Catching Up - What I'm Up To

It has been quite a while since I have given a progress report. I am spending less time working on this site and more time developing it into a memoir.

I regret not being able to respond to many emails. I appreciate each and every one. Please know your words make me feel less alone.

My DP and DR remain chronic but manageable -- they are less frightening but still keep me quite isolated. I will say perhaps I have come to “accept” this state yet still consider this a horrible symptom which steals joy from my life every day.

I also still have chronic anxiety and depression; my depression is currently under control. The anxiety comes and goes but manifests mainly as anticipatory anxiety or social anxiety. I continue to force myself to socialize though I feel calmer when life is on my own terms. I am overall an anxious individual, and anxiety is in a sense always “rumbling away” under the surface.
I remain on the same medications noted in my meds and therapy chapter.

In terms of therapy, I continue to work with my ACSW using Dialectical Behavioral Therapy. I also see a psychiatrist about thee times a year for medication monitoring.

Please be aware that much of the research into Depersonalization/Derealization Disorder (as it is now called in the DSM-5) on this site is already out of date. I am thrilled by major breakthroughs in mental heath research over the past fifteen years which I am certain will lead to greater understanding of this disorder.

Please refer to the IoP website in particular for updates, or search PubMed or similar resources. Also joining any DP support group online will yield updated information.

I wish you all the best. Peace and peace of mind. As always, keep fighting so you may experience even the simplest joys.

Be Well,

One Not Be A Chamber

670 ("One need not be a Chamber—to be Haunted—")
by Emily Dickinson (1830-1886)

One need not be a Chamber—to be Haunted—
One need not be a House—
The Brain has Corridors—surpassing
Material Place—

Far safer, of a Midnight Meeting
External Ghost
Than its interior Confronting—
That Cooler Host.

Far safer, through an Abbey gallop,
The Stones a'chase—
Than Unarmed, one's a'self encounter—
In lonesome Place—

Ourself behind ourself, concealed—
Should startle most—
Assassin hid in our Apartment
Be Horror's least.

The Body—borrows a Revolver—
He bolts the Door—
O'erlooking a superior spectre—
Or More—

The Charleston Massacre -- How We Can Speak Up If We Suspect Violence To Self Or Others

I am stunned by yet another mass shooting by the young man who carried out the South Carolina church massacre. For months he had confided in friends of his intent to perform some heinous act; he not only mentioned killing individuals in a church, but in other locations such as a school.
The question again is “Could this have been prevented?”

As has been reiterated again and again, the majority of individuals with ANY mental illness are more likely to be victims of crime not perpetrators of violence. Situations such as these fall into a very specific category with their own unique characteristics; there are clear warning signs.

Dylann Roof, in my opinion, is yet another example (such as Lanza, Roger, Holmes, and others) who were clearly “disturbed” individuals -- I am not clear on how they would be diagnosed, but they were clearly not thinking logically.
This does not excuse these heinous acts and these individuals should all be prosecuted to the full extent of the law for murder.

I am very concerned Roof’s friends did not report his constant hateful rants and his statements indicating plans for a spree of this type. We all should be encouraged to do so.

Per an article in the Washington Post:

Justin and Jacob Meek, as well as Christon Scriven, 22, a neighbor who is African American, said Roof never struck them as racist but sometimes talked about violence. “I don’t think he hated blacks,” Scriven said. “I think he hated humans.”

When they were drinking one night recently, Scriven said,
Roof talked about shooting up a school. Another time, he spoke of going on a shooting spree at the College of Charleston.
“My reaction at the time was, ‘You’re just talking crazy,’ ” Scriven said. “I don’t think he’s always there.” [End statement]

When a young male, a loner of a young age (Roof is 21), whose life path went off-track in 9th grade, who was unemployed, who was obsessed with racism (the theme of his rage), who had no close friends or any constructive relationship with his family, expresses himself this way WE NEED TO TAKE NOTICE AND WE NEED TO TAKE ACTION. We need to take these threats seriously. Since human behavior is so difficult to predict there is no way to know if this violence could have been averted, but maybe, had his friends spoken up, maybe this horror could have been prevented. This is certainly not their fault, however, we need to spread awareness on the topic.

Here is a very touching article by the mother of one of the children murdered in the Sandy Hook massacre. She also notes … Read The Full Article Here

By Nicole Hockley June 23 at 7:04 AM
Nicole Hockley is the Managing Director of Sandy Hook Promise.

“While the motives for this hate crime may be very different from the crime that took my son from me, there are similarities. Access to firearms. Mental health issues. Ignored signs that violence was imminent. And the destruction of yet another seemingly safe place.
In 70 percent of all gun violence acts (including suicides), at least one other person was told an act of violence would be committed. We need to educate ourselves, and our children about the warning signs. And we need to train ourselves to reach out to trusted adults when we hear or see threats.
We are failing to deal with the toxic combination that we see in acts of violence. Sometimes it’s irrational fear, hatred and racism. But for many Americans who lack the skills to cope with stress and anger, or for the very few with severe mental illness, easy access to a firearm leads to tragic loss.”
… [End statement]
May all the victims of such violence Rest In Peace. We have many issues to address including virulent racism in this country, but this story is unique and multifaceted.

DP/DR Subgroup of PTSD - Breakthrough

Here is an encouraging update in understanding depersonalization -- in this case as a subtype of PTSD; PTSD is an anxiety disorder and as I have always suspected, DP/DR belong under the category of Anxiety Disorders, not Dissociative Disorders.

This article may also someone explain the use of the unofficial diagnosis of “complex PTSD” which is attributed to childhood abuse.
- Sandy -

Altered Circuits May Cause ‘Out-Of-Body’ Symptoms in Some People with PTSD <--- Click Here for full article.

Margaret McKinnon, Ph.D.
May 5, 1015
For some people with post-traumatic stress disorder (PTSD), symptoms go beyond the flashbacks, nightmares, sleeplessness, and tense feelings that trouble many. Up to 30 percent of people with PTSD also suffer from symptoms known as depersonalization and de-realization––that is, they experience “out-of-body” episodes or feelings that the world is not real. These disturbances to awareness and consciousness are known as dissociation.

New research now reveals that brain circuits involved in fear processing are wired differently in these people than in others diagnosed with PTSD. The findings, reported in Neuropsychopharmacology, suggest that such patients need different treatment options.

PTSD with dissociation is recognized as a distinct subtype of the disorder. It is most common among people whose PTSD developed after repeated traumas or childhood adversity. Genetic factors can also increase the risk of developing PTSD with dissociation.

Studies have found that reminders of traumatic events trigger different patterns of neural activity in patients with dissociative PTSD than they do in people who have PTSD without dissociation. In both groups, emotion-regulating brain circuits are thought to be disrupted. Emotional responses are undermodulated (under-regulated, or controlled) by the brain in most people with PTSD, causing them to relive traumatic events and experience hyperarousal symptoms such as being easily startled. In people with the dissociative subtype of PTSD,
in contrast, emotional responses are overmodulated (over-regulated) by the brain, leading to emotional detachment and the subtype's characteristic feelings of depersonalization and derealization.

Senior author Ruth Lanius, M.D., Ph.D., of the University of Western Ontario led a team of scientists that included two-time (2007 and 2009) NARSAD Young Investigator grantee Margaret McKinnon, Ph.D., of McMaster University in Ontario. The scientists used functional magnetic resonance imaging to compare activity in the brains of 49 people with PTSD, 13 of whom had been diagnosed with the dissociative subtype of the disorder. Their study also included 40 people without PTSD.

The researchers focused their analysis on parts of the brain that connect to the amygdala, a small structure deep in the brain that is involved in emotion and fear processing. They examined connections to two parts of the amygdala: the basolateral amygdala, which evaluates sensory information and helps integrate emotions, and the centromedial amygdala, which helps execute fear responses.

They found that in the brains of patients with the dissociative subtype of PTSD, the amygdala was more strongly connected to brain regions involved in consciousness, awareness, emotional regulation, and proprioception (the sense of body position) than it was in PTSD patients without the dissociative subtype. The researchers say that patients' dissociative symptoms may be directly related to these alterations in the brain's functional circuitry.

A Fellow Advocate Speaks Out About Bipolar

I have found a fellow advocate who speaks openly about his experience with bipolar disorder. He has joined the ranks of those who talk openly, without shame, about what are clearly medical disorders deserving the same treatment as any medical illness. And these are words coming from direct experience.

Click Here:

The Cross X Roads: Bipolar Disorder Support

“Bipolar Disorder is not a choice. It is a stigmatized isolating diagnosis and I am tired of hiding! I am going to fight to give the young, the old, the diagnosed, and undiagnosed a voice. We don't need to be afraid.
We no longer need to be silent…” R.A.

Please take a look at this wonderful comprehensive site. This is not only a personal blog, but contains a wealth of information on bipolar disorder.


“Say What You Need To Say”
You are NOT Alone.

Oliver Sacks Says Farewell

I am very sad to hear that one of my heroes, Dr. Oliver Sacks, has terminal cancer. The following article is a deeply moving announcement of his impending death; his eloquent words speak for themselves. He has lived a rich full life, and will continue to do so until the very end which may come in only a few months.

His rich legacy will stay with us forever, and his lifetime of knowledge continues to enhance our understanding of the human brain. He is a neurologist who cares deeply for his patients, and has been open about his own struggles with an inability to recognize faces, migraines and other conditions.

I consider his book
The Man Who Mistook His Wife For a Hat required reading for everyone. Other favorites of mind are Awakenings, An Anthropologist on Mars, Musicophilia, and Hallucinations. His second memoir is due to be released in a few months as well.

I also highly recommend the film version of
Awakenings featuring the Robert de Niro and the late Robin Williams.

I was extremely fortunate to have attended one of his lectures in Los Angeles in the 1990s on the artwork of brain damaged individuals. Seeing him in real life only reaffirmed my belief that he is a kind soul and dedicated physician.

Thank you doctor Sacks, and Godspeed.

"There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death." - Oliver Sacks -

Read the full article in the New York Times HERE.

My Own Life
Oliver Sacks on Learning He Has Terminal Cancer