Derealisation, disassociation - what help is out there in UK?

[BuryingAcorns]

DS (aged 20) has suffered MH issues before and I've always been able to help as I have experience of dealing with severe depression. But now he is having frequent attacks of disassociation/derealisation brought on by severe anxiety. I really want to help but I don't even understand exactly what he is going through. He's tried to describe it and said it is terrifying but I didn't really follow why.

Has anyone had it? Does anyone know what the best form of help for it is? He is prepared to try something like Sertraline as a last resort (never tried anti-depressants before due to his age as we'd heard too many horror stories of them having very adverse affects on teens.) Are any talking cures effective? Are there any support groups or would he be better off not focusing on it too much?

Sorry - I meant to say TIA for any information or advice.

Has he been referred for therapy? Grounding techniques can help in the moment (5 things he sees, 4 things he hears, 3 he can touch, 2 he can smell, 1 he can taste)

He needs to see his GP. They may put him on an anti anxiety medication. As a pp said, grounding techniques are useful and he can learn different strategies in CBT. Try anxiety UK, they are an organisation that specialise in anxiety. They offer different kinds of therapy and have a helpline: www.anxietyuk.org.uk/

Op, as a teen I went through quite a long period when I used to have extreme anxiety and often had attacks of derealization/disassociation. This was back in the early 90s long before mental health was talked about so much like it is now, so I had no idea I was even having panic attacks or what was happening at all. At the time it was horrendous and lead to me becoming somewhat agoraphobic for a while. The best way to describe the feelings your son is having is that it's almost like you've been zapped out of your body and you can see what's happening around you, hear people talking to you etc, but it's distant and dream like, its very very had to explain unless you've had it. It's as though nothing feels real and you're an unwilling character in a show, hence it's title I suppose, but you also know at the same time it is real and you have to keep functioning in that moment. Very very odd feeling. This went on for a few years gradually getting worse up untill my early 20s and then I realised I had to get help. I tried, antidepressants, which didn't help, and I took beta blockers for a couple years and they did help to some degree. Counseling also didn't help for me. What did help was just learning as much as I could about what was happening, what causes panic attacks etc, that they can't harm you, I learnt breathing techniques to calm myself down when I felt it arising, and also distraction techniques to ground my thoughts. Gradually it started to lessen and I started to feel much better. I'm now 30 years down the line and live a happy, mostly panic free life, as much as anyone with a busy life can anyway! I have odd days where I feel on edge like most people and it's made worse when I'd I've had a drink the night before so I avoid that mostly. Reassure your son that this won't last forever and he can get better again, and in the meanwhile just be there for him. I didn't even tell my family when it all started as I didn't think they would understand and I thought they would think I was going mad, I thought I was going mad! It's good that he's been able to come to you and know you're there for him and listening and supporting him.

OP - Where abouts are you? He needs trauma-specific therapy, ideally not EMDR in the first instance until he's stabilised, medication can help but doesn't cure. You can DM me for more information, but usually psychoanalytical or psychodynamic therapies delivered in a flexible mode with TF-CBT, Group Therapy, Art Therapy etc. work best.

Books that are good are My body keeps the Score (Van Der Kolk), Coping with trauma-related dissociation, Trauma is Strange, The living Legacy of Trauma (though I am only part way through that one). Psychoeducation is key.

Are there any support groups or would he be better off not focusing on it too much?

There are some and it's good to engage with others, I can find the names for you. Is it OK if I PM?

Thank you for this. He has already had some basic therapy that has taught these techniques.

Thank you so much @ZebedeeRebel . He has begun therapy tonight which is I think mainly CBT.

He is certain it isn't trauma related, which is a relief as he comes from a very stable and loving background. But he is high-functioning autistic with ADHD and so finds change exceedingly stressful. This summer he moved house, fell in love for the first time, entered his final year at college and also landed an incredible internship. He knew he was trying to do too much at once and had no down time at all. He was so busy he couldn't see friends, had no time even to go shopping and got into a high state of anxiety. The dissociation was a reaction to the anxiety. But it has become quite invasive and persistent. So he probably needs a slightly different approach.

God I loathe loathe loathe derealization. It's horrendous he has my sympathy 🙁

Is he on medication for the ADHD? I've recently been prescribed medication, and it has made a huge difference to my anxiety, over thinking, getting stuck in negative thought loops.

Antidepressants haven't really made a huge difference and the side effects haven't been great. But the calm that I feel now was so unexpected.

@Hangupsrus - Thank you for your post. What you describe is pretty much exactly what he has described. He is already trying grounding techniques and has done a load of research on it and is trying to gently contain it so it doesn't control him. But he has spent the last three days talking about nothing else obsessively so it is definitely dominating him right now.

This is really helpful. Do you mind me asking which medication you found helped, especially with the anxiety and overthinking - those are his key symptoms.

There is a mall charity called Unreal which can advise.

linktr.ee/unrealcharity

And there are researchers at KCL studying it but not much is known.

Activities that involve physical body movement and other people are all helpful. So swimming or dance classes etc that strengthen the connection between brain and body.

Thank you. He really hates it too. I have sympathy but can't really imagine what it is like so can't relate to this when he explains it.

Yes, I struggled with his until 30's. What really helped me was yoga (or any type of excercise, really - endorphins are amazing for depersonalisation) and breathing exercises (I found alternate nostril breathing extremely helpful), along with medication (I was originally on citalopram but switched to sertraline when pregnant/ breastfeeding) and a short course of therapy I had while at uni. It was the therapist who introduced me to alternate nostril breathing actually. We did a lot of talking about recognising emotions - which is pretty hard when you are prione to dissociating), from what I recall.

Previously, I used to self harm as a way to break out of a dissociative state. I haven't done this in over a decade as I've learned better ways of coping. Not just with my emotions and thoughts but also by finding ways to reduce exposure to stressful events and later, to cope with stress when necessary. This involves learning.problem solving and communication techniques, self soothing techniques, even better diary management and organisation techniques because disorganisation = stress = dissociation.

In short, there are a million little things that can help but no one easy fix! As it seems to be a kind of splitting off of body and mind, thinking from feeling and self from the rest of he world world you do need coping strategies which span the physical senses, your thoughts and emotions, your sense of self and interaction with the world and other people.

I dealt with this for a period of about 3 months and it was horrendous. I still have mild cases now but at its peak, and this will sound crazy and it’s hard to explain, I thought I was dead. I can tell you the exact moment it happened too, I was walking along holding my then partners hand. He told me I was hurting his hand and I hadn’t realised I was holding so tight. I then looked at a shop sign which was bright and it was like I got sucked into the shop sign and left my body.

I didn’t take any medication, but got signed off work and I was adamant I could sort it myself. Daily meditation, spending a lot of time in nature and daily movement, specifically yoga for me, helped a lot. And thankfully, it has never returned like that.

Thanks for this. I will send him that link.

Maybe I shouldn't say this but another thing I found helpful was a mild trip I had from a psychedelic truffle. It contained a small amount of psylocybin apparently and it definitely reset something in my brain. I would love to try this again one day - maybe when my kids are grown up and I can go back to being irresponsible 😬

Seriously though, there are research trials going on at the moment with psychedelics and dissociation. It's something to look into 🤔

I had this in my early 20's. A book called " self help for your nerves " by Dr Claire weekes was truly amazing. Amazon or perhaps your library will have it.

It is terrifying, and hard to explain.

I had an 18 month long period of this in my early twenties and had a few shorter episodes in my thirties. The only way I can describe it is it's like living in a video game and your body is auto pilot but your eyes are like a Perspex glass over your face.

Which makes no sense at all but that's my best attempt lol

It truly is the most terrifying experience a person can have because you don't know if it's ever going to end. I spend most days worrying it'll happen again

The medication is concerta, which I'm finding really helpful.

Look up the charity Unreal which supports depersonalisation.

Physical activity and social s as activity is important to connect brain and body so swimming or cycling or dance classes are good. And too much internet is bad for this.

I had this for a few years, absolutely terrifying.
I felt I had no choice but to die, it was awful.

Mine was trauma from childhood and it was a coping mechanism as a kid (Alice in wonderland syndrome and dissociation), then it popped up again as an adult.

I find it triggering to even talk about it, the fear is unreal but I'm definitely getting better as I'm able to write about it.

Smoking cannabis definitely made it worse for me as a teenager.
Diazepam definitely helps and relaxes me so I always keep a dose on me. It immediately stops the panic.

Citralopam (spelling) has been my most successful anti anxiety med, 20mg a day been on it 2 years after my last attack of it.

I've had it and yes, it's terrifying. YouTube it, there are quite a few people who describe the effect and some of them have really good explanations. For me, I didn't feel like anything was real, I felt detached from my body as though I was looking outside of myself. My hands moved faster than my mind could comprehend and then crippling anxiety that went with it was really tough.

The things I found that helped me:

Mantra's. I was fearful I would forget who I was, so In the midst of an attack, I would recite my name, where I lived and my phone number. It allowed me to concentrate on that instead and gave me peace of mind that I wasn't loosing my marbles.

Reading: reading out loud the sentences so I would have to focus on them instead of what was happening, really helped. This was my go to as I had no alternative but to concentrate on the words in front of me.

Just being there will help him. Mine was because of complex PTSD so as long as he has some support he will get through it. Mine suddenly disappeared a few years later and have only had 1 or 2 episodes in the last 17 years ❤️

I have had two periods of this that lasted for months, at a time. They are horrendous and they make you feel you are going mad, but you're not they are a perfectly normal body response, that's gone a bit off kilter.
For me both periods of DPDR followed a series of panic attacks and anxiety. The best way I have found to understand it is when you are having a panic attack your body is responding to a real or perceived threat - a tiger will eat me. A panic attack happens when your body thinks it is going to die, so to save yourself the pain of a tiger attack your body cleverly disconnects itself. You don't feel any emotions and everything feels quite unreal during DPDR. Its a bit when you get a shock and everything stands still and feels unreal around you, but for a prolonged period.
I found it helpful walking in nature and other techniques for anxiety ( counting objects) to take my mind off it, when you focus on it it feels worse.
There are lots of videos on YouTube now about it that help you understand.