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Hi All,

I hope most of you are doing better than me. I feel like my symptoms are getting worse and worse as the days go on. I just feel like I don't know up from down anymore and its becoming difficult for me to think straight lately. I have considered checking myself into the psychiatric unit but have had one hospitalization before and it did nothing for me. At the time I thought my symptoms were bad but they are much worse this time around. I know if I go to the hospital it won't help at all and I just feel very isolated at this time. I am not sure why I am writing this because nothing has helped this time around. My current psychiatrist has recommended Ketamine treatment and I have also considered ECT treatment. Does any of you have any experience with these? What do I do? I just really feel that I am not capable of making decisions for myself at this time.

Thanks,

Zach
 

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Ketamine is a dissociative drug that can make depersonalisation. It can be beneficial to refractory depression. ECT the same. The is no indication that ECT works in depersonalisation disorder. rTMS at the right VLPFC might be beneficial but you need a provider that uses neuronavigation to find that location. Most rTMS clinics don´t have neuronavigation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906152/
 

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You could try rTMS, which treats depression and is being tested as a treatment for depersonalization.
The locations used for treatment of depression with rTMS are not the same as in depersonalisation. In depression it is usually low frequency at the right DLPFC and/or high frequency at the left DLPFC. These locations are easy to find but they have almost no effect on depersonalisation. In depersonalisation it is the right VLPFC and the location in difficult to locate without a MRI scan of the whole brain and a rTMS clinic that have the equipment to make a calibration of the rTMS coil from the scan with computer program. 90% of rTMS clinics cannot do that.
 

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Wow, that's unfortunate. Will there ever be more equipment to do it?
Yes, The equipment used is called neuronavigation and has been used in all trails for depersonalisation. It is very used in psychiatric and neuroscience research at universities but not on the private marked for rTMS.So, the trails done at universities are difficult to replicate for private providers. rTMS is only approved for depression at some location that are very easy to locate without neuronavigation. So, they don´t have neuronavigation because they don´t need it. But, makes of rTMS and neuronavigation are growing and coming with new equipment to make more precise locations in other areas in the brain. So, there is likely more on the private market who will get it and can make the correct locations. I expect many will be able to do it the coming year.
 
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