Ant thoughts on Dissociation?

[dippy1]

Hi. I seem to experience a very scarey episode of dissociation when confronted with unexpected stress. Usually happens when I've been in "strong" or "coping" mode but am suddenly faced with a challenge. I get real distorted visual experiences (faces look like scarey plastic dolls or hearing becomes intense and unpleasant) During  these episodes I get a very strong feeling of depersonalisation/loss of reality and they are totally horrible. It's usually so severe that I feel I have lost my sanity.

Often they can precipitate a complete mood swing (downwards, and quite precipitously) and usually they haunt me for days afterwards.

Yesterday my therapist offered me an explanation, which made some sense, suggesting that I have two strongly opposed personas; a coping one and a needy one. She thinks the dissociation experience is what happens when my two worlds collide suddenly. Situationally speaking this fits. Her spin was that this is a positive thing as I use it as a defensive mechanism in order to survive.
I'm struggling to "see" the positives of depersonalisation, and view it as completely unpleasant and frankkly terrifying.

I'd be really grateful for anyone else's thoughts, oppinions or experiences with this.  Would anyone think this is bipolar type behavious or just part of a major depressive episode (supposedly resolving)  

Furthermore, does anyone think it's drug-related.

Soory for the longish post, thanks for reading it. x

[cyclegirl54]

Hi, i have sufferred from a dissociation on 3 separate times over the past 14 years when I have gone back on lithium 900 ml per day. It seems seems to take 2-3 months after getting my levels up then my body disconnects and I feel totally flat then as I thaw as I call it my head if full of pressure, zaps etc. with anything I put into my body, food, caffiene,etc. Because I cannot tell when I am hungry it makes it very difficult to maintain a good weight because I do not gain weight with the use of Lithium. My doctors don't really have any answers and just finally linked with a psychiatrist who of course is ruling out medical first.This dissiciation can last up to a year and takes it tole on you, it's like my life is on hold. I eventually come back into my own body with the lithium. I am starting to get some of my body sensations back 3 and half months but taking the same course as the last 2 times. Therefore, I am discontunueing the lithium to see if I can intervene this dissociation myself instead of waiting. I am doing it slowly as I know the problems that can happen if you don't. Can you let me know if anyone else has ever had this issue of dissociation when introducing Lithium back into their body. No one seems to be able to give me any straight answers and I am not crazy. I have worked in the field of social services for 32 years so am not a stranger to anti-psychotic medications. Thank you

[jst4shanell]

I dissociate.  My last one was a couple weeks ago.  It's a weird sensation actually.  I start doing things I would NEVER do normally.  Then I snap out of it and don't remember hardly anything that happened at all.  My psychiatrist and psychologist suspected this years ago.  They couldn't say for sure so they never said anything to me.  My pdoc said it's like having two personalities in a way.  It's from early childhood trauma.  My trauma's were quite severe.  Anyways, my pdoc wasnt too concerned about it.  He was more worried about delusions, hallucinations and paranoia (I was manic).
I hope this helps somewhat.  It's a very weird sensation.  Not fun when you snap back into reality.  I have been in trouble because of it.  

[LeftCoastChick]

I'm glad you posted back. Any trauma, regardless of how long it is, especially in childhood, can really impact your psyche. I used to take my mind out of situations as a child and as an adult I did that in two situation types, high stress and intimacy. So I can understand that you are going through intergrational therapy, with that, drug can assist with stablility, but therapy has the most response. I used to come out of my pdoc's office exhausted after an hour session. It took me about a year to really get a handle on it. I rarely if ever disassociate now. I don't remember the last time I did.

Seroquel can really help, especially with the anxiety and stress, once you are used to it, you can take it during the day, so that your levels can remain constant, instead of dropping between doses other drugs . Many other AP's don't have that option. I also do not recommend Seroquel XR, there have been some nasty side effects with that, but I know that only from what others have posted. I can take ativan if needed, but prefer to take an extra 25mgs of Seroquel (pdoc approved some flexiblity) , because it's not sedating and longer acting.

Having a good MS on board can help with the anxiety, I"m on both Lamactil and Lithium, both for depression, and work very well. I was getting mid sleep anxiety attacks, I've never had those before, and it was very distressing.  My pdoc actually upped my Lithium and Lamactil and it's worked suprisingly well.  I've had very little side effects, except when I don't drink enough water, my extremities swell. Considering the side effects of other drugs these two are pretty benign. There is the fear of a serious rash with Lamactil, but that %rate is 0.08 in 100, basically 8 in 10,000 get that problem, and usually because they are placed on higher doses too quickly, the key to this drug is slow titration of 12.5mgs per week  Lithium has been on the market for over 50 yrs as a MS and AP (at higher doses)  This drug works suprisingly quickly and the dosage can be changed quickly as well, depending on what emotional state you are in, you won't have the same withdrawal symptoms as other drugs.

Check this link out, it talks about first, second and third line drugs as well as combinations of drugs. It might be of use to you.
http://www.gacguidelines.ca/index.cfm?ACT=topics&Topic_ID=25&Summary_ID=209

[dippy1]

Hi , thanks for your comments, I've survived a few full on days thanks to the quetiapine I think. My main problem has been a very short fuse and major irritability. I have a p.doc who I've been seeing for over a yera, the p.nurse works for/with him.
My therapist (a pyschology doctor) talks about "intergration" as a goal for my therapy but I'm not sure how she means to bring this about...mostly sessions at present are deconstructing me rather than reconstructing...it's early days I guess.
My main diagnosis (and only definite one) was/is major depression, I suffered from extreme anxiety and social phobia at the onset too but those are generally a lot better.
The dissociative moments are triggered by extreme stress (in my frame of reference; not necassarily things other people might class as extreme stress) and usually, but not always signal the start of a downward spiral inmy mood. They got worse recently when I slowly weaned myself off valium. (I think the increase in quetiapine has probably replaced and is more effective than the valium) The p.nurse has spoken of BP, the p.doc feels that further labels may not be helpful at the moment and sees it all as major depression problem; more concerned by symptom manangement than labels which is fine with me.  We have discussed the relative merts of adding in a MS but I already have many side effects to tolerate from the current cocktail. He's certainly not worried about being creative with med use and things are up for review next week.

I don't personally think anything I've experienced could be called a delusion and I'm not sure schizoid tendancies are there either, I've wondered about BPD but honestly reading the lists of signs/symptoms it doesn' really fit. Perhaps the p.doc is right when he says the label is less important than the treatment.

BTW I had an outwardly normal but rather dysfunctional upbringing and a major traumatic event in my teens. This I didn't speak to anyone about for several years and I think that has been a big part of my downfall.

Thanks again ,Kx

[LeftCoastChick]

It sounds like your disorder is not BP in nature, Seroquel aka quetiapine works as an anti-psychotic, so if you are having delusions and serious disassociation, it will definitely help level you out. You mentioned you have pnurse, but do you have a pdoc who can do a full diagnosis? It's hard to really judge or expect what will go on with you unfortunately. You may have more then a couple of disorders going on. Once you've got all meds in your system, I can imagine you will feel much more levelled out. :) I would think but reading your posts, you've presented with definitely disassociative and schizoid tendancies as well as borderline personality. Especially since you've had some traumatic experiences.  I disassociated after long term abuse as a child, but with therapy in my late 20's,  when I dealt with the trauma, it went away.

PM me anytime. I do hope your pdoc can figure out what's going on, the labels on the disorders as far as I'm concerned these days just helps me to get the right meds, that will make me feel better.

[freebird227]

I have a lot of experience with a dissociation  disorder. This was pre Bi-Polar and pre meds. I worked with a woman one of the best in my area for 4 years. It was a process of uncovering the root causes of the disorder. I am pretty well intergrated today unless I get really angry or feel extreamly powerless.Sometimes I think Bi-Polar is too limited a term for me because I am so multifacid. I have actually  been looking at the possibility of some Borderline mixed in the pot. A thought..The borderline could be from my tragic and violent  childhood. The dissociation was. My suggestion... Don't let it go un 'checked ' ask a lot of questions about your meds and do some of your own research  and see what fits and what doesn't. Much luck....freebird227

[dippy1]

Update.

Hi. My dissociative moments have receded and I've ha a week or so of being in agood mood and really productive; more so than for over a year. I increased my bedtime dose of quetiapine but found I was feeling "wired" with irritability and anger in the afternoons/evenings. My sleeps are short (five to six hours at the moment despite the increased quetiapine). In view of this, I've re-added a morning dose of quetiapine and now things seem better..yeasterday for the first time in ages I felt "normal".

question 1: Is the quetiapine stabilising my mood?

question 2: was expecting a downward swing to end the "high",but it has not came, can I dare  to hope that this pattern may be receding?

question 3: what measures can I take to "keep" myself exactly where I am now?

thanks, and wishing everyone a peaceful christmas.

K

[monkeyc]

Yes diazepam withdrawl does make you more prone to anxiety; I use it myself and have read a lot about it because of that.

I think that the dissasociation could be caused my many factors including anxiety and stress, It might be that you are doing what your therapist says, I dont have the background there to judge.

I do however think that if these continue and the quetiapine is not working one of the AP drugs may work for both this and mood stabilisation giving you the benefits of both - this might be a good way to trial mood stabilisers.

I doubt these are psychotic as well, dissasociaton is a seperate thing to psychosis entirely.

Hang in there, the answers will come.

[dippy1]

Thanks, Guys.

I think I first experienced it duting the onset of my major depressive episode last year. I'm currently on reboxetine, citalopram, quetiapine and temazepam. I was using diazepam for about twelve months but have weaned myself slowly (and painfully) off that. I think being without the diazepam may make me more prone to the stressful triggers. Cartainly strong emotions feel more raw at present.

As for past recreational drugs, nothing major, bit of pot as a teenager and nothing strong(long ago now) but it does feel "like a bad trip" when it happens.

My p.nurse didn't seem that bothered when I described them to her, not sure I've discussed them with p.doc but won't see him now til next year. My only "label" is major depression but there has been talk of polarity; discussed MS at last appointment but on balance decided not to as already suffering fairly bad side effects!! :-s

As for childhood trauma; yes one isolated but very traumatic event and a slightly dysfunctional family upbringing but I guess that's not unusual.

My therapist is a doctor of psychology and pretty experienced.

The quetiapine clearly doesn't prevent the episodes and as I have insight of sorts throughout I figured they couldn't be psychotic in nature.

I value your ideas, thanks.

[ILADVOCATE]

Yes I am aware that tardive psychosis still has to be straightened out even as a criteria and I wasn't even thinking of that. I was just pointing out that to me that there were perhaps some more common or uncommon but still known neurological disability that might be the root cause. I don't believe that an anti-psychotic would cause this, what I experience is totally different as I in no way "believe" it and its a neurological manifestation but illegal drugs as you described can definitely do this kind of long term harm. In fact it was from the psychosis induced by people addicted to ketamine that they found that glutamate transmission had been depleted and that's how they started researching glycine to begin with. Regardless a neurologist would have a better understanding of these issues.

[monkeyc]

As always what does your psychiatrist say to you.

Some drugs can cause dissasociation, in particular many pain killers such as pethadine, fentanyl and morphine can cause these  and of course illegal drugs can as well, amphetamines and marijuana and LSD all do - any psychoactive has the capacity to do this.

I find the persona's comment odd so I dont know how to touch that one, its sounds a bit unusual to me.

As to tardive psychosis no people should NEVER discontinue medication EVER without a doctors advice and supervision - every person is different and its vital that people do not start looking for extra causes until the normal diagnostic works have been completed.

[ILADVOCATE]

My question is where do these personas come from? Are you diagnosed with dissociative identity disorder? Dissociation by nature is psychotic. Did your psychiatrist explain why you experience this? And more importantly what it could be treated with. Did he suggest an antipsychotic? Dissociative identity disorder is extremely rare and usually comes from child abuse or other traumatic experiences. Regardless its worth talking over with a therapist as well and that is part of recovery.
   As for "drug related" did you use recreational drugs in the past? Depending on what it is there can be some permanent brain damage from some of the more extreme/harmful drugs but it depends on the drug and amount of time you used it. I experience dissociation from the neurological disability they are studying me for as a criteria "tardive psychosis". That is clinically related to tardive dyskinesia which I have in advanced form. I do post about it but with caution because I wouldn't want people to discontinue current antipsychotics and a lot of research is left before it can be named as a criteria. All I am saying is that there are neurological causes that are more common as well that bring on dissociation. If you could tell me when it started and what you think brought it on I might have ideas on what it might be. And if its drug related, regardless of what kind of drug, a consultation to a neurologist is certainly warranted.

[GeorgiaAnnie]

wow,  I applaud you for being back sane.  Sounds scary.  I hear noises now, and just have to keep going like I don't notice it.  Panic is so easy to understand.  I use marijuana to avoid my fear of the outside.

Hope you're able to breathe and stabilize throughtout these experiences, and glad therapist has a good explaination.  One of my soaps has characters with coping personalities.  abc.com/onelifetolive.  Jessica and her mom are multis....