got a question for you. do you think the dpdr from which people can recover in a few years is fundamentally (maybe biologically) the same „illness“ as someone who got this for 20 years?
Not necessarily, since other mental disorders can also be both episodic and permanent (like depression or psychosis) and I am not aware of evidence that this indicates a fundamental difference. There is evidence that depression and psychosis can become more severe with each episode and the likelihood of the symptoms becoming permanent rises with each subsequent episode. This might also hold up for depersonalization disorder, where the course patterns "permanent" and "initially episodic, but later permanent" are the most common courses.
Have tried nalmefene and naltrexone myself. I could not tolerante such high doses need because the affinity to kappa it very low. Felt nothing. I think Joe Perkins could tolerante a very high dose for a long time without effect. One with a heroin addiction here was shifted from metadone to buprenorphine and felt a 20% reduction.
Someone on Longecity was cured while taking buprenorphine. Currently only combining buprenorphine with naltrexone (similar to ALKS-5461) might be the safest and most cost effective way to block the kappa-opioid-receptors.
but then we have some people (even if its limited) who recovers also after 10+ years without a specific treatment. just with things like meditation or lifestyle changes. do you think they reach a shift in their brain what makes that possible or it is a psychological thing?
They exist, but they are not as common as many people want to believe and in most cases it is difficult to draw conclusions from their recovery stories, especially regarding the direction of causality between the things they did and their recovery. Maybe their symptoms got better by themselves and this made them change their lifestyle?