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    Suggest treatment for depersonalization disorder

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Posted on Tue, 20 Jan 2015 in Sexual Health
Question: Feeling detached from people and the outside world.
Whatever im doing feels like a dream. Feeling detached from myself like its not me but dont feel like im anyone else. Doesnt sound like me when I talk. Struggle interacting with people just dont like hearing voices or my voice.
Will these feelings dissapear
doctor
Answered by Dr. Chintan Solanki 39 minutes later
Brief Answer:
Yes, these feelings can disappear

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

I can understand your feelings of detachment.

I read your another query also answered by another doctor. You have consulted psychiatrist and also undergone CT scan. You did not mention the result.

From available history, I think you are suffering from some type of dissociative disorder.I have considered your neurological check up is normal.

Your history suggests you have 'Depersonalization disorder" which is marked by a feeling of detachment or distance from one's own experience, body, or self.

I am narrating its detail for your information:
These feelings of depersonalization are recurrent. Of the dissociative disorders, depersonalization is the one most easily identified with by the general public; one can easily relate to feeling as they in a dream, or being "spaced out." An individual with depersonalization disorder has this experience so frequently and so severely that it interrupts his or her functioning and experience. A person's experience with depersonalization can be so severe that he or she believes the external world is unreal or distorted.

If you feel you are in the same situation ,discuss with your psychiatrist. It can be treated for sure and you can come out from this problem completely.

Treatment:
Mostly dissociative disorders are triggered as a response to trauma or abuse.
Treatment for individuals with such a disorder is psychotherapy mostly, however a combination of psychopharmacological and psychosocial treatments is often used.
Many of the symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, and can be controlled by the same drugs used to treat those disorders.
You might benefit from antidepressants or antianxiety medication.

Hope I have answered your query, I will be happy to answer more queries if there.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Chintan Solanki 26 hours later
Hello

Thank you for your reply. I want to describe some of my symptons briefly and if you could just confirm what
and what meds you think will be suitable and what theses symptons are and will they subside.
I am tense and anxious consistently panicky and feel like I wanna scream like a crazy person but I dont.
I only have the major anxiety or panic attack csuse of the way im feeling during my attack I have to hug some one so tight cause im so scared.
ive read alot about peoples stories and known people who suffer from anxiety but they still live a normal life
but I feel paralized to take the next step.
wont leave the house at all only to go doctors 3mins away from home and someone has to be with me at all times I cannot be alone at all otherwise I freak out.
-if someone talks to me sometime s I answer on my mind cause I don't want to hear my voice as if feels weird.
-caught up in my own mimd c
Sorry I wasnt finished and I accidentally clicked submit.
-caught up in my mind
-feel foggy and I a trance
-the thought of doing anything freaks me out. Struggling to cope everything I do/talk seems like too much effort.
-how am I even doing this (acting normal)
-scared to leave the house (adapting to the change of scenery or another person.
-picture the outside world and that freaks me out.
-feel weird when around more than one person.
-I have a large family and cause im staying with my parents alot of visitors or siblings come over all the time it takes a while to adapt and get comfortable around whoever comes and when they leave the thought of them coming back or having to see them again terrifies me.
Anyway my thoughts/feeling is too long of a list I really just want to know these thoughts are part of anxiety or something else.

doctor
Answered by Dr. Chintan Solanki 18 hours later
Brief Answer:
Your possible diagnosis is panic disorder with agoraphobia

Detailed Answer:
Hello XXXXXXX

Thanks for information and detail symptoms.

It seem that you have frequent episode of panic attacks.
In between panic episodes your mind is apprehensive about the situation in which you are alone. For you being alone means no one is there to help you if something bad happens to you. These rumination of thoughts causing major disturbance in your routine life.

You also try to avoid the situation where you are in crowd or with unknown persons.It is agoraphobia. This avoidance behaviour is restricting your activity and keeping you more at the home.

These all symptoms are suggestive of panic disorder with agoraphobia. It is a type of anxiety disorder. For confirmation of diagnosis, detail history, physical-neurological examination and mental status examination are required by a psychiatrist.

Treatment of this is also available in form of pharmacotherapy and psychotherapy.
In medicines, SSRI group of medicine specifically paroxetine is helpful and anti anxiety benzodiazepine is given for initial symptomatic relief.
In psychotherapy psychodynamic psychotherapy and cognitive behavior therapy(CBT) are useful.
Both pharmacotherapy and psychotherapy can be started together depending upon choice of patient.
Depending upon severity of symptoms , effects of medicines and motivation of the patient in psychotherapy, one can be normal in 3- 6 months from panic disorder. After being completely normal, treatment can be stopped gradually in next 3-6 months as per doctor's advice.

One differential diagnosis possibility is psychotic type of disorder in which fear is the dominant feature. Patient feels being harassed, watched, controlled or tortured by someone/unknown though in reality it is not like that. It is called delusion. Because of this fear person avoids to go out of the home.In your case it is a rare possibility.

For detail evaluation personal interview with psychiatrist is essential.please consult doctor and start the treatment.

Hope I have answered your query, I will be happy to help further if needed.

Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Chintan Solanki 59 minutes later
Hi

So the psychiatrist does the physical - neurological examination. I have see one and if he thought it was necessary wouldn't he have picked up on it and recommended it.

even when I'm around people I know I get freaked out though. Is that from panic or agriphobia.

Are my thoughts anxiety related aswell.

In your opinion do you think I will have a full recovery.
I don't know how I got so bad. I had the relapse 4 months ago but the last 2 months my symptons worsened and changed I guess. Can I get any worse than this.

I'm taking vitamins for pyrolle at the moment. Gp told me this will improve the seritoin and gaba in my brain.

Can I still take the ssri medication the vitamins.
Or will I have to stop the vitamins if there both doing a similar thing.



Regards,
doctor
Answered by Dr. Chintan Solanki 3 hours later
Brief Answer:
Yes it is due to anxiety likely, need treatment like ssri

Detailed Answer:
Hello,

Thanks for follow up.

Dear XXXXXXX all of your symptoms suggest anxiety problems. You can be recovered from the same for sure.
Psychiatrist does the basic physical and neurological examination to rule out any physical cause. If he/she finds something, patient is referred to concern doctor. If examination comes normal, psychiatrist will do the treatment.

I think vitamins supplement will not help you for solving your problem.
You need to take SSRI and benzodiazepine after consulting doctor. You can take vitamins with that. Do not stress more yourself about your illness and recovery. You will be normal as I mentioned in last answer with proper regular treatment.

Hope I have answered your query. If still any query there, I will be happy to answer. If not, you can close the discussion and if feasible give your feedback so I can improve service. In future you can contact me directly if you wish with this link: http://bit.ly/drchintansolanki

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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