Derealisation really is ****, I know your reality becomes dream like and it’s hard to differentiate the 2. Then there's the effect on cognitive function, delayed reactions and memory loss. It's all caused by depression or anxiety or both, the mind switches to a safe mode so your not fully concious of the stress your reality causes you.

Sorry to hear about the doctor visit, hot medical professionals can be quite distracting. Do you mind sharing what some of that letter contained?