How did Jeffrey Abugel recover?
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One of the antidepressants with the fewest side effects in me. It lowered the blood pressure so I became more dizzy. Then there the dietary restrictions but one gets used to them. I tried before it was known I had depersonalization. It was thought I had a form of atypical depression then.
Depersonalization in its primary form is a pharmaceutical treatment resident disorder with no formal treatment that can be replicated in a larger group of patients. There might be anecdotal stories of a drug working in some but they fail to replicate in others who try. Refractory conditions are normal in psychiatry. Many with depression do not respond to antidepressants and ECT is expensive and given reluctantly. So, it is why that focus is on the development of brain stimulation techniques is increasing to address these refractory states.
Who says I can? I read into all research into depersonalization, research in brain stimulation/rTMS as a way to come out of it.
So, when deep rTMS coil is approved in Europe or a location in Eastern Europe have rTMS equipment with neuronavigation and a deep coil I expect to try the right VLPFC or dorsal nexus a location between the medial prefrontal cortex and anterior cingulate that most brain imaging studies says are active in depersonalization. Can not be done now.
I have tried to help you but you rejected the help. You are complaining about emotional numbing, insomnia and loss of appetite. These symptoms sounds more like major depression. You have also been seen by a professor who have done research into depersonalization and written books about it and he have said that you do not suffer from depersonalization but major depression with secondary symptoms of depersonalization. So, you are suffering from major depression but identifies yourself with another condition. Major depression is a far more serious condition than depersonalization.
you wrote to me in the start of the summer and I replied to you that you should contact a rTMS clinic in italy that have the best equipment in all of Europe to get a treatment for major depression. It is a clinic that have rejected me and going into depersonalization likely due to many conflicting date pt. But, they would likely be open to major depression. I wrote to you that they had equipment to interventions into locations other clinics in Europe can not do because they use a deep coil despite it is not approved for clinical use, They could have tried locations like the medial prefrontal cortex that works in depression, PTSD and OCD. If that didn't work they could have tried the right Orbitofrontal cortex that works in depressive states with anhedonia. Other rTMS clinics in all of Europe do not have the equipment to do that . They have and use a deep coil and have neuronavigation. They use equipment you find in research facilities.You could open some doors with depression diagnosis you have from a professor and likely several German psychiatrists. But, you insisting on have depersonalization and not major depression is almost the largest obstacle for you getting help. You could have been on Sardinia for one month this summer and tried these locations. They would have given you two sessions a day at 100.euros session. So, their prices was also fair.
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my onset 10 months ago was also with anxiety, panic attacks and a major depressive episode. my depression is going to be better but my dp is still there.. any thoughts of this? its quite similar to your onset i think
According to some texts the outset of depersonalization in its primary form is in 50% connected to a major depression and usually followed panic attacks. It was the case with me with depression for 6.month, 3.months into the depression depersonalization followed by panic attacks that made emotional numbing. In others it is just related to panic attacks without prior depression. Typically the depression will subside and the panic attacks replaced by emotional numbing that reflects the overregulation of emotions related to the panic attacks. Then there will be a pure state without symptoms of depression or anxiety and it will be depersonalization in its primary form without be secondary to another condition.
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well, after 10 months, i feel still anxiety sometimes, and i have slight emotions. but no panic attacks. my anxiety is 90% related to thoughts like „what if this disorder destroy my whole life" and „what if this will lasts forever".
and do means the similar outset for me i will have this my whole life also?
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how many people you know who tried deep tms with depersonalization disorder and has gotten better? you said anything about italy i would fly in a few weeks if the effectivity is likely
I don't know any with depersonalization who have tried deep tms. The reason I write about deep TMS is because the locations active in the prefrontal cortex in depersonalization and linkly makes the over regulations of emotions are too deep for a normal rTMS coil to intervene in. So, you really can't intervene properly in depersonalization as it stand. This is also the case with many with depression who do not respond to normal rTMS.
The place in Italy have rejected me, depersonalization is not on their site. They likely see the disorder and the data as to conflicting about locations. I don't know. The point is that they will not work with the disorder as it stands. So, they will reject you to. But, they use a deep coil not formally approved for clinical use yet. They linkely have because some with relations to the clinic are university researchers and do research with used rTMS and they have got the coil though those channels and not as a clinic. I hope the coil will be approved for clinical use in Europe the coming year.
The place in Italy have rejected me, depersonalization is not on their site. They likely see the disorder and the data as to conflicting about locations. I don't know. The point is that they will not work with the disorder as it stands. So, they will reject you to. But, they use a deep coil not formally approved for clinical use yet. They linkely have because some with relations to the clinic are university researchers and do research with used rTMS and they have got the coil though those channels and not as a clinic. I hope the coil will be approved for clinical use in Europe the coming year.
I am not intersted in rTMS clinics that are expensive and do not have the equipment to intervene in the locations found active in the prefrontal cortex in depersonalization . You need neuronavigation to find these locations and that rules out 95% of the clinics in Europe. Then there are the suspected locations. The right VLPFC can partially be stimulated by a normal coil, -like 20% so the risk of partial or no response is very high. There are several texts saying that a deep coil is needed to stimulate the right VLPFC properly . The location might not even be correct as most research points towards the medial prefrontal cortex and anterior cingulate as central. This locations you need a deep coil. This rules out all rTMS clinics in Europe, except the one that have rejected me. RTMS is used experimentally for depression in many public health system in Europe. The setup for their machines are only for the left and right DLPFC. They do not have neuronavigation or deep coils. So, they can technically not do it and legally not allowed to. It is only rTMS at the left and right DLPFC that have been approved for depression they are allowed to treat. When you go to other locations you are doing a experiment. In the public health system that have to be approved by a ethical board. So, it will not happen. It is only private clinics with the equipment doing it "off-label" that can do it.
One could try rTMS at the right TPJ/angular gyrus if the outset is recent, - within 5-7. years. There have been one trail at the right TPJ in 2011 and 50% had a response and it was among those who have had depersonalization the least time. The reductions was seen in symptoms related to derealisation and least related to emotional numbing. The French angular gyrus trail is just a larger replication of it. It should be published within the coming six months. That trail can be replicated without a deep coil but you likely need neuronavigation to find the location.
https://dacemirror.sci-hub.do/journal-article/cecf6c87ef47f78a30dbc4977dafe630/mantovani2011.pdf
https://dacemirror.sci-hub.do/journal-article/cecf6c87ef47f78a30dbc4977dafe630/mantovani2011.pdf
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so you think i would have good chances with my outset of 10 months ago?
Yes, in theory. But, wait until the French trail is published as it is much larger in size and the also do a follow Up and makes some scanning in respondents and non-respondents. Much more information in that trail due to that if they follow their design. Anyway you can not get a treatment due to COVID and travel restrictions until spring. But, there ought to be a good chance for symptoms reductions. Emotional numbing should be the least affected and it might likely be related to a regulation in the prefrontal cortex that still is active. I think in those who don't respond this location might be to dominant. I have tried this location without effect. I think that the activity in the prefrontal cortex have to addressed first and this location might be more productive to try again if that happen. I don't think that the TPJ/angular gyrus is the "core location" but it plays a central role.
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i just found a clinic in turkey they make deep tms and have neuronavigation. there is also a professor for counseling. what you think mg? i could fly instant to turkey and its sooo fucking cheap. rtms 30 euro per session deep tms 80 euro
i could make a whole experiment with those stuff hahahahhttps://npistanbul.com/eriskin-psikiyatri/manyetik-uyarim-tedavisi-ttmu
edit: they make deep tms with brainsway. but they have neuronavigation. could that be useful?
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