-inducing situations and take steps to trigger maximum panic. Next, I would tell myself out loud that everything I was afraid would happen (I would spontaneously disappear, I would go insane, I would kill myself) actually would happen. As if this were not enough, I was told to actualize these fears by pretending to stab myself, pretending to jump off cliffs, pretended to capsize my boat, etc. The theory was that when nothing bad happened, my brain would realize that there was nothing to be afraid of, and that over time, the panic I experienced when I encountered these situations would subside. When the panic subsided, the rest of the symptoms should vanish as well.
Sure enough, after only a few months of behavioral therapy, I experienced almost a complete cessation in the panic symptoms. I still worried about having panic attacks, and the memories of the attacks remained vivid for quite some time, but the anxiety was essentially gone. I was sleeping well, too. For the first time in months, began to feel like recovery might actually be a possibility. It was agreed that the counseling sessions were no longer needed, and I even stopped taking any medication.
The only problem was that at least once a month, I continued to experience a multi-day period of intense mental discomfort. While the panic symptoms were no longer present, and the anxiety was largely absent, it was still profoundly uncomfortable. Every time it came, I became consumed with escaping it. These spells had a very strange quality to them. I would feel slightly depressed and lethargic, but it was much more than that. I felt separated from my self and disconnected from reality, almost like a robot. While the sensations were vague and hard to articulate, however, they were very vivid, and very uncomfortable. After a few of these spells (I don’t know what else to call them), I did some more googling, and ended up on a page about depersonalization.
I had come across this term previously, but was always quick to dismiss it. It wasn’t so much that it didn’t seem to apply to me, but rather that I was frightened by it. After all, it was considered a disassociative disorder (that had to be bad!) and the wikipedia page indicated that there was no cure for it. However, this time around, the more I read, the more that it seemed to perfectly explain what I was feeling. Emotionally Numb? Check. Unusual Perceptual Sensations? Check. Brain Fog? Check. Feeling in a dream-like state? Check. Feeling cut-off or detached from the world? Check Check Check. In hindsight, what I first experienced as a senior in college was a spell of depersonalization and all of the psychic turmoil since then was directly due to further spells and/or to my inability to make sense of what was actually happening to my mind!
I devoured a book on the subject, and learned that very little is known about depersonalization, even though millions of people may suffer from it. I learned that on average, 10 years elapses between the time that symptoms first appear and the diagnosis of depersonalization is made. I learned that for some people, the cause is trauma, while for many others, bad drug experiences are to blame. What begins as a natural response by one’s brain to trauma quickly morphs into an all-consuming state for some, for reasons that are poorly understood. Worst of all, the disorder is hard to conceptualize, hard for those afflicted by it to explain to others, and hence, very difficult to treat.
After a few months of this, I realized that the depersonalization spells were unlikely to abate on their own- or at least unlikely to abate if I didn’t address them specifically. I was dealing with a fair amount of stress in my life at this point: the birth of a daughter, the sending of my oldest child back to the US for a few months to spend time with his grandparents, moving into a new house, and gearing up for our busy fall season. This stress was certainly compounding the depersonalization, such that the two were starting to feed off of each other, just as before.
It was during this time that I suffered another minor breakdown. I was traveling for work, and became completely overwhelmed by a bout of depersonalization and intense irrational thoughts. I found myself trapped in a nightmare of my own making, with no way out. I tried to soldier on, but this time around, I just didn’t have the energy to put on a happy face and pretend everything was okay. My colleagues could see that I wasn’t doing well, which they attributed to work-related stress. At 3am one night, I promptly bought a plane ticket back home, informed my colleagues of my decision, and took a taxi to the airport.
It seemed as if everything was unraveling. The narrative that I had been maintaining since conquering the panic disorder had fallen apart. No longer could I plausibly convince myself that my mental problems were a thing of the past, and that I was well on my way to recovery.
After speaking to my parents and the psychiatrist-friend, I decided to resume taking the daily dose of sertraline (Zoloft) after a two-month hiatus and began a new round of CBT treatment. I promptly contacted the therapist that had helped me overcome the panic attacks and arranged to resume our counseling sessions, conducted via Skype. We began by trying to identify the triggers of the depersonalization, which I originally thought might be related to idleness (i.e. having too much time to ponder the imponderables of life). I was instructed to start keeping a record of my experience, in the form of a ‘thought record.’ Basically, every time my level of psychological discomfort spiked (whether due to depression, anxiety, depersonalization, etc.), I was to record the feelings that it triggered, followed by the ‘automatic thoughts’ that my brain generated. Afterwards, I was to override these automatic thoughts with alternative thoughts, and record the impact on my emotional and cognitive states of mind. The theory was that the irrational and unproductive thoughts were brain malfunctions, and by actively and immediately correcting them, I would teach my brain to generate thoughts that were more helpful, or at least less destructive.
Unfortunately, after a few weeks of this approach, it was obvious that I wasn’t making any progress. Granted, I wasn’t putting forth a ton of effort- there was just something about this approach that didn’t resonate with me, and I found it difficult to utilize the thought record in a sincere way. Perhaps we had misidentified the cause of depersonalization; she suggested that it actually be due to feelings of guilt. From our conversations, she had ascertained that I hold myself to a higher standard than is perhaps healthy, and that I apparently beat myself up when I fail to live up to my own unrealistic expectations. This seemed plausible, so we started over, and rejiggered the thought record, with an emphasis on identifying unhealthy feelings of guilt. After a few weeks, it was apparent that this paradigm was also flawed. The problem was not that I didn’t have feelings of guilt – or difficulty dealing with periods of idleness and boredom, for that matter – but that I often felt overwhelmed and imprisoned by my thoughts, and if anything, I wanted to spend less time and energy engaging with them. By its very nature, the thought record assignments demanded the opposite.
While the therapist was sincere in working with me and clearly had my best interests in mind, the approach that she advocated simply didn’t resonate with me, and hence, had no chance of ever working. I stopped the weekly counseling sessions, and turned instead to a handful of self-help books that I had bought many months earlier but remained unread on my digital bookshelf.
I should mention that throughout this entire period, I had maintained a practice of sitting meditation and Tai Qi (which some would say is basically a more active form of meditation). Guided by books that were heavy in science and psychology and light in spiritualism, I threw myself into the meditation with new purpose. I was guided by a handful of books, online resources, and even a podcast. I began to feel like I was making real progress, and then a month later, I experienced another horrible bout of acute distress, seemingly out-of-the-blue.
I opened Paul David’s At Last a Life, an e-book that I had purchased on a whim as part of a downloading binge that left my hard drive filled with self-help tomes that would most likely never be opened. I read a few pages, and I realized that Paul was neither a psychiatrist nor was he a neuroscientist nor a spiritual teacher. It was immediately apparent that he had no evident training in the topics that he was discussing and was a mediocre writer, to boot! And yet, Paul’s plain-spoken prose penetrated deep into my mind, and I’m pretty sure that the night I read his book was a real turning point for me.
So what was his message? That one had to STOP fighting and resisting all of the horrible things that were happening in one’s mind, and simply allow them to be there. I had heard variations of this a thousand times before: “Become friends with your depression.” “Just observe the anxiety without becoming caught up in it.” “View everything – both real and imagined – non-judgmentally.” However, I always found such advice to be too counter-intuitive to take seriously. Why would I ever want to make friends with my depression? I wanted it out of my mind as soon as possible!
And yet, something about the way that Paul David expressed this idea (ad nauseum, using the simplest terminology available) resonated with me. After reading that this approach finally enabled him to cast off the shackles of mental illness, after ten long years of suffering, I was sold! No longer would I fight the awful thoughts that seemed to be taking over my mind. No longer would I try to overpower the depression and anxiety with time-worn tactics that had seen me through them in the past. No longer would I try to deliberately distract myself from the depersonalization. Instead, I would simply allow all of the garbage in my mind to be in my mind, acknowledging its existence, and continuing to live my life the way that it demanded to be lived!
Armed with a fresh perspective, I threw myself back into meditation. I was no longer meditating in order to escape from the 24/7 circus of my own mind with the hopes of achieving spontaneous bliss. Instead, I began to approach meditation as the intentional courting of uncomfortable thoughts and feelings, so that I could practice allowing them to be there, and observing them non-judgmentally. I made an effort to meditate even when I really didn’t want to. The same went for exercise, work, hobbies, and all social engagement. Whereas previously I might have canceled doing something, like having dinner with a friend, now I not only went through with such plans, but approached them with gusto! If was feeling depersonalized, I would go for a run anyway, not caring whether it helped me feel better. Previously wary of making plans that might be difficult to break, I decided to make more plans and made it harder to break them. I challenged myself to be in situations that I knew would be uncomfortable. I spent time with people that I was not entirely comfortable around just so that I could observe the discomfort that it aroused and fully immerse myself in that discomfort!
And you know what, it worked! To such an extent that, a month later, I already started to believe that at some point in the not-too-distant future, I would no longer be plagued by intense mental distress. That’s not to say that I suddenly felt great and was free from intrusive thoughts, and cured of depersonalization. Far from it. There were still many days, where I felt terrible, and was certain that the DP had returned for good, or that I had merely discovered another new trick to keeping the depression at bay, which would lose its effectiveness soon enough. Still, each time a wave of discomfort swept through me, I continued with the practice of simply allowing it to be there, and made every effort possible to resist the urge to resist.
Over the next few months, the uncomfortable days were reduced to uncomfortable hours, and then mere minutes, in which the distress came and went, seemingly without any kind of conscious intervention. I stopped taking the medication and reading self-help books. My wife noticed that I almost completely stopped complaining about feeling like shit. It’s hard to imagine that only 6 months ago, I sincerely believed that I would have to continue to muddle through life in a miserable state, with death (whether self-imposed or natural) the only thing to look forward to. This is starting to feel like a distant memory, to such an extent that while penning this narrative, I sometimes wondered whether I was describing the experience of someone else! There is a part of me that is still terrified by the prospect of depersonalization, and I’d be surprised if I didn’t experience a few more setbacks before I’m fully recovered (whatever that means!). Still, I finally feel like I have the toolkit, and more importantly the mindset, to deal with whatever my brain throws my way, going forward.
Conclusions
Now that I’ve provided you with some context as to what I was dealing with, as well as the extent of my frustration and suffering, I’d like to share my thoughts on what helped me to get where I am today and what didn’t.
1) One of the best quotes I’ve ever come across in a self-help book (or in general, for that matter), is this nugget: “As to methods there may be a million and then some, but principles are few. The man who grasps principles can successfully select his own methods. The man who tries methods, ignoring principles, is sure to have trouble. (Harrington Emerson).” The way I came to understand this idea is that the worst thing one can do when trying to overcome depersonalization is by trying different methods willy-nilly without regard to underlying principle. Speaking personally, each time my depersonalization flared up, my mind would begin racing with thoughts of what else I might try to end my depersonalization: Should I start smoking cigarettes? Should I start eating meat? (I am mostly vegetarian). Should I embrace a life of hedonism? Or maybe a life of pure altruism? Should I become a monk and try to find a cave? Should I become a religious convert? Should I develop concrete goals for myself? Should I quit drinking coffee and/or drink more alcohol? Should I be doing breathing exercises multiple times per day? Should I try different medication, or a higher dosage of the current medication that I’m taking? Should I move back to the US and check myself into a mental hospital?
I seriously considered a treatment program that asserted that depersonalization was a product of fractured relationships with one’s immediate family, even though I have great relationships with my family. I considered paying $3000 up-front (equivalent to the average annual salary in the country that I live in) for a 14-day treatment program vaguely characterized as “energy healing.” I’m not arguing that any of these approaches are necessarily wrong, but rather that they comprise a scattershot treatment approach, and were hence guaranteed to be ineffective. But why? Couldn’t it be the case that I would hit paydirt with one of them?!
2) I’m firmly convinced that for a method to be effective, it must be based on the underlying principle of acceptance. In other words, the only way to actually overcome mental discomfort is to make peace with it. We’ve all heard the expression, what you resist persists. From personal experience, I can attest to the fact that this is 110% true. The more I fought what was going on in my mind, the stronger it became, and the more powerless I felt in dealing with it. On the other hand, when I stopped fighting the discomfort and tried my utmost to simply allow it to exist in my mind, I found that it lost most of its power. The discomfort was still there, and deep down, I obviously wished it wasn’t. However, by not trying to actively push it out of my mind, it ironically ceased to bother me.
This skill is difficult to cultivate. As I said, I tried and failed to implement this mindset several times over the last year because not only had I not fully accepted it, but I lacked the capacity to put it into practice. I wanted to believe that there was an instantaneous cure for mental suffering, and if I just kept searching, I would definitely come across it. It was only after reading Paul David’s book (At Last a Life), which advocated such an approach, did I finally start to believe it. I read a handful of books with a similar theme, including “You are not your brain,” by Jeffrey Schwartz, “Wherever you go, there you are,” by Jon Kabbat Zinn, and “The Mindful way through depression,” by Mark Williams, et al, all of which I can highly recommend.
From my personal experience, I think that practicing meditation/mindfulness is the best way to cultivate the attitude that you need to make peace with whatever is bothering you, since the practice literally involves dealing with all (uncomfortable) sensations, perceptions, thoughts, feelings, etc, as they arise, and simply allowing them to be there. If you’ve never meditated before, you will probably find meditation extremely discomforting, and it’s very possible that it will make your depersonalization and anxiety worse in the short-term. However, if practiced “correctly” and consistently for an extended period of time, my experience suggests that it will provide a foundation for confidently dealing with discomfort as it arises in daily life (i.e. outside of meditation practice).
Unfortunately, I don’t have anything particularly insightful to add to the extensive body of work that already exists on the subject of meditation, other than attesting to its effectiveness in relieving suffering. If you are willing to give it a shot, I would recommend buying a book and/or trying to find a teacher.
3) Adhering to a specific therapeutic regimen with a qualified therapist may be a good idea, though I think you need to look carefully at the type of therapy that is being practiced. I had great success with the behavioral techniques encompassed in Cognitive-Behavioral-Therapy in the treatment of anxiety and panic, but did not achieve any results with the cognitive techniques. In my first round of CBT, my “homework” involved putting myself directly into terrifying situations without trying to escape the ensuing anxiety. It worked wonders, to say the least. However, in round two of CBT, I tried to address my cognitive errors directly by overpowering my irrational thoughts with rational thoughts. Ultimately, I found this exercise to be frustrating and not helpful, which is why I made the decision to stop doing therapy. Frankly, I don’t think this technique could ever be helpful in dealing with primary depersonalization because it seems to imply that it can be overcome by actively trying to correct one’s thoughts. If meditation has taught me anything, it is that we have no control over our thoughts, so how could we possibly hope to actively change them! In contrast, I’ve learned that by simply allowing the uncomfortable thoughts and sensations to exist without falsely empowering then, they will stop appearing on their own!
There are at least two therapeutic models that I have come across which are consist with this idea: mindfulness-based therapy and acceptance-and-commitment therapy. There are a few books that have been written on both subjects, and I can recommend “The mindful way through depression,” by Mark Williams et al, and “Overcoming Depersonalization Disorder: A Mindfulness and Acceptance Guide to Conquering Feelings of Numbness and Unreality,” by Fugen Neziroglu et al.
Any therapist worth his salt should tell you that it is not his/her job to make you better. Making yourself better is your job. Personally, I think the therapist should serve as a guide rather than as a doctor. What I mean is that a therapist can help you develop a treatment regimen, but you are responsible for carrying it out. A course of weekly therapy sessions for a year, in and of itself, is unlikely to relieve you of anything more than your savings. Only through a combination of hard work and a change in the way that you view your suffering, will you get better.
4) With the right attitude and treatment program, you should start to see results in weeks or months. On the one hand, this means that years of therapy isn’t necessary to rid yourself of depersonalization. Unfortunately, it also means that you shouldn’t expect relief in mere days, let alone hours. I am skeptical of any treatment programs that promise a cure in 10 days. I am also skeptical when doctors insist that one should be on medication for a non-psychotic mental disorder for the rest of one’s life.
5) Speaking of which, I don’t have anything against medication, but for it to be effective, I firmly believe that it must be combined with changes in one’s mindset and lifestyle. I took a low dose of sertraline for two short periods (4 months each). I was told that antidepressants should be taken for at least a year, but given that I was dealing primarily with DP and anxiety, and probably secondarily, with depression, I respectfully ignored this advice. For me, the sertraline made my depersonalization worse for the first week I was on it (both times) to the point that I wanted to stop taking it. I didn’t experience any other side effects, and figured that it couldn’t hurt to continue taking it for as long as I felt was necessary. While I’m sincerely happy for those whose symptoms (of depersonalization, etc.), improved just from taking an antidepressant, my experience suggests that medication alone is not enough.
I also think that certain medications are probably detrimental to recovering from mental illness. I remain grateful to the sleep aid (Xanax/alprazolam) that helped me get through a period of intense anxiety-induced insomnia, but I always saw this a stop-gap measure. There have been so many times over the last year when all I wanted was to take a Xanax and feel instantly better, For the most part, I deliberately resisted this impulse, because I knew that each time I responded to feeling uncomfortable by taking a pill, I was only reinforcing the notion in my brain that discomfort was something that must be alleviated immediately. As I have written, this is the opposite message that you should be instilling in yourself!
6) You cannot outthink mental illness. This might sound-self-evident, but it was perhaps the hardest lesson for me to learn. I used to believe that I could think myself into being happy, or keep the panic at bay by consciously suppressing it, or rationalize away irrational thoughts. Sometimes, I even managed to achieve temporary success with these methods, but the result was always that the symptoms returned with a vengeance. Moreover, I have always enjoyed reading philosophy, and part of me believed that when I found the right philosophy on life, or read a moving text on existentialism, I would achieve immediate clarity, and my symptoms would vanish. While I still find philosophy intellectually interesting, I no longer believe that it has any power to directly diminish my mental suffering.
7) Spend less time trying to diagnosis yourself with other disorders, less time googling symptoms, and less time on online psych forums. Whenever I felt particularly distraught, often the first thing I did was to go online and see if there might be a disorder that I had overlooked. Over the last year, I strongly considered that I might have one or more of the following disorders: depersonalization, major depression, generalized anxiety disorder, bipolar disorder, panic disorder, phobic disorder, multiple personality disorder, borderline personality disorder, post-traumatic stress disorder, obsessive compulsive disorder, attention deficit disorder, chronic fatigue syndrome, and others. At this point, I’m comfortable with the label of depersonalization disorder, but ultimately I realize this is pretty arbitrary. Many of the symptoms I felt were common in many of the disorders I listed above, which is how I found my way to them in the first place. While the medication and treatment protocols obviously differ for different disorders, I think for those suffering with vague (but pronounced!) discomfort of the kind brought by depersonalization, it’s less important to achieve a diagnosis and more important to establish the right treatment.
Speaking of symptoms, I experienced some weird ones. Panic. Sudden, intense depression. Lethargy. Apathy. Racing Thoughts. Intrusive thoughts. Obsessive suicidal thoughts. Fear of tunnels. Floaters in my eyes. Fear of airplanes. Fear of the open water. Rapid heartbeat. Hopelessness. Emotional numbness. Inability to Concentrate. Disconnect from reality. Disconnect from my own body. Fear of my own mind. Insomnia. Fear of going to sleep. Restlessness. Lack of Appetite. Lack of Motivation. Hyperawareness…..and hundreds of others that I either can’t remember or can’t put into words. I wasted an extraordinary amount of time online trying to make sense of all of these symptoms. After my epiphany a la Paul David, I realized that the specific symptoms are irrelevant to treatment and that dwelling on them is counter-productive. In the end, all of these symptoms were caused by my brain being stressed, which responded by sending out an endless stream of “deceptive brain messages,” and nothing more than this. By focusing intently on these symptoms, I succeeded only in making my brain more stressed, which made the symptoms more intense, and so on. Stop focusing on the specific symptoms. Period. When you accept the symptoms as they are, they will cease to bother you, and ultimately cease to exist.
Finally, I would encourage everyone to spend less time on psych forums, especially the kind that seem to serve as echo chambers of hopelessness. My “research” into depersonalization brought me to many of these forums, and for the most part, I found them not to be helpful. I understand how these forums serve as virtual communities for those suffering from various afflictions. At the same time, I think it’s hard to believe you will ever get better when everyone else in the forum is complaining that nothing works and that getting better feels impossible.
8) Make positive lifestyle changes and reinforce good decisions. When you’re feeling like shit, it’s especially important to eat healthy, exercise, be social, and live an ethical, well-rounded life. To be honest, on my worst days, I didn’t want to do any of these things. And when I forced myself to do them, I often felt worse. However, by doing these things repeatedly, especially when I didn’t want to, I began to realize that whatever I was feeling did not have the power to influence how I lived my life. After a while, the fact that I was feeling depersonalized seemed to feel downright irrelevant when I was debating whether to make plans to see a friend or go for a run.
At the same time, it’s important to not see hanging out with friends or going for a run or eating healthy foods as a means to an end of becoming less depressed or less depersonalized. Sometimes, I would go for a run with the express purpose of trying to make myself feel better. When I discovered that I felt the same or worse afterwards, I was filled with frustration and I began to question why I had gone for a run in the first place, rather than just lie in bed and rest (aka mope). When I changed my perspective, however, and began to see all of these things as part of a well-rounded, full life – a life which may or may not also include depression, depersonalization, etc. – doing them became less tedious and more enjoyable.
9) Depersonalization seems more likely to become chronic in those that are especially focused on themselves and/or their own thoughts. I have no actual evidence for this, save for my own experience. I have found that periods in which I was most focused on my own gratification and even my own psychological well-being, almost inevitably culminated with mental distress, such as depersonalization. Basically, I would feel depersonalized for a few days, succeed in distracting myself with some kind of self-serving pursuit which led to feeling great for a few weeks. Then, I would start dwelling on how great I was feeling while hoping that I could sustain it indefinitely, which then led back to me feeling depersonalized. I now think one of the keys to becoming less depersonalized over time is to do things which take me out of myself, or at least out of thinking about myself 24/7. Try this for yourself…you might be surprised by the results.
Ultimately, I think that depersonalization, depression, anxiety, and other forms of mental suffering are a natural part of existence. My own experience suggests that they only develop into full-blown disorders or pathologies when we simply cannot accept their presence. We dwell on them and resist them and try to conquer them, which of course ultimately reinforces the notion in our brains that these forces are not only real, but should be regarded with fear and kept at bay. By recalibrating the way that we relate to these feelings, we diminish their power to harm us, while amplifying their power to help us grow.
Consider this: last year, when I finally admitted to my wife that I was suffering acutely and that I was finding it hard to get through each day, she responded as follows: “You need to see this as a gift, rather than as a curse. One day you will surely feel gratitude for having experienced this.” And do you know what? Despite rolling my eyes at the time, I am starting to believe that she was right…
