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depersonalization etiology and anxiety/ocd

Posted by g_g_g_unit on July 3, 2013, at 11:19:39

I know this is quite a complex question -- and maybe something that couldn't be done justice to here -- but I was wondering if it was helpful or a hindrance to think of depersonalization as a separate entity/treatment target in the context of a primary anxiety disorder?

as I've mentioned here numerous times, I've suffered from OCD that's grown progressively more severe over the past 9 years. around the time of my first incident of Major Depression, I began to experience depersonalization phenomena (a sense of being unreal, pointless philosophical questions related to identity); previously, I had had similar feelings triggered by SSRI trials, but they seemed to persist following the onset of MDD.

since then, with the MDD, OCD and anxiety remaining untreated, the sense of detachment has persisted -- in fact, much of the past 6 years feels dream-like. however, what's become more problematic is that the depersonalization has become more and more phobic over the past 2 years, accompanied by agoraphobia, constant fears related to 'losing my mind', severe OC-related avoidance (it's complicated, but I feel like if I stop monitoring myself and pay attention to any other activities, I'll go crazy, which has come to restrict me from doing nearly anything).

what frustrates me is that I can recognize that there is a clear OCD component (the root disorder), but at the same time the depersonalization sensations feel valid (and didn't exist for the first 3-4 years of OCD). I set 'rules' about treatment -- this will probably sound very silly to most, but might register with those who suffer from OCD -- for example, I've come across one account in the archives of Effexor helping someone with DP and Ace's account of Nardil helping him, and so feel like I *have* to try those two drugs and that only they will 'cure' me. (for the record, I did try Nardil, early into treatment and pre-DP, but gave up after 12 weeks due to side-effects).

sometimes I feel like I'm looking for a drug that will make me feel real/alive again and wonder if that's fruitless, and if I should instead focus on the phobic/obsessional part. however, most anxiolytics to date (SSRIs, anticonvulsants etc.) have done little to treat the phobic anxiety and often worsen the feelings of dissociation.

I'm currently trying to save up for a Riluzole trial, but often feel plagued by the thought that it's the 'wrong' drug (i.e. because no one has specifically reported it helping DP) and that I'm being 'irresponsible'/doing myself a disservice. I hate this disorder.

 

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poster:g_g_g_unit thread:1046340
URL: http://www.dr-bob.org/babble/20130617/msgs/1046340.html