@NaoSky @BethRags: I'm not sure how often I've had depression, I've lost count. This is definitely one of the most severe and long episodes I've had, but I've had similar episodes going all the way back to my teens.

I've had derealization/depersonalisation going on for at least as long, although right now that, too, is more intense than usual, so much so that I'm worrying whether it isn't crossing some kind of line where I'm losing touch with reality altogether. I have this theory that during a depressive episode, all of the other bad stuff becomes amplified, so that it all kind of ramps up together.

I've had these symptoms with varying intensity since way before I was on any meds, and right now I'm temporarily off meds, so I think we can rule that out as a cause. I do have a history of child abuse, which may well be responsible for the dissociative symptoms as well as "activating" my bipolar.