Life After Depersonalization Disorder
It seems that as I’ve gotten older, I actually know less. What I do know however, is that generally I’ve been lucky to be pretty happy, from childhood to now, despite some definitive bumps in the road. Lately, I have been coming to terms with the fact that my upbringing wasn’t as ideal as I had always consciously thought it was. However, despite the issues that were present, I was a pretty smart, resourceful, imaginative, happy kid, with interests that would develop into passions, and ideas that were ever so seemingly important at the time, but that would dwindle away soon in the winds of adolescence.
But everything I had ever known became compromised in an instant, one late afternoon in February of 2016, when I was twenty-one years old. The rug was pulled out from under me, and the lightning strike of derealization hit me like a bullet, while I was discussing my existential angst with someone in great detail. Everything I had ever known became transparent, but even the transparency itself was transparent—into nothingness. Life itself became one of those bathrooms with mirrors on all the walls, showing the same image times infinity, only this time that mirror with that infinite image became the physical landscape for my actual reality, except with no explanation, no preparation, and most importantly, no directions for how to go back.
At first, because of the visual flatness that overtook the three-dimensional world, I thought it could possibly be a vision problem. However, with a few google searches of my exact symptoms, I quickly came across depersonalization-derealization disorder (ICD-10 F48.1), a dissociative disorder that has been largely left out of public (and medical) awareness. Though I have no conclusive scientific research to quote because of the significant lack thereof, from my personal experience, DP/DR seems to be caused by conflicting psychic reactions to either trauma, anxiety/panic, or the effects of drug use, mixed with a specific analytical, logical, but highly sensitive personality type. Mix this all with any noteworthy level of unpredictability in upbringing, inconsistency in family or household dynamics or relationships, or any developmental incongruence and you have a perfect recipe for learned dissociation that ultimately could lead to the dissociative phenomena of depersonalization and derealization.
The medical community will usually admit that chronic depersonalization/derealization and its causes have not been researched enough to have a consensual place in the literature, as it is a highly misunderstood and underdiagnosed condition. The primary reasons for this are that most of the complexities of the experiences of depersonalization and derealization, the metaphysical nature of it all, is beyond the capability of language to accurately capture. The symptoms that are describable however, are already well-documented in the literature on other disorders, and so usually one is labeled with another diagnosis. While the other diagnosis is usually related and telling of part of the story, it is usually the case of jumping over the elephant to squash an ant. Because of all this, medicine has no reliable answers for psychological turmoil of this nature as of yet.
Marijuana seems to be responsible for a sizeable percentage of DP/DR cases, and for this reason the current ideological shift towards marijuana politically, culturally and economically should be alarming. I think having these dissociative experiences probably gives one somewhat of an ability to identify risk factors and potential candidates for developing these experiences, but caution and awareness is still needed on a large scale, which the current marijuana trend directly inhibits. Marijuana in terms of legalization and becoming a fashionable, low-risk habit that can be taxed and profited from, is worrying and urgently requires a vocal minority to make known the certain risks that most young adults are not aware of. The further this road that marijuana legalization and subsequent use goes, the more we are unfortunately going to become more familiar with depersonalization disorder. This is regretfully an indisputable, logical conclusion to come to. At the frustration and bemusement of all healthy marijuana users out there, this may sound comical, but it would be irresponsible of me to not say that despite their frustration, incidences of DP/DR will undoubtedly increase as marijuana use increases due to legality.
Once I realized that this disorder was likely the accurate description of the experience I was having, an instinctual part of me knew that an aspect of my life was over as I knew it, at least for an extended period of time. I fought it internally as best I could day and night, rationalized it as a phase of shifting into adulthood, and wrestled it until complete exhaustion, but this beast would not back down. It was chronic, 24/7, and it doesn’t just go away quickly without warning like how it comes on.
Depersonalization detonated in my brain and left my consciousness a barren wasteland. From a colorful, emotionally exciting world that existed inside my mind, to a mental landscape burned by a psychological atom bomb, I was forced to continue on with my life and figure out how to be. There was no pressing pause, no chance to take time to figure anything out, and no escape from the new perception I was forced into existing in. From this wasteland, I realized that I would still be expected to build an empire. In a world where much of one’s superficial value is placed on what one can give back to the world through working hard at a job and spending the money made at that job out in the world to strengthen the economy, I would still have to do all of this while grappling with the emptiness that inundated my internal and external world. It was either continue on while balancing the feelings of unreality and the turbulence of an unwelcomed altered state of consciousness, or don’t and fall by the wayside.
For the first few months it was as if I had taken a drug that never completely wore off. And in another sense, it was like being pulled down to drown in water but always managing to keep my nose just above the water to get a breath in. Looking into the distance, up and out into the sky, into my own nostalgic memories, it all lost an undeniable, human quality. I would describe it as the quality of connecting my inner emotional center, the “me”, with my intellectual identity that are both supposed to navigate my consciousness with cohesion and create a unified experience. When these don’t work properly with each other, a fragmented perception of reality results.
This disconnect creates a hole that is both vastly empty but also somehow contains experience. It is this connection that ultimately separates the humans from the cats and dogs. The quality of meaningful emotional depth, the quality of my space in time versus the other’s space in time, the quality that binds all thoughts and feelings, emotions and ideas together into the intrinsic whole that creates a person from the depths of the very foundations of who they are, all the way up to the words they speak. It is the quality that gives a human the desire to exist as a human.
As a tree, this existential shift, if possible, would easily prove neutral and not problematic, because of the obvious purpose that trees serve in symbiosis with the planet and the ecosystems in which they inhabit. Humans, on the other hand, serve no purpose to mother nature, and we do not inherently provide benefit to it by our mere existence on the earth. Because of this, this mental shift creates a unique challenge for us as human beings to create the type of constructive existence that we have collectively agreed upon over the millennia as our destiny. Even those affected by this painful condition must go out and build, while balancing the no-thing-ness that permeates the validity of everything outside the mind. We must keep up with our peers, and add to this collective destiny. Because medicine hasn’t provided consistent answers for me with this experience, over the years I have came to a conclusion that helps me and can perhaps help others soldier on—perception of reality exists on a spectrum, a ranging scale, and not on two sides of a coin or via an on-off switch. It is not black-and-white and is not an all-or-nothing thing. Perception of reality is subject to change, and the nature of reality is not fixed. There’s no rule that says these things can’t change with time, and therefore our perception may very well shift with our life experiences and understandings. Most importantly, it is okay if it does.
I, like many others, had been given access to a region of the mind that is locked to most, and when it all started I was at the stage of my life where I would soon be pushed out into the world to not only build an adult life, but also keep those earth-shattering sensations quiet while I did it. Fast forward, I found a job that looked interesting, and although I was nervous to now have to perform in the job while neutralizing my distorted perception of my world, I was partially, or at least pretended to be, hopeful that I may somehow come out on top. Over the course of about six months, this hope began to fade. I felt a significant uptick in my panic towards the sensations, and became essentially non-functioning. It didn’t help also, that the steps taken for accommodation of mental health issues in the corporate workplace are reprehensible and lacking of any level of appreciable humanity. (I was literally told that if I was having surgery that more could be done for me, because it would be more measurable.)
In its most simple terms, DP/DR is overwhelming sanity disguised as complete insanity. It shows a person certain truths about life that are undeniable once truly understood in the gut. It is awareness of awareness. The mind becoming aware of its own mechanisms. And consciousness seeing through itself to the other side of the curtain that exists an empty and endless universe of non-existence.
After hanging on by a thread for two and a half years, being told by good-hearted psychologists that my symptoms were merely byproducts of panic disorder and obsessive-compulsive disorder, I decided it was time to try the chemical route. Even if the byproduct statement is true in a sense, not addressing the dissociative symptoms themselves as legitimate and problematic on their own has proven time and time again ineffective, for me and for many others. I began taking fluoxetine (Prozac) 10 mg.
After about four weeks, the Prozac thankfully started having some effect. I felt a depth to my inner monologue and a mental clarity that hadn’t been felt in years. It was like I could reach back into my mind and grab onto feelings of my past, and a thick veil began to lift in the days and weeks to come. Soon after, I came to a conclusion about my immediate future and wellbeing and decided to move back to Chicago where I had lived prior for some years to be on my own as an adult living a proud life once again. I felt a meaningful drive towards my ambitions that was covered by the storm clouds of depersonalization and derealization.
Though the symptoms have since waxed and waned some, a psychiatrist I began seeing has immense confidence I can conquer this and keep the symptoms down to a sustainable level. I began taking lamotrigine (Lamictal), an anticonvulsant usually used to treat epilepsy and rapid cycling in bipolar disorder (every session is partly a lesson in psychiatry). The combination of lamotrigine and an SSRI has been shown to be of some benefit in the treatment of depersonalization disorder. In the case that these ever stop working, we have a plan of action. When the selective serotonin reuptake inhibitors fail, we’ll move on to the tricyclic antidepressants. When those fail, we’ll move on to the monoamine oxidase inhibitors. When the MAOIs fail, the atypical antipsychotic route can be attempted. If those don’t work out, we’ll try opioid antagonists. If those fall short, a reliable last-resort weapon to fight depersonalization and derealization is a daily dose of clonazepam.
It is important with any mental health challenges to find external things that help one’s internal environment. These could be finding purpose in helping others, believing in a cause, or simply having some hobbies or healthy distractions. Also, a good exercise routine is free endorphins, and a healthy diet means brain-enhancing nutrients, so take biology up on those offers. Besides the Prozac and Lamictal, I also take NAC (N-Acetyl Cysteine), inositol, lemon balm, hawthorn, nettle, vitamins B12 and D3, magnesium, an omega-3 supplement sourced from algae oil, and occasionally a zinc supplement. I find purpose for myself in helping animals and the planet with a plant-based diet, and I workout more days than I don’t. I also meditate, listen to comedy podcasts to focus my mind on other people’s voices, and have creative outlets in painting and the piano. These are the things that ground me in the thick of feeling ungrounded. And at some point, hopefully soon, we will have anti-dissociation drugs.
But depersonalization and derealization have given me gifts that I will be forever indebted to the sensations for. I cherish the stereotypical small things in life as miracles. A juicy peach or cold breeze is enough for me to be happy and for me to genuinely feel that my life is fulfilled. Connection with other people, showing my family I love them forever so very much, showing my friends I am loyal to them even when it’s been a while since we’ve talked, smiling at someone less fortunate on the street, or driving down Lake Shore Drive in Chicago, in traffic or not, are all simply enough for me in this world. Even though DP/DR is a painful state, if the entire world were suddenly struck with the condition, the world would be a much better place. It wouldn’t be long before the current wars would cease, compassion and helpfulness would become the norm, destinies apart from money would be realized, dreams would start to be more courageously materialized, the phones would be put down and we’d look into the eyes of our loved ones more, and the layers of separation that inhibit us from all living life together in love would be seen for the lies that they are.
Even though still today I am far from perfect or back to my twenty-one-year-old self, I have enough calmness and clearness to see that depersonalization and derealization have shown me that a fulfilling life is and has always been, right in front of me. It is something I have always had, and is not something to be sought after, but enjoyed from now until my last breath. The universe has already accomplished a fulfilling life for me, by simply giving me the gift of life, the gift of today, the gift of this very moment.
I will always carry with me the burden of the state of being that depersonalization disorder put me in, but my life has been forever changed for the better because of the unending satisfaction of life as it is that I have been forced into feeling, as a method of survival to hold onto life in the midst of it dismantling in front of me. From trying to keep my mouth above water to not drown, to living a simple life on a raft on top of the water, REpersonalization and RErealization, my life after depersonalization disorder, means living a life where I have finally realized that my raft on the water is actually my strength, resilience, positivity and gratitude. My life after depersonalization disorder is my finally coming to the understanding that even if that raft is my only possession in this world, that possession alone makes me a rich man. It is the possession I’ll keep to help me be the best version of myself, to help me live the best possible life I could ever want—the life I’ve always had.
If you are someone who is suffering with dissociation or any other psychological challenge(s), whether you know it or not, you are a warrior. You are the strongest person on earth and you make this world an amazing place. You bless this world every day with your presence and I thank you for that. You set the example for all of us on how we should continue on in the face of pain, and appreciate deeply the times of happiness. Despite what societal forces may lead you to believe, it is absolutely okay to not feel good. No matter how long you have been suffering, try to understand with an ounce of hope that there is always another avenue to explore to improve your state of mind. I feel you and I am with you. Allow my story to be one of hope for you to get through each moment you feel you are slipping. You are my hero.