Derealization & Depersonalization: Peculiar Bits of Business

Published September 24, 2010

we’re discussing neurobiology, I’ll also point out that research is showing that issues with glucose metabolism causes abnormal functioning of the visual, auditory, and somatosensory cortices. Well, given the fact that these areas process incoming stimuli, and our response, is it surprising that altered functioning may lead to DD?

Treatment Alternatives

Naturally, treatment selection for DD is driven by cause. I mean, if DD are presenting as a result of a stroke, the obvious treatment focus is going to be upon the aftermath of the brain accident. However, if the cause of DD is, say, childhood emotional trauma, psychotherapy is indicated. By the way, the insight-oriented and cognitive behavioral therapies, as well as hypnosis, have been successful in the management of DD. And there are any number of strategies and techniques, such as mindfulness, that you can implement on your own.

Now, on the medical side of the fence, scientists at one time found hope in naloxone (Narcan) for the treatment of depersonalization. Naloxone, an opioid receptor blocker, is typically used to treat opioid (drug category that includes heroin, morphine, oxycodone, etc.) overdoses, specifically addressing central nervous system and breathing complications. Well, naloxone very positively impacted depersonalization in the lab, though a cousin medication, naltrexone (Revia), didn’t produce the same outcomes. It seems the success of naloxone involved the role of what’s known as an endogenous opioid system in the generation of depersonalization. Giving this subject due consideration would take pages; so for now just know that it all has to do with the existence of opioid compounds (endorphins are one of these) throughout our central and peripheral nervous systems, which play a big role in regulating our responses to stress, including the management of cortisol. Also managed is the blunting of the distressing and emotional component of pain. Complicated stuff. Well, the naloxone mission was ultimately abandoned for a number of reasons, including the fact that it can only be administered intravenously.

Though not as yet FDA approved for the treatment of DD, Transcranial Magnetic Stimulation (TMS) has shown some promise for relief. TMS, first developed in 1985, is a, well, gentle massage therapy for the brain. And it’s given by short magnetic pulses, which come from an electromagnet placed on the scalp. The massage is actually limited to the cerebral cortex, which is the approximately one-tenth of an inch outer surface of the brain. Cool thing is the impact of TMS treatment has some staying power after its administration. TMS has been getting much more attention since the mid-1990’s. Perhaps more to come.

Okay, let’s wrap it up by talking meds. No doubt they’ve helped millions of DD sufferers, but I’ll guarantee you that physicians and scientists don’t really know the “hows and whys.” At any rate, some of the meds that have provided assistance are the benzodiazepines lorazepam (Ativan), clorazepate (Tranxene), and alprazolam (Xanax). Then there are the tricyclic antidepressants amitriptyline (Elavil), doxepin (Sinequan), and desipramine (Norpramin). Of course, the SSRI’s fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) made the cut. But, then again, they always do. The anticonvulsant/mood stabilizer, lamotrigine (Lamictal), used to get a lot of press with regard to DD relief; however, its stature has fallen a bit. Finally, there are the atypical antipsychotics such as aripiprazole (Abilify), quetiapine (Seroquel), and risperidone (Risperdal). Give the use of meds in combating DD a lot of thought, and ask very specific questions of your psychiatrist should you choose to pursue them.

So there you have it, some random thoughts regarding DD. As I implied from the get-go, I feel so badly that I can’t bring you a cure; however, I sincerely believe the more we examine and discuss DD, the more likely concrete relief solutions will come to the fore.

After a life-long bout with panic disorder – and recovery – and a career in the business world, Bill found his life’s passion, his life’s work. So he earned his master’s degree and counseling credentials, and he’s now doing all he can to lend a hand to those having a tough time.
Bill authored a panic disorder education and recovery eworkbook entitled, “Panic! …and Poetic Justice,” which is available on his website and online store for immediate download. Also available is information regarding a collection of poems he wrote along his panic disorder and recovery journey entitled, “The Poetry of My Life.” Lots of good stuff to see, and more to come.
In addition to doing psychiatric emergency work, Bill continues to do a lot of writing. He’s conducted numerous mental health workshops for non-profit organizations and remains available to offer more. Bill is a national and local member of the National Alliance on Mental Illness (N.A.M.I.).