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How did Jeffrey Abugel recover?

11K views 51 replies 10 participants last post by  35467 
#1 ·
Hey everybody,

does anybody know how Jeffrey Abugel (author of "Stranger to My Self" and co-author of "Feeling Unreal") recovered from DPD?

If I remember correctly, he never revealed how he cured his DPD. In his book and in an interview on YouTube he says that he had DP for 11 years and that it took him 11 years to even get the right diagnosis (which means that he must have been cured shortly after he got the diagnosis).

I think it would be really interesting to know how he got cured.

Thank you! :)
 
#27 ·
but how you can live with that ?
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.
 
#29 ·
but you survive...i cant it like you
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.
 
#31 ·
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.
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
 
#32 ·
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.
 
#33 ·
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.
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?
 
#34 ·
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.
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
 
#35 ·
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.
 
#36 ·
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.
 
#37 · (Edited by Moderator)
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
 
#38 ·
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
so you think i would have good chances with my outset of 10 months ago?
 
#39 ·
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.
 
#40 · (Edited by Moderator)
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.
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 :D i could make a whole experiment with those stuff hahahah

https://npistanbul.com/eriskin-psikiyatri/manyetik-uyarim-tedavisi-ttmu

edit: they make deep tms with brainsway. but they have neuronavigation. could that be useful?
 
#41 · (Edited by Moderator)
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
biggrin.png
i could make a whole experiment with those stuff hahahah

https://npistanbul.com/eriskin-psikiyatri/manyetik-uyarim-tedavisi-ttmu

edit: they make deep tms with brainsway. but they have neuronavigation. could that be useful?
Yes, i would not contact them before the french trail is published. They might reject you because the current trails are too small and conflicting. The french trail will also likely bring more information about the condition. So, they will have that trial to look into too.

You can not come to them anyway due to COVID-19. You can likely get your MRI scan done in Turkey too for around 100.euros. In Western Europe or the us it would be around 700-1000.euros. They have a Magstim rTMS equipment and there are no deep coil. They can replicate all current trials. Also much cheaper to live there. The turkeys lire is in free fall. I think it could become very cheap.

The Brainsway deep tms is interesting too. These are h-coils and like helmets designed specific for a condition. I can not see if they have the helmet for OCD. I would like to try that. It is designed to stimulate the medial prefrontal cortex and anterior cingulate. These locations are currently seen as the most central if you take the average studies done. Depersonalization have strong OCD components with constant self monitoring and checking that are very close to obesssive compulsive disorder. It could be interesting to try that approach. Again the French trail should in their design do some follow up with fMRI scanners and they might look into regulations done in the prefrontal cortex. If there is a conformation that the medial prefrontal and anterior cingulate plays this role than I think they might be open to try to do deep tms if the have h-coil for OCD.
 
#42 ·
Deep tms is typically 4-6.weeks but it stimulates much deeper into the brain to structures that a normal rTMS coil can not access. There is a clinic in Palm Beach that is also a testing site for "Brainsway"and they have in some reports written that they have tried depersonalization but they have not written what they have used as intervention or if there was any positive response in those they treated. I might write to them.

this small video is about deep tms for OCD at the Palm Beach deep TMS Center about a woman having constant OCD systems related to her personality for 30.years.
 
#43 · (Edited by Moderator)
Deep tms is typically 4-6.weeks but it stimulates much deeper into the brain to structures that a normal rTMS coil can not access. There is a clinic in Palm Beach that is also a testing site for "Brainsway"and they have in some reports written that they have tried depersonalization but they have not written what they have used as intervention or if there was any positive response in those they treated. I might write to them.

this small video is about deep tms for OCD at the Palm Beach deep TMS Center about a woman having constant OCD systems related to her personality for 30.years.
no i dont have to wait due to covid. im turkish citizen with right of residence in germany. i can fly. first a prof would examinate me and talk with me about my symptoms. then we would decide if its worth a try.

but in which symptoms i have to expect an improving in symptoms with the ocd coil? one of my main symptoms is being in a dream state. and because i did it one time to overcome all my symptoms in the past just with ignoring and live life (it tooks 4 years until full recovery) i dont really make self checking. also not comparing with my former state.
 
#44 ·
no i dont have to wait due to covid. im turkish citizen with right of residence in germany. i can fly. first a prof would examinate me and talk with me about my symptoms. then we would decide if its worth a try.

but in which symptoms i have to expect an improving in symptoms with the ocd coil? one of my main symptoms is being in a dream state. and because i did it one time to overcome all my symptoms in the past just with ignoring and live life (it tooks 4 years until full recovery) i dont really make self checking. also not comparing with my former state.
Using a OCD coil is a experiment and you have to have read much into the disorder and brain imaging studies to see that there might be this potential relation. You can not assume they know that or will read so much into It. The reason I would wait for the French trail is because they in their design write they would do a follow up with fMRI scanners in those in the active part of the trail. They would likely look for differences in those who had a response, partial and no response. It will like point towards activity in the prefrontal cortex and likely the dorsomedial prefrontal cortex and anterior cingulate. If that is the case you would have more information to act on. The dream state is related to the right TPJ/angular gyrus but if you don't have any response from that location it will be difficult to see why today. You could try the right TPJ/angular gyrus and/or the right VLPFC now and if it not of any benefits see what the French trail will show and try "Brainsway" OCD protocol if the French trail shows the activity in the anterior cingulate and dorsomedial prefrontal cortex plays a central role in partial or non response group.
 
#45 ·
Using a OCD coil is a experiment and you have to have read much into the disorder and brain imaging studies to see that there might be this potential relation. You can not assume they know that or will read so much into It. The reason I would wait for the French trail is because they in their design write they would do a follow up with fMRI scanners in those in the active part of the trail. They would likely look for differences in those who had a response, partial and no response. It will like point towards activity in the prefrontal cortex and likely the dorsomedial prefrontal cortex and anterior cingulate. If that is the case you would have more information to act on. The dream state is related to the right TPJ/angular gyrus but if you don't have any response from that location it will be difficult to see why today. You could try the right TPJ/angular gyrus and/or the right VLPFC now and if it not of any benefits see what the French trail will show and try "Brainsway" OCD protocol if the French trail shows the activity in the anterior cingulate and dorsomedial prefrontal cortex plays a central role in partial or non response group.
yeah it sounds seriously plausible. but i have the feeling my symptoms go worse. im not really sure but my symptoms feel every week different and that makes me afraid of if it goes worse :( therefore i want to start a treatment as soon as possible..
 
#46 ·
No, but if you want to have a intervention now then the basis are two locations based on two trails. The right TPJ and or the right VLPFC. The right TPJ and angular gyrus are the same location. This is based partially on neurological patients showing derealisation due to a tumor or seizure from this location and partially brain scans. The French trail uses the term angular gyrus term but their references are the same as the TPJ trail.

https://clinicaltrials.gov/ct2/show/NCT02476435
 
#47 ·
If one looks at "Brainsway" own site over providers your clinic that you refers to should only have a coil for major depression and not OCD. They write that another provider should have both the coil/ helmet for depression and OCD. It could be an error or he just wrote some generalizations about deep tms and only have a coil for depression. The other provider they say should have a coil for OCD is this one. https://www.kemalarikan.com/
 
#48 ·
No, but if you want to have a intervention now then the basis are two locations based on two trails. The right TPJ and or the right VLPFC. The right TPJ and angular gyrus are the same location. This is based partially on neurological patients showing derealisation due to a tumor or seizure from this location and partially brain scans. The French trail uses the term angular gyrus term but their references are the same as the TPJ trail.

https://clinicaltrials.gov/ct2/show/NCT02476435
what you mean with no xd no for what? :D
 
#49 ·
If one looks at "Brainsway" own site over providers your clinic that you refers to should only have a coil for major depression and not OCD. They write that another provider should have both the coil/ helmet for depression and OCD. It could be an error or he just wrote some generalizations about deep tms and only have a coil for depression. The other provider they say should have a coil for OCD is this one. https://www.kemalarikan.com/
yeah youre right. they have also the h7 coil for ocd, but i dont know if they have neuronavigation. i just wrote them. they will likely have similar prices.
 
#50 ·
yeah youre right. they have also the h7 coil for ocd, but i dont know if they have neuronavigation. i just wrote them. they will likely have similar prices.
No, there is no normal set up for neuronavigation in their pictures. It could be that they use a more primitive method that is also cheaper. That the navigation is done separately once and the location is marked with a pen and photos are taken and the mark is then refreshed every time you come.
 
#51 ·
No, there is no normal set up for neuronavigation in their pictures. It could be that they use a more primitive method that is also cheaper. That the navigation is done separately once and the location is marked with a pen and photos are taken and the mark is then refreshed every time you come.
i hate my luck. one provider hasnt neuronavigation and the other not that coil.. why always me..
 
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