I understand that asking here is not the same as going to the doctor, but how to cope with a seven-year derealization (arose due to severe stress)?

I understand that asking here is not the same as going to the doctor, but how to cope with a seven-year derealization (arose due to severe stress)?

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answers (2)

Answer 1
September, 2021

Wrong or not entirely true.

Antipsychotics by themselves and as the first line of treatment for DP-DR (F48.1) are only post-Soviet incompetent doctors. Antipsychotics MAY be indicated, but atypical, and not all, and not all, and not always. If there is no schizo disorder behind DP-DR, then the appointment of an atypical is generally seen as an increase in the effect of blood pressure. Although the antipsychotic effect of atypical is also useful, for example, in psychotic depression, not to mention schizo. The DP-DR phenomenon itself does not require the antipsychotic effect of the antipsychotic, but is, as it were, a "window" into the disorder, where the antipsychotic effect is poured. If, for example, a person has primary depersonalization disorder, then the antipsychotic is considered only as a potentiation of blood pressure.

DP-DR occurs with anxiety, depression, PA, schizophrenia, etc., as a defensive reaction, but is subpsychotic phenomenon and marker of the severity of the condition. But it also happens as an independent syndrome, without admixtures of other disorders (rarely).

Treat like this: an antidepressant of the SSRI / SNRI / clomipramine + lamotrigine (only a few in Russia can treat DP-DR with lamotrigine). And in the USA it is the GOLDEN standard of DP-DR treatment. The use of SSRIs in mono gives 30% of remissions, and then, often only relief of the condition, and the use of lamotrigine in mono gives almost nothing, BUT SSRIs + llamas (from 200mg) give 70% (!) Remissions!

In addition, in some cases, lithium, magnesium, memantine, dopaminomimetics can be added to increase blood pressure.

The Nuller method is so-so. You can't really count on naloxone - it shoots 1 time out of 10. The high dose of phenazepam is also so-so. Deprecated.

But Nuller is cool and wrote and invented a lot of things.

Answer 2
September, 2021

Treatment of derealization / depersonalization should, of course, begin with an accurate diagnosis. This will help you choose the right drugs and, as a result, bring your recovery closer. Derealization / depersonalization are symptoms, not individual diseases. There are a lot of diseases that are accompanied by such symptoms: it can be either a borderline disorder (neurosis, for example), or a whole mental disorder. It is very important to analyze in detail the whole story, all the symptoms and flow. And this, as you understand, can only be done by a specialist.

It is no coincidence that I mentioned the selection of drugs. Unfortunately, getting rid of this kind of problem with the help of psychotherapy is quite problematic, and in some cases even impossible. First-line drugs for DR / DP are antidepressants and antipsychotics. I would even single out antipsychotics in the first place, since antidepressants are characterized by selectivity. Actually, antidepressants are preferable for borderline disorders, and antipsychotics for, for example, schizotypal disorder. Everything is extremely individual, so it's better not to pass by the specialist's office here.

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