Brief Answer: Never in ALS Detailed Answer: Hi and thank you so much for this query. ALS (Amyotrophic lateral sclerosis) is and exclusive motor neuron disease. This means that is only presents with signs of muscle functions like muscle weakness, loss of reflexes, exaggerated reflexes, etc. What makes it very characteristic is the involvement of motor neurons leaving the brain(upper motor neurons) as well of motor neurons going to the muscles(lower motor neurons). The initial presentation of this disease is never derealization. Derealization is more common in psychiatric conditions like schizophrenia, acute psychotic disorder, drug intoxications, etc. It is not a presenting symptom of ALS. I hope this addresses your query fully. Thank you so much for using our services and please feel free to ask for clarifications if need be. I wish you the best of health. Dr. Ditah, MD.

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Brief Answer: More information is needed but less likely Detailed Answer: Hi and thanks for following up with me. Depersonalization is not simply a one time experience. It should be recurrent with you being aware of, it interferes with normal functioning and there is no other condition that may explain this. You having anxiety would be able to justify a feeling of our body being non existent and causing these symptoms. You are no where near this right now. Being worried about this so much may actually exacerbate and reinforce the symptoms making it even more convincing for you though not the case. For now, do not get worried about this unless something new comes up. Thanks and feel free to ask for further clarifications. If you would like to do some more patient readings from a trusted site, let me know. Dr. Ditah, MD.

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Brief Answer: Reassure yourself and you would do better! Detailed Answer: Hi and thanks for following up with me. The main concern with psychiatric conditions is that the more you think about it the more you make it real and it becomes a bigger problem. You need to remind yourself that all is okay and not let troubling thoughts to distract and disturb you this much. Buspar is a good drug and am sure it would help to control your anxiety. Working with your therapist on how to use behavioral measures to control these thoughts and feeling would be of additional help. The single most aggravating factor is how often you think about this. Avoid being alone as this would most likely lead you to thinking about this and making it worse. Get involved in gatherings, social activities and fun activities with friends. These would be very helpful. I hope you get the chance to meet with your therapist soon and gain more help. I wish you well and feel free to ask for more information if need be. Thanks. Dr. Ditah, MD.

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Brief Answer: It is a great idea discussing with me, please! Detailed Answer: Hi and thanks for this follow up. Telling you what the main problem and aggravating factor is serves mainly to inform you so that you can take measures to address them. This would help reduces the impact this has on you. Probably before discussing this with me, you may have unconsciously not realized that the more you think about it the more you get worried. It is in this light that I considered giving you some clues on how to overcome. You have done the perfect thing by contacting me because I believe you have learned what makes it worse and how you can address it while at the same time also getting reassurance that you would be okay. I wish you well. I hope this helps. Feel free and please do not be hard on yourself by again thinking you did the wrong thing discussing with me. At times, this is just the reassurance we need to keep going. Dr. Ditah, MD.

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Brief Answer: Thank you so much, too! Detailed Answer: Thank you so much for your kind words. I am humbled to know some of the worry has been relieved. This is our greatest wish for our clients. I wish you a great evening and a wonderful week ahead. Thanks. Dr. Ditah, MD

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