[Sulla]

Hi All,

As the title suggests, Why is The treatment and knowledge about Depersonalisation / Derealisation DP / DR / DDD so bad? Its bad everywhere, but here in Ireland, its as though no one has EVER heard of it!
What is Depersonalisation:

Its the 3rd most common underlying mental disorder, is a major cause of anxiety, panic, OCD and self harm. From 1-2% of the population have it, but is so under-researched its actually hopeless almost being a sufferer.

"Here is an abstract from a 2003 [In DP/DR research terms still a relatively new article!]

Quote:
"Depersonalisation (DP) and derealisation (DR) are subjective experiences of unreality in, respectively, one’s sense of self and the outside world. These experiences occur on a continuum from transient episodes that are frequently reported in healthy individuals under certain situational conditions to a chronic psychiatric disorder that causes considerable distress (depersonalisation disorder, DPD). Despite the relatively high rates of reporting these symptoms, little research has been conducted into psychological treatments for this disorder. We suggest that there is compelling evidence to link DPD with the anxiety disorders, particularly panic. This paper proposes that it is the catastrophic appraisal of the normally transient symptoms of DP/DR that results in the development of a chronic disorder. We suggest that if DP/DR symptoms are misinterpreted as indicative of severe mental illness or brain dysfunction, a vicious cycle of increasing anxiety and consequently increased DP/DR symptoms will result. Moreover, cognitive and behavioural responses to symptoms such as specific avoidances, ‘safety behaviours’ and cognitive biases serve to maintain the disorder by increasing awareness of the symptoms, heightening the perceived threat and preventing disconfirmation of the catastrophic misinterpretations. A coherent model facilitates the development of potentially effective cognitive and behavioural interventions."

This is a huge mental health issue, but gets so little attention in what is an under funded and staffed health issue anyway.

Now the media blitz has screwed up Benzodiazepine prescribing, they are doing the same with Anti Depressants, happy pills, over-prescribing etc etc. Why always aimed at people with Mental health issues, not Statins, or BP, Cancer meds [which are in fact WAY LESS effective than Anti Depressants! People with DP/DR really need these meds, its about the only KNOWN way to help. CBT and relaxation help, but apart from a ton of quack remedies, thats it.

We have enough to face as it is. I have had this for 35 years, since age 14, Chronic, disabling and for 10 years MY OWN HELL! Yet we are made to feel like junkies or worse when we are already fighting a little known and massively understudied Disorder.

In Ireland the situation for sufferers under GP's is utterly awful. Meds which are integral to just surviving Depersonalisation and OCD etc etc are being withdrawn, patients left with nothing! Purely because some total idiot in the HSE decided on a blanket cut in Benzodiazepine and anti anxiety meds! People will die, MORE suicides, more self harm, more hopelessness. Its so bad suffering DP in the first place, now being demonised simply because no one knows about it is criminal. Its been known about for 140 years and known as an underlying disorder in itself for many years now. But who cares? I know my own GP, is more worried about their reputation in prescribing than in patient care. Drs are getting so bad that patients are dying. Just because of media and politics, NOTHING to do with care or help. What happened to duty of care by Drs and health workers?

But this is far from just Ireland's problem, I belong to a FB group with a large membership devoted to DP/DR DDD OCD etc. There are people from every corner of the globe and Drs everywhere are treating us patients the same!

There is a large and growing Face Book group, but we are simply left on the sidelines. The research now is NO better than when I first got it in the 80's and often patients don't find out what they have for years as Drs know so little about this!

This is so wrong, but nothing EVER happens!

Sorry for the rant, but I know so many young people so close to suicide and the only people they have are us the people within the DP/DR groups, which are small and very sparse. Even long term sufferers [which make up 25% who will never recover from it] are finding it tough as the very things that help, that make us feel in any way normal are being cut from under us. We in many cases took years to become stable, even ON meds, now we are being forced into a situation where, many will simply give up the fight. Its always a fight just surviving with DP, but this, this makes even people like me who have lived good valued lives, working and productive, just want to give up and yes I really do feel like that its that bad! Its horrifying and TBH GPs and others simply DO NOT CARE!

Regards [again sorry for the rant, but end of tether!]

There were links but under 10 posts ....

- Shaun

[Travelinglady]

I don't know what the problem is. I know some people still don't want to believe in DID and such.

Even here in the States, docs have gone cuckoo about not prescribing certain drugs. GP's will only prescribe certain drugs short-term and some not at all. I take Tramadol and Hydocodon. I can now only get them from my official pain doc and am going to the subject to random drug testing.

[amandalouise]

Originally Posted by Sulla

Hi All,

As the title suggests, Why is The treatment and knowledge about Depersonalisation / Derealisation DP / DR / DDD so bad? Its bad everywhere, but here in Ireland, its as though no one has EVER heard of it!
What is Depersonalisation:

Its the 3rd most common underlying mental disorder, is a major cause of anxiety, panic, OCD and self harm. From 1-2% of the population have it, but is so under-researched its actually hopeless almost being a sufferer.

"Here is an abstract from a 2003 [In DP/DR research terms still a relatively new article!]


This is a huge mental health issue, but gets so little attention in what is an under funded and staffed health issue anyway.

Now the media blitz has screwed up Benzodiazepine prescribing, they are doing the same with Anti Depressants, happy pills, over-prescribing etc etc. Why always aimed at people with Mental health issues, not Statins, or BP, Cancer meds [which are in fact WAY LESS effective than Anti Depressants! People with DP/DR really need these meds, its about the only KNOWN way to help. CBT and relaxation help, but apart from a ton of quack remedies, thats it.

We have enough to face as it is. I have had this for 35 years, since age 14, Chronic, disabling and for 10 years MY OWN HELL! Yet we are made to feel like junkies or worse when we are already fighting a little known and massively understudied Disorder.

In Ireland the situation for sufferers under GP's is utterly awful. Meds which are integral to just surviving Depersonalisation and OCD etc etc are being withdrawn, patients left with nothing! Purely because some total idiot in the HSE decided on a blanket cut in Benzodiazepine and anti anxiety meds! People will die, MORE suicides, more self harm, more hopelessness. Its so bad suffering DP in the first place, now being demonised simply because no one knows about it is criminal. Its been known about for 140 years and known as an underlying disorder in itself for many years now. But who cares? I know my own GP, is more worried about their reputation in prescribing than in patient care. Drs are getting so bad that patients are dying. Just because of media and politics, NOTHING to do with care or help. What happened to duty of care by Drs and health workers?

But this is far from just Ireland's problem, I belong to a FB group with a large membership devoted to DP/DR DDD OCD etc. There are people from every corner of the globe and Drs everywhere are treating us patients the same!

There is a large and growing Face Book group, but we are simply left on the sidelines. The research now is NO better than when I first got it in the 80's and often patients don't find out what they have for years as Drs know so little about this!

This is so wrong, but nothing EVER happens!

Sorry for the rant, but I know so many young people so close to suicide and the only people they have are us the people within the DP/DR groups, which are small and very sparse. Even long term sufferers [which make up 25% who will never recover from it] are finding it tough as the very things that help, that make us feel in any way normal are being cut from under us. We in many cases took years to become stable, even ON meds, now we are being forced into a situation where, many will simply give up the fight. Its always a fight just surviving with DP, but this, this makes even people like me who have lived good valued lives, working and productive, just want to give up and yes I really do feel like that its that bad! Its horrifying and TBH GPs and others simply DO NOT CARE!

Regards [again sorry for the rant, but end of tether!]

There were links but under 10 posts ....

- Shaun

Here in NY (the one in the USA as opposed to other locations) treatment providers treat symptoms...example if the patient comes in stating they are feeling numb, spaced out, out of touch with their body/environment.. (depersonalization/derealization disorder symptoms) the treatment provider must evaluate ....all....problems mental and physical that may be causing this symptoms. usually the first one they work on is whether the person is using drugs/alcohol and whether they have depression and other problems that share the same symptom. they prescribe antidepressants and monitor the patient for about 6-6 weeks. if their symptoms have subsided or eased up they continue with the meds either because this varified they had depression/anxiety disorders not a dissociative disorder or because the medications actually did help their dissociative problems. contrary to myths there are medications that can help a person with depersonalization/derealization disorder. the only way to find out if that patient is one that can be helped this way is by prescribing the meds for a time and monitoring their progress or lack there of.

Another thing that affects how treatment providers are treating their patients with depersonalization/derealization disorder is the fact that here in the USA we have recently moved to a new standard of diagnosing and treating mental disorders because of the new diagnostics and treatment standards /guidelines in the new DSM 5 by the american psychiatric association. I dont know if ireland is moving into using this new standard or if they are still using their own ways of treatment/diagnosis manuals.

As for using abstracts for data...just a bit of info....abstracts are like an abstract painting. anyone can put any thing into them and get anything they want out of them. here in NY abstracts are not exactly the right resources to use because they are basically drafts /research papers put together by college students doing their thesis papers to graduate their psych course. I did an abstract (thesis paper) my self on how mental disorders are prevalent among the homeless and poverty stricken communities. to do them the student uses what data they can find whether that data is true or not form a hypotheses (guess on whether this can or cant be true) then set out to write a thesis/abstract on only the views (using present or outdated materials doesnt matter which looks better if you can find material that is with in the past 100 years) that prove your hypotheses correct.

my suggestion dont get bogged down with what you find in abstracts. your treatment providers can help you obtain information about mental disorders and treatment there of that is reflective of todays standards.

yes I know of many facebook groups on many mental disorders. I have found them to be not very helpful and usually have a mix of people who do and dont have the problems that they are there to discuss or they are there just to see what the group is all about so they join then copy and paste other posts to fit in. many times in facebook groups I would recognize a post and scroll back and find that identical post by someone else...there are many people on facebook that also have more than one account and enter the same group as many people. I have 5 facebook accounts. one for work, one for friends and family, one for gaming, and one for a friend who passed on a few years ago and one for a facebook group I am in. but there is nothing stopping me from using one or more of my other accounts from joining the same group 2,3 or what ever times I would like to and posting as different people from all around the world, facebook members do not have access to knowing all their members ip addresses, actual locations and such.

my point is online groups are not falible and just like anywhere online people can be anything, anyone and have any problem they like and even share the same problems whether or not they have that actual problem.. so I never go by online groups for accurate information as to whether something is or isnt treating mental disorders and their patients right. theres no way to varify whether whats being posted really is accurate or not online.

[vvector0000]

I don't think doctors can relate to it, because it defies words.

I am now going through constant moderate DP punctuated by episodes of extremely severe DP. I don't have panic attacks. This started when I was 11, so I have 27 years of psychic toughness under my belt.

It's easy for me to understand, basically being a borderline personality, I broke up with my girlfriend of 6 years, and moved into my own apartment and live alone. She just told me I couldn't come back (when I was inpatient at psych) and was very immature about it. She's 36.

Anyway, I've been drifting around and at times, totally losing my identity and sense of self, don't recognize my face in the mirror, etc. Can't get a job till this clears up.

There are 3 medications supposed to help diminish DP and I am on two (arguably three) - Lamictal at a whopping 600mg, clonazepam and imipramine (clomipramine is the other, and there's not an appreciable difference).

The point of all this is that CBT and other therapy is necessary to reintegrate into the world. I hide in my mind. Medication can't touch this. Clonazepam steps on it a little, but not much.

If it got any worse when it was severe I'd probably have delirium symptoms and wander around aimless on the street till the cops picked me up.

--

It's abominable how little they study this and how little they teach. My psychiatrist is in his 60's and, after seeing many, I will never see a young psych again. With age comes wisdom in the world of headshrinking, and you can bet on that.

TC
vv

[psychfan1]

I hope you can get involved in the Treatment of Patients for Dissociative Disorders study, known as the TOP DD, it's run by Dr Bethany Brand and is international.

DPD/DR is often linked to early trauma/abuse and attachment issues - have you got access to any psychotherapy? As in long term stuff, not 8 weeks of CBT.

The lack of training about DDs is apparent to all of us, and it is NOT ok. Medication is pretty limited for many with dissociation and I also rate the anti-psych meds drivel that many people come out with. Psych meds are essential for some people just to have any standard of life at all, and many people need both meds and therapy combined just to survive.

I wonder how many of those who criticize psych meds actually realize that many of them are the SAME drugs that also treat non-psych symptoms? As for the hype about herbal medication use instead... well why use something less well tested, and less well researched?
If you check how many interactions with perscribed medications there are for the popular ones like St John's Wort it is a shocker.

Benzos are being phased out due to addiction issues, which can get pretty serious, not just long term side effects.

btw - reddit has a subreddit for DPD/DR.