You Are Not "Going Crazy"

No, you are not going "crazy" ... this is a fear of many whose primary disabling symptoms are DP and DR. Your DP can get very serious, and some have been temporarily hospitalized for not being able to function with DP, but this doesn't mean you are (of the old definition) "insane" anymore than anyone with "garden variety" OCD, panic, anxiety, or depression is "insane."

I dislike the words "crazy", "insane", or "schizo." They are extremely derogatory and conjure up old stereotypes of screaming, babbling patients in a locked mental facility.

Those who ask this question most likely fear schizophrenia, psychosis, or a total loss of touch with reality. DP, panic, and anxiety alone as your primary concerns are highly unlikely to be signs of impending schizophrenia or psychosis.

Structure, Routine, and Distraction

My personal equation is: CHANGE=STRESS=ANXIETY=DP=MORE ANXIETY (and the cycle begins).

Change can take many forms. Stress can take many forms. Stress can be external or internal; some of it you can control some you can't. This makes a daily routine imperative -- one tailored to your ability to function, your needs, goals, and limitations.

Know what is in your power to control and you will be able to work around it. Know what exacerbates your DP and either face it head on or eliminate it from your life.

Try to keep a very regular, predictable daily routine, one that is not beyond your tolerance level, but one that challenges you a bit, gives you contact with others, a sense of purpose, and plenty of distraction. Try to keep regular hours -- get up at the same time each day, go to bed at the same time each night. And have something to look forward to each day.

I have had to accept I have limitations because of my DP. I no longer engage in many activities I love. I have no children because of this illness. My career has been compromised, many life goals have passed me by. But in the process of getting better, even at 48, I have found new outlets for my talents. Have faith that what you cannot do may be replaced with something just as meaningful.

Sometimes I think I have finished mourning the past, but dreams die hard. I am not saying this is an easy task. But life is worth living. Take it day by day and take control of what makes each day more productive, more positive.

Make peace with what you can't handle, and cultivate those talents, that strength you have to continue with other pursuits. Set goals, a daily routine that produces less stress. Try to believe we all hold an important place in this world regardless of our limitations.

And remember, never lose hope that we can get better. That many have conquered DP, depression and anxiety. We live in a time where advances in neuropsychiatry and alternative treatments are moving at an incredible pace.

And one final note. For some of us with any kind of mental illness, just getting up in the morning can be torture. I have been there. I highly encourage you, no matter how awful you feel to get up at a reasonable hour in the morning, take a shower, and dress for the day. If this is all you can do, you will still feel better, and this can help lead to a next step, be it cleaning your home, taking a walk, etc. No accomplishment is too small. Attempt to make your life as normal as possible, though I know this is so difficult.

Stay Physically Healthy

Vigorous exercise significantly increases my DP and outdoor activities exacerbate my DR. Regardless, many DP sufferers engage in all forms of exercise as a means of decreasing anxiety and releasing some "feel good" endorphins.

Yoga is a popular exercise which is more aerobic than it appears. Exercise classes or gyms get you out of the house. Exercise videotapes are great to use at home.

For overall health and peace of mind, engage in some form of exercise -- something you really enjoy or simply have to get done anyway. Garden, weed, walk, run, hike, vacuum, clean the house, clean the refrigerator, roller blade, wash your car, walk through a large museum or botanical garden, organize a closet...

Sleep can help or exacerbate DP. Many with DP, anxiety, and depression feel constantly tired. I often feel this way. First check with your doctor to see if your medications may be causing this. Not sleeping enough or sleeping too much can make DP worse. Try to keep a regular sleep pattern. If you aren't working or getting out of the house, occupy yourself to avoid sleep. There is always something to do around the house.

Eat nutritious meals, take in plenty of water and eliminate caffeine and artificial sweeteners; the latter is especially important if you suffer from IBS, (Irritable Bowel Syndrome, which is an unfortunate companion of anxiety.) Caffeine can exacerbate anxiety and DP and is found in coffee, tea and many popular soft-drinks. Limit or cease alcohol intake and eliminate all recreational drugs. Many have had DP onset with the use of cannabis or other recreational drugs; why tempt Fate with "just an occasional toke?" don't make things harder on yourself by not taking care of your general health.

Getting physically ill (such as with the flu) can exacerbate DP. You can feel worse with a cold, flu or more serious physical condition. Seek medical help as necessary and know this will pass when you are feeling better.

DP and Somatic Symptoms vs. Other Medical Illnesses

DP sufferers experience numerous strange symptoms that are very real, but are generated by the brain. For example visual disturbances can occur with DP precipitated by recreational drugs. One may see trails of light, "shimmering walls," sparkles, "halos" around lights, and the like. Others feel dizzy, faint, have vertigo, or experience strange electrical "shocks" going through one's head (often a side-effect of medication withdrawal).

Sometimes such symptoms are medical symptoms that need to be treated like any other physical illness.

I experienced swirling pinwheels and "sparkles" in my peripheral vision for about 3 years when I was at university. My psychiatrist at the time kept telling me these were "somatic psychiatric symptoms of stress." This was not the case. I actually had the warning signs of retinal detachment which necessitated emergency surgery at the age of 24. Fortunately my eyes are in good shape now.

Case in point: If you are experiencing any unusual symptom it may just be part and parcel of the DP or anxiety/panic. On the other hand it could very well be an actual medical problem. Don't become alarmed. Even if only to ease your mind, seek medical help. You don't need any more medical problems -- the DP is enough!

How Do I Explain This To Family And Friends?

If depersonalization and derealization are difficult for medical professionals to fully understand, you know how difficult it is for mentally healthy individuals to comprehend. DP and DR are invisible to others. -- "You "look so normal, why can't you just pull yourself together? I can't see anything wrong with you at all." Explaining what you're feeling is extremely difficult and it is especially difficult to explain how your symptoms impact your daily functioning and your ability to enjoy life.

I have never discussed my illness with employers and I admit I have given up on trying to explain my DP/DR symptoms to most people altogether. I often simply say I have severe depression. Unfortunately there is still stigma attached to being mentally ill and most people who have not been touched by mental illness do not understand that the brain can get sick.

In communicating with close friends or family it is helpful to present case histories, personal stories, or simple medical descriptions. Give them time to read some short articles and suggest they ask you questions. The key is to present someone with clear, simple information, and not overload them with details. Bottom line, don't expect an understanding of your illness, but more an understanding that you are limited by these symptoms and they are of a medical, neurological origin -- not that "you aren't trying hard enough." You might mention your need to take medications. For some this makes DP/DR "sound more like a real illness."

Fortunately (or unfortunately) a very effective explanation can be, "This is like a bad trip that never goes away." Many friends (some of whom you'd never think may have tried LSD, or any recreational drug for that matter) will seem to understand immediately. I hear stories however of friends then expressing, "Wow, how great to feel like you're tripping all of the time!" Discouraging to say the least.

Bottom line is most people will have an extremely difficult time understanding any mental illness. However, I have found that certain friends and family who love you will accept your limitations, respect them and remain supportive as best they can. This is not easy for them either -- those who don't want you to be ill, who want you to be "your old self" again.

I have found dear friends who accept me as I am, and those who have dropped out of my life since I have "come out of the closet." This is the risk you take in trying to explain your situation. But you will be pleasantly surprised at who will stand by you, regardless. It is a test of love and strength for both you and your loved ones. You will also find that some of your friends and family have their own "secret burdens" and will find relief in sharing their problems with you. There is some advantage to be open about our human frailties, there should be no shame in sharing them. But understand that some people will never understand, and may walk away -- often out of fear or confusion. This is beyond your control, and not your fault, it is just a fact of life.

Relationships, Intimacy, and DP

Mental and physical illnesses often interfere with having a healthy loving relationship. In every case the problems are unique and vary in severity. Some individuals are able to have fulfilling relationships, while others choose solitude. Chronic mental illness can place tremendous stress on both partners in a relationship, or on an entire family.

DP is extremely difficult for healthy people to understand, even the most empathetic people. A partner or lover who doesn't understand DP or mental illness can feel frustrated trying to "help" or "make you feel better." Some partners may begin to believe "you aren't trying hard enough to get better," that "you seem perfectly fine." Even those who love you unconditionally can become worn down trying to understand and accommodate your symptoms and feelings.

Sadly, DP sufferers often have difficulty truly enjoying an intimate relationship. The sense of distance and disconnectedness makes love a painful experience. Many go through the motions to please a partner. Others are unable to do so.

Side effects from medications can also affect the libido in both men and women. This is obviously especially difficult for men. I have heard from some men, however, that intimacy actually helps them escape the DP for a time. As a woman I have never felt this way, though I'm sure this is true as well for some women. Genuine, loving intimacy can be a powerful distraction if one is not seriously depersonalized.

I wish I had an easy answer for how to handle this problem. Mental illness affects all areas of life, occupational and social. I can only state the following for myself:

• The most successful relationships in my life have been with men who have some emotional problems themselves. I don't seek out such relationships; I have always unconsciously gravitated to such men and vice versa. But in many successful relationships this need not be the case.
• Over the years, I have become more open about my emotional problems (with well-chosen people in my life). It just seems more constructive to get things out in the open from the start.
• And on a more encouraging note, medications, time and therapy have lessened the debilitating power of my DP, and have given me the ability to enjoy intimacy far more than in the past.
• Healthy people need loving and unconditionally accepting partners. Those of us with mental illness are no exception. There are many caring partners for all of us out there. Give them a chance. Give yourself a chance. There is nothing more important in life than a strong, loving relationship. The loving support of a partner is critical in maintaining one's emotional health.

Seek The Familiar

When seriously DPd, there seems nothing that can help. However, simply sitting in a familiar room, or holding a familiar object can be comforting. I often close my eyes and sometimes put my arms around myself, something I did as a child. Sometimes I run my hands over the fabric of the sofa or chair I'm sitting in.

Because my eyesight is so bad and I wear glasses all the time, removing my glasses can be comforting. The myopic blur softens the 2-dimensional appearance of things and the sudden "change" can sometimes give me a minor perceptual "kick" back into reality.

Listen to familiar music. A familiar TV program, especially if it's a rerun, or a favorite video you've seen ten times. Touching, watching, or hearing anything familiar can be grounding for me.

Excessive TV watching can become hypnotizing however and can make you feel more isolated. When I'm very depressed and DPd I've found I feel even worse if I plant myself in front of the TV for too long. So read something "mindless" like "The National Enquirer". Go for pulp fiction. You don't have to go for anything cerebral, just something somewhat engrossing and distracting. Flipping through any magazine, looking at the pictures, reading the article titles, not even reading it, can sometimes help you focus and take your mind off of the DP.

Keep A Journal

This is an excellent way to keep track of good and bad days. A journal can reveal a pattern of hidden stressors that exacerbate your DP which you can then deal with accordingly.

Monitor caffeine intake, sleep patterns, situations that increase DP. A journal is also an excellent way to chart the efficacy of medications, note side effects or subtle positive effects. You may be surprised to see changes for the better in a journal; this can reinforce feelings of hope and strength.

A journal can be cathartic. Instead of overloading a friend or relative with fears and concerns, writing them out is a constructive release.