[180284]

Hi everyone,

I have recovered from dp/dr multiple times in my life, however, three years ago I had a very strange panic attack/mental breakdown (not sure what it was really), which triggered a different kind of “enlightenment” haha. I had no dr - everything looked real, no brain fog, nothing. Strangely, almost no dp symptoms as well. I felt connected to my body, no autopilot or looking at the world from the back of my head. The only thing that happened, is that I completely lost my sense of self. It felt like I couldn’t access the emotions and feelings related to my identity. I remember that after the panic attack, I immediately stood up from my bed and I didn’t know where should I go or what should I do next because I couldn’t understand myself at all.

Before the panic attack started, I got a little bit of dr but a minute later it felt like the dr completely subsided and kind of transformed into this loss of sense of self (dp, I guess).

I went through periods of severe dpdr in the past, but from what I remember, my identity was never impacted as much. I was scared of being alone with myself because I would get lost in my mind thinking about who I am and then would freak out. Very disturbing experience.

I used the same recipe that helped me to escape dpdr episodes in the past - exercising and focusing on other things. After 6-7 months everything kind of stabilized and I felt much better. I can’t really say if the dp went away or I just became accustomed to it but during the past 2-3 years I felt quite normal and productive.

A month ago, I was under a lot of stress/anxiety and this identity thing returned. This is definitely the peskiest symptom that I’ve experienced with dpdr.

Does anyone else has/had this kind of dp (loss of sense of self)? How do you deal with it? I've never tried SSRIs or any other antidepressants/mood-stabilizers, only benzos. Do you think ad's could help? Thanks.

 

[Trith]

Hi everyone,

I have recovered from dp/dr multiple times in my life, however, three years ago I had a very strange panic attack/mental breakdown (not sure what it was really), which triggered a different kind of “enlightenment” haha. I had no dr - everything looked real, no brain fog, nothing. Strangely, almost no dp symptoms as well. I felt connected to my body, no autopilot or looking at the world from the back of my head. The only thing that happened, is that I completely lost my sense of self. It felt like I couldn’t access the emotions and feelings related to my identity. I remember that after the panic attack, I immediately stood up from my bed and I didn’t know where should I go or what should I do next because I couldn’t understand myself at all.

Before the panic attack started, I got a little bit of dr but a minute later it felt like the dr completely subsided and kind of transformed into this loss of sense of self (dp, I guess).

I went through periods of severe dpdr in the past, but from what I remember, my identity was never impacted as much. I was scared of being alone with myself because I would get lost in my mind thinking about who I am and then would freak out. Very disturbing experience.

I used the same recipe that helped me to escape dpdr episodes in the past - exercising and focusing on other things. After 6-7 months everything kind of stabilized and I felt much better. I can’t really say if the dp went away or I just became accustomed to it but during the past 2-3 years I felt quite normal and productive.

A month ago, I was under a lot of stress/anxiety and this identity thing returned. This is definitely the peskiest symptom that I’ve experienced with dpdr.

Does anyone else has/had this kind of dp (loss of sense of self)? How do you deal with it? I've never tried SSRIs or any other antidepressants/mood-stabilizers, only benzos. Do you think ad's could help? Thanks.

I know that what we call antidepressants can be efficient for anxiety, or at least some of them. But people have very different reactions and according to the forum it doesn't seem that there is any particular antidepressant that works better than another one. At least not that I know of. In my case Sertraline removed my DPDR but gave me impossible side-effects and I had to stop, and Seroplex, Prozac and Effexor did not help me, but some killed (or sometimes nearly) my ability to have an orgasm while on treatment, which was interesting.

 

[180284]

I know that what we call antidepressants can be efficient for anxiety, or at least some of them. But people have very different reactions and according to the forum it doesn't seem that there is any particular antidepressant that works better than another one. At least not that I know of. In my case Sertraline removed my DPDR but gave me impossible side-effects and I had to stop, and Seroplex, Prozac and Effexor did not help me, but some killed (or sometimes nearly) my ability to have an orgasm while on treatment, which was interesting.

Hi and thank you for your response! It’s interesting that Zoloft, Seroplex, and Prozac are all in the same class of antidepressants but only one of them was effective for you. I didn’t know there could be such a significant difference between SSRIs. It sucks that you couldn’t continue with it :/

I know they can have sexual side effects and this is one of the main reasons I’m hesitant to try it. On the other hand, it’s hard to build and maintain relationships when you have no firm sense of yourself. What I’m most concerned about is the emotion-numbing side effects that I know some people get. I’m already pretty numb emotionally so you know…

I just got prescribed vortioxetine (serotonin modulator and stimulator) and from what I read it seems to have less sexual and emotion-numbing side effects in comparison to "classic" ssris. I think I will give it a try because I really want to see what meds can offer me.

Also, I'm interested - what kind of symptoms do you have and for how long? Is it episodic or constant?

 

[Chip1021]

Hi and thank you for your response! It’s interesting that Zoloft, Seroplex, and Prozac are all in the same class of antidepressants but only one of them was effective for you. I didn’t know there could be such a significant difference between SSRIs. It sucks that you couldn’t continue with it :/

I know they can have sexual side effects and this is one of the main reasons I’m hesitant to try it. On the other hand, it’s hard to build and maintain relationships when you have no firm sense of yourself. What I’m most concerned about is the emotion-numbing side effects that I know some people get. I’m already pretty numb emotionally so you know…

I just got prescribed vortioxetine (serotonin modulator and stimulator) and from what I read it seems to have less sexual and emotion-numbing side effects in comparison to "classic" ssris. I think I will give it a try because I really want to see what meds can offer me.

Also, I'm interested - what kind of symptoms do you have and for how long? Is it episodic or constant?

The emotion-numbing of SSRIs are not side-effects. Those are the therapeutic effects. Aside from a placebo response, which is exceptionally strong for depression, antidepressants are not “happy pills.” They don’t give you euphoria like ecstasy or LSD, nor do they increase alertness, attention, and focus like stimulants. To the extent they do anything at all, they simply numb you to the experience of your emotions, which some severely depressed persons see as a major improvement.

 

[Trith]

Hi and thank you for your response! It’s interesting that Zoloft, Seroplex, and Prozac are all in the same class of antidepressants but only one of them was effective for you. I didn’t know there could be such a significant difference between SSRIs. It sucks that you couldn’t continue with it :/

I know they can have sexual side effects and this is one of the main reasons I’m hesitant to try it. On the other hand, it’s hard to build and maintain relationships when you have no firm sense of yourself. What I’m most concerned about is the emotion-numbing side effects that I know some people get. I’m already pretty numb emotionally so you know…

I just got prescribed vortioxetine (serotonin modulator and stimulator) and from what I read it seems to have less sexual and emotion-numbing side effects in comparison to "classic" ssris. I think I will give it a try because I really want to see what meds can offer me.

Also, I'm interested - what kind of symptoms do you have and for how long? Is it episodic or constant?

My DR symptoms have been constant for a bit more than 20 years, with a peak around +6 years, a decrease and a plateau for about 10 years. And my DP symtpoms are now rare and episodic mostly. What I mean with DR is a feeling of unreality, a kind of glass wall between me and the rest of the world and less ability to enjoy the place where I am. I am like never really anywhere. And my DP episodes are a decrease in sense of familiarity with myself and others, places and also thought processes.
About SSRI's, there are some possible and probably rare long term effects like post ssri sexual dysfunction (PSSD). It is rare and sometimes it is still probably worth it to try the medication, but it is worth looking into before you make a decision. Otherwise, for me, everything that isn't permanent is worth trying. I am not afraid to lose some aspects of my sexuality for a few weeks or get some more emotional numbing just to try something, except if sexuality is important just now and I want to postpone the med. You don't get married with the meds, for me everything is ok provided it is reversible. The thing is I am not sure everything is reversible (in rare cases). It's not good to frighten people about this, but it is good to have information.

 

[Trith]

The emotion-numbing of SSRIs are not side-effects. Those are the therapeutic effects. Aside from a placebo response, which is exceptionally strong for depression, antidepressants are not “happy pills.” They don’t give you euphoria like ecstasy or LSD, nor do they increase alertness, attention, and focus like stimulants. To the extent they do anything at all, they simply numb you to the experience of your emotions, which some severely depressed persons see as a major improvement.

I am not sure this is true. There is similar criticism towards anti-psychotics for example. Some people say that anti-psychotics are just there to numb people so that they are easier to manage but they don't help the person. I heard that for years and it is really not true. Even the old anti-psychotics that make you walk like a zombie and drool because you can't close your mouth anymore, even those do actually remove hallucinations efficiently and can (but not necessarily) improve lifestyle depending on the person. That being said, it is possible that hospital personel do give more anti-psychotics to people to make them more docile through the numbing side-effects, it is possible that some people do get only the side effects, but that doesn't mean the medication doesn't have other good effects for everybody, that's rather a problem with how the pill is used by those doctors.
About SSRI's, I did experience strong numbing with Sertraline. Actually it wasn't as simple as numbing, because I could feel emotions, and they were actually positive, but for example I could not cry when sadness was coming up. When I normally cry, and it is probably the same with everybody, I feel some knot in my stomach and the sensation goes up in my body, to my head and then I start crying and I have the feeling I am evacuating something and something gets unlocked in me and then I feel better. So I am talking about the good type of crying, not the desperation type of crying. And with Sertraline I could feel that sensation coming up, but then it disappeared just before reaching my head and I was left with nothing, my eyes stayed dry and nothing was unlocked like usually, not particularly locked either, but it was frustrating to feel that coming and not being able to go to the end of the process. And it was the same with orgasm. I could masturbate and feel pleasure increasing, and just before orgasm, one stage was totally absent and my pleasure just vanished into nothingness and then nothing happened. With another SSRI orgasms were possible for me, but harder to reach, but when I did reach them they gave more much more pleasure, so who knows. But sexuality was not my priority at the time. Anyway, for me it is more complex than simple numbing. At that time I did feel more happiness, and not just more neutral or more zombie. A friend who tried Sertraline too for a month at the lowest usual dosage like me and told me he had no side effects but just realized he felt happier. He did not have strong depression before, it was quite mild. Saint John's Wort is also an SSRI and here I can say that it really made me happier. I could take it occasionally before going out and I was much more sociable and outgoing, I also felt more pleasure and ease in my body and I enjoyed more to speak with people. It was rather "de-numbing" I would say. I did not have depression at that time but tried it just for DR (and it didn't really help for DR, even at the max dosage). Even weeks after I could feel that my mood was more solidly positive and less vulnerable to daily problems. But most people don't feel this or not this intense. (but just as a side not, if you are interested in trying Saint John's Wort, note that it has a lot of interactions with other medicines, even contraceptive pills, and as a precaution in a lot of places they say you should probably not take it together with anything else)
I read also some therapists say that emotional numbing means the dosage should be adjusted. Again, for some people emotional numbing might be desirable, but in general I don't think this is the objective of such medication or that they work only in this way.

 

[Chip1021]

I am not sure this is true. There is similar criticism towards anti-psychotics for example. Some people say that anti-psychotics are just there to numb people so that they are easier to manage but they don't help the person. I heard that for years and it is really not true. Even the old anti-psychotics that make you walk like a zombie and drool because you can't close your mouth anymore, even those do actually remove hallucinations efficiently and can (but not necessarily) improve lifestyle depending on the person. That being said, it is possible that hospital personel do give more anti-psychotics to people to make them more docile through the numbing side-effects, it is possible that some people do get only the side effects, but that doesn't mean the medication doesn't have other good effects for everybody, that's rather a problem with how the pill is used by those doctors.
About SSRI's, I did experience strong numbing with Sertraline. Actually it wasn't as simple as numbing, because I could feel emotions, and they were actually positive, but for example I could not cry when sadness was coming up. When I normally cry, and it is probably the same with everybody, I feel some knot in my stomach and the sensation goes up in my body, to my head and then I start crying and I have the feeling I am evacuating something and something gets unlocked in me and then I feel better. So I am talking about the good type of crying, not the desperation type of crying. And with Sertraline I could feel that sensation coming up, but then it disappeared just before reaching my head and I was left with nothing, my eyes stayed dry and nothing was unlocked like usually, not particularly locked either, but it was frustrating to feel that coming and not being able to go to the end of the process. And it was the same with orgasm. I could masturbate and feel pleasure increasing, and just before orgasm, one stage was totally absent and my pleasure just vanished into nothingness and then nothing happened. With another SSRI orgasms were possible for me, but harder to reach, but when I did reach them they gave more much more pleasure, so who knows. But sexuality was not my priority at the time. Anyway, for me it is more complex than simple numbing. At that time I did feel more happiness, and not just more neutral or more zombie. A friend who tried Sertraline too for a month at the lowest usual dosage like me and told me he had no side effects but just realized he felt happier. He did not have strong depression before, it was quite mild. Saint John's Wort is also an SSRI and here I can say that it really made me happier. I could take it occasionally before going out and I was much more sociable and outgoing, I also felt more pleasure and ease in my body and I enjoyed more to speak with people. It was rather "de-numbing" I would say. I did not have depression at that time but tried it just for DR (and it didn't really help for DR, even at the max dosage). Even weeks after I could feel that my mood was more solidly positive and less vulnerable to daily problems. But most people don't feel this or not this intense. (but just as a side not, if you are interested in trying Saint John's Wort, note that it has a lot of interactions with other medicines, even contraceptive pills, and as a precaution in a lot of places they say you should probably not take it together with anything else)
I read also some therapists say that emotional numbing means the dosage should be adjusted. Again, for some people emotional numbing might be desirable, but in general I don't think this is the objective of such medication or that they work only in this way.

Im not sure if anything you said here actually contradicts my response. I would have to agree with most if not all of this. What you said about antipsychotics is not an either/or proposition. APs make people feel like zombies and reduce or get rid of “hallucinations.” I think that is two ways of saying substantially the same thing. The confusion is that we conceptualize hallucinations as something that is being produced by a diseased mind (brain), rather than an action that a person is performing (though perhaps not really willfully). That’s kind of like saying laughing gas makes you feel loopy and disoriented but it can also serve as a painkiller. Whether drugs work or not depends mostly on how the person interprets and responds to the changes in his experience, and the value/priority he places on those changes. For some, sexual impotence is a small price to pay for being able to keep their jobs and homes. For others, it is devastating because their sexuality is very important to their pursuit of happiness. This is one of the many reasons why I’m no longer pursuing treatment with psych meds—I’m not even sure what I value at this point.

Is it true that St Johns Wort is an actual SSRI? I knew it was used for depression, but that’s something I did not know about it, if true. Interesting.

 

[Trith]

Im not sure if anything you said here actually contradicts my response. I would have to agree with most if not all of this. What you said about antipsychotics is not an either/or proposition. APs make people feel like zombies and reduce or get rid of “hallucinations.” I think that is two ways of saying substantially the same thing. The confusion is that we conceptualize hallucinations as something that is being produced by a diseased mind (brain), rather than an action that a person is performing (though perhaps not really willfully). That’s kind of like saying laughing gas makes you feel loopy and disoriented but it can also serve as a painkiller. Whether drugs work or not depends mostly on how the person interprets and responds to the changes in his experience, and the value/priority he places on those changes. For some, sexual impotence is a small price to pay for being able to keep their jobs and homes. For others, it is devastating because their sexuality is very important to their pursuit of happiness. This is one of the many reasons why I’m no longer pursuing treatment with psych meds—I’m not even sure what I value at this point.

Is it true that St Johns Wort is an actual SSRI? I knew it was used for depression, but that’s something I did not know about it, if true. Interesting.

That's true, what matters mostly is the effect on the persons behavior and wellbeing. I think I meant just that something like emotional numbing isn't necessarily the primary action of a medicine, because it can happen that they function without causing emotional numbing, and you are also right when you say that emotional numbing can be desirable for some people. Also for anti-psychotics, I meant that they don't just zombify people, because this would suggest that zombifying someone would make them more manageable and not necessarily remove their hallucinations. Also, second generation anti-psychotics work better than first generation ones, and they have much less of that effect. I tried standard dosages of second generation antipsychotics as well as a standard dosage of Haldol, and the difference was really striking. Haldol really made me dumb with no memory while the others were like a walk in the park.
About Saint John's Wort, I had to double check. It's not entirely correct actually. First people who say it works like an SSRI seem to say "it is thought that..." or "research suggests that..." and not clear facts. The following abstract says it is a non selective re-uptake inhibitor, which, if I understand it correctly, means that it is a re-uptake inhibitor for serotonin but not only. If it contains several active ingredients it is hard to apply conclusions about it to regular SSRIs.

"
Hypericum perforatum (St John's Wort): a non-selective reuptake inhibitor? A review of the recent advances in its pharmacology

Hypericum possesses a unique pharmacology in that it displays the pharmacology of many classes of antidepressants and new mechanisms not typical of standard antidepressants. The most potent of all its action is the moderate to high potency for inhibition of the reuptake of monoamines, serotonin, dopamine and noradrenaline and the amino-acid neurotransmitters GABA and glutamate. Unlike standard reuptake inhibitors, hypericum exerts this reuptake inhibition non-competitively by enhancing intracellular Na+ ion concentrations. At a receptor level, chronic treatment with hypericum downregulates beta1-adrenoceptor, upregulates post-synaptic 5-HT1A receptors and 5-HT2 receptors. Although the major constituent responsible for the antidepressant effect is thought to be hyperforin, other constituents such as hypericin, pseudohypericin, flavonoids and oligomeric procyanidines may also play a direct or indirect role. While reuptake inhibition may more than likely be responsible for most of the antidepressant effect, other mechanisms may also contribute alone or in combination to exert the overall antidepressant action. " Hypericum perforatum (St John's Wort): a non-selective reuptake inhibitor? A review of the recent advances in its pharmacology - PubMed

 

[Chip1021]

That's true, what matters mostly is the effect on the persons behavior and wellbeing. I think I meant just that something like emotional numbing isn't necessarily the primary action of a medicine, because it can happen that they function without causing emotional numbing, and you are also right when you say that emotional numbing can be desirable for some people. Also for anti-psychotics, I meant that they don't just zombify people, because this would suggest that zombifying someone would make them more manageable and not necessarily remove their hallucinations. Also, second generation anti-psychotics work better than first generation ones, and they have much less of that effect. I tried standard dosages of second generation antipsychotics as well as a standard dosage of Haldol, and the difference was really striking. Haldol really made me dumb with no memory while the others were like a walk in the park.
About Saint John's Wort, I had to double check. It's not entirely correct actually. First people who say it works like an SSRI seem to say "it is thought that..." or "research suggests that..." and not clear facts. The following abstract says it is a non selective re-uptake inhibitor, which, if I understand it correctly, means that it is a re-uptake inhibitor for serotonin but not only. If it contains several active ingredients it is hard to apply conclusions about it to regular SSRIs.

"
Hypericum perforatum (St John's Wort): a non-selective reuptake inhibitor? A review of the recent advances in its pharmacology

Hypericum possesses a unique pharmacology in that it displays the pharmacology of many classes of antidepressants and new mechanisms not typical of standard antidepressants. The most potent of all its action is the moderate to high potency for inhibition of the reuptake of monoamines, serotonin, dopamine and noradrenaline and the amino-acid neurotransmitters GABA and glutamate. Unlike standard reuptake inhibitors, hypericum exerts this reuptake inhibition non-competitively by enhancing intracellular Na+ ion concentrations. At a receptor level, chronic treatment with hypericum downregulates beta1-adrenoceptor, upregulates post-synaptic 5-HT1A receptors and 5-HT2 receptors. Although the major constituent responsible for the antidepressant effect is thought to be hyperforin, other constituents such as hypericin, pseudohypericin, flavonoids and oligomeric procyanidines may also play a direct or indirect role. While reuptake inhibition may more than likely be responsible for most of the antidepressant effect, other mechanisms may also contribute alone or in combination to exert the overall antidepressant action. " Hypericum perforatum (St John's Wort): a non-selective reuptake inhibitor? A review of the recent advances in its pharmacology - PubMed

I would argue that the most important thing is whether or not the patient finds the effects of the drug helpful for achieving his own self-defined goals. Scientific information about a substance is like a road map. It can point out various destinations for you, but it can’t tell you where to go. I suppose one of the differences between you and me is in how our values form our ideas on these subjects.

This information you present about St Johns Wort is very interesting to me. It seems like it just throws its force at every neurotransmitter that has ever been associated with depression, lol. Not only does it seem to have a non-selective effect like the original MAOIs did, but it also is said to work on GABA and glutamate. And then a bunch of very sciencey things that I couldn’t even begin to understand or scrutinize. But the general gist of that article is rather amusing to me. Basically how I read it is “SJW seems to help with depression. It does all of this stuff. One, some, or all of the stuff it does may or may not have anything to do with its antidepressant effect.”

i have always found it silly that neuroscientists are looking for that one molecule, structure, or transmitter that is responsible for depression. They don’t generally seem to understand or appreciate the relationship between words and things. They think that just because we use different words to conceptualize our sense of self and the problems we face, those words must refer or be reducible to discrete entities or processes in the material world. We are often asking ourselves “what is the explanation for a thing” before we are even sure of the thing itself. We keep talking about how depression/mental illness has its source in problems with neurotransmitter…something or other. But what IS depression? What ARE neurotransmitters and what function do they serve for the body-as-machine? I think it’s important that those questions be answered before we have any hope and understanding the relationship, if any, between neurotransmitters and depression.