Coming soon
dpdrhelp.org is an ambitious attempt to crowdsource understanding and treatments to the dissociative mental health condition commonly described as depersonalisation and derealisation (DPDR). It is in the final stages of production and should be released soon. In the meantime there is a brief summary page regarding DPDR until the site is ready.
What is depersonalisation and derealisation?
These are experiences that involve the loss of all or some feelings of self, processing problems with the consciousness that cause reality to feel dreamlike, colourless, two dimensional, or fuzzy and out of focus. There is often brain fog and problems finding short term and long term memories, especially without prompts. It is very uncomfortable for people who have the condition, often alongside feelings deep isolation, of madness or that a person is losing their mind.
What triggers depersonalisation and derealisation?
An obvious trigger or cause is not required and there are many, but there are three that always stand out, in order:
- the most common reported associated trigger is trauma or stress, particularly long term childhood trauma or abuse, but can also be more recent intensive and persistent stressful events.
- recreational drugs are the next most common reported trigger, and the vast majority of these reports involve cannabis in some way which is by far the most common drug trigger for DPDR.
- psychiatric drugs like antidepressants or antipsychotics consistently come up as the third most common trigger in surveys with a consistent 5% response rate. It's likely this figure is underrepresented due to underdiagnosis as psychiatry has an institutional problem that does not recognise their own psychoactive drugs as a trigger for DPDR.
Potential triggers can generally be summarised to "anything that creates central nervous system stress, and that includes trauma and almost all psychoactive drugs". There are several physical medical conditions that have the same or similar symptoms to DPDR and these should be ruled out first, particularly if there is not a very obvious trigger.
How long does depersonalisation and derealisation last?
There is no fixed time frame. Hours, days, weeks, months, years or indefinitely are all correct answers for many people. Many cases heal through time and taking care of yourself within the first 18 months. Meanwhile, stories of recovery after 18 months consistently attribute the recovery to some kind of change, action or event, so if your DPDR has lasted at least two years, you will likely need to do something to improve the situation. This is the purpose of the upcoming website.
How can I recover from depersonalisation and derealisation?
Everybody can improve their condition and it is expected that you will be able to get to a point where you can experience emotion, have a sense of self, and live a life that contains hope and happiness in it. On that path, many will also completely recover, but those that do not can still expect to recover much of themselves, their faculties, and their experience of the world so things are much better than they are today.
Where do I start?
The project splits methods into two parts; ones that are low risk and can (and should!) be explored by everyone regardless of how long they've had DPDR, and those that are more interventionist, come with more risk, and are suggested only for people who have had DPDR for longer than 18 months. In general, it is a firm recommendation that all drugs are left off the table for the first 18 months as all psychoactive drugs besides creating additional stress on the central nervous system have the potential to both worsen and help DPDR, and there is a very real risk that in attempting to treat DPDR with drugs it causes a significant and long term worsening of the condition. As such, better to stay within methods that do not present that risk within the time that DPDR statistically heals from time for many people.
When drugs are documented in the second phase after 18 months, the project focusses on experience creating "session based drugs" like MDMA and psychedelics as a path that presents better sustainable outcomes than "daily dosing drugs" like antidepressants or other psychiatric drugs where a person attempts to change their state through the direct effects of being constantly under drug influence.
Phase one methods
It's important to consider all physical, environmental and mental stressors. What we mean by this is anything that adds load to the central nervous system. Often these are. This is not about being able to carry this load, it is about reducing it to a level where it is more manageable and then as things improve in the future then more can be accomplished. This requires thinking holistically; and this term means thinking of the human mind and body as a complete organism where all aspects of that machine contribute and matter. The trigger has come and gone, the camel has collapsed, now we need to help the camel stand again and that means unloading the weight for now even if it were able to carry that weight before.
Sleep regulation
The most important point beyond all others. Sleep has a direct relationship with DPDR and the state of a person's DPDR is reflected in their sleep quality, and their sleep quality is directly reflected in the state of a person's DPDR. It's not simply sleeping for a regular period of time, it is that the sleep is restorative and a person awakens feeling rested, at least to a minor degree. Many people with DPDR do not feel tired before they sleep, and after sleeping do not feel like they actually slept at all, just that they skipped eight hours. If a person has intense and deeply uncomfortable feelings of madness, this is almost entirely related to this one point, and generally getting this more under control will the be greatest thing a person can accomplish for their internal pain.
- physical tension can greatly impact sleep, particularly if there's any sensitivity at the back of the head or in those regions. This can sometimes be resolved very quickly with dry needling, where a needle is used to puncture muscle knots (myofascial trigger points) and create an immediate feeling of somatic release. There are also physical therapies that can be worked on muscular pain elsewhere in the body. Using a ping pong ball or other massage tools like a small blackroll at the back of the head can help a little before sleeping.
- pay adequate attention to mattress, light and proper back support. Try different sleeping surfaces, with and without a pillow, with different pillows, and if you find something that helps, don't be afraid to make changes. It's important to keep a regular sleep pattern, go to bed at a regular time, and don't eat too late
- do you maybe have sleep apnea? This is particularly common with people who are heavily overweight, and if you can't breathe in the middle of the night either your oxygen levels will drop and/or you will wake up slightly so you can breathe and will never get deep sleep. Sometimes ENT surgery can fix it, sometimes losing weight, sometimes you need a CPAP machine or something. Doctors have a take-home test, and it's common for people with DPDR to come back with "minor sleep apnea" due to breathing irregularities that go hand in hand with DPDR - but if it comes back with major sleep apnea, then there's something else going on. There are cases of DPDR that are entirely a result of sleep apnea, and resolving the sleep apnea completely resolved the DPDR.
- keto diet can be a fundamental part of permanently improving rested sleep quality for many people - and much of the sleep improvement can last even if you stop later. There is a whole section of this site dedicated to keto at release. 20g-50g of carbs per day, try to keep it healthy greek style, first week is hell, benefits usually start after the second week (but might be weeks three or four...), try to keep with it for at least a couple of months if possible.
- psychological things matter - stress, trauma nightmares, things in your subconscious can stop you sleeping properly. These are harder to deal with. Talk therapy might help, so might specific trauma theapies. Realistically people might need MDMA therapy to resolve this side, and MDMA therapy can be especially effective particularly if repetitive nightmares are involved.
- in a pinch an antihistamine like loratadine (don't use diphenhydramine!) can help if you're so out of pattern you cannot sleep. Loses it's effectiveness after two or three nights so really just a one night kick to get you back in rythmn again.
Psychological exercises
Just a brief run down of some of the main ones. Learning these can be helpful even when combined with everyone else and can be viewed as part of learning to understand how your body feels and how its current state it, but for some people it has much more radical restorative effects.
- mindfulness based stress reduction: "body scanning"
This method attempts to reconnect you with your body and feelings through active observation. There was a person who had DPDR for 10 years who completely recovered by doing this daily for a month.
https://www.youtube.com/watch?v=Q2HOkytOs6I - progressive muscle relaxation
This technique provides relief for a significant number of other people, and generally most people at least feel a bit calmer after practising it. There was a person with DPDR for 25 years who completely recovered by doing this multiple times a day for a month.
https://www.youtube.com/watch?v=ihO02wUzgkc - staring at spirals
a number of people have recovered in minutes from just accidentally or intensionally looking at spirals in some form, including one who had lived with DPDR for six years. Whether this is a hypnotic effect, some kind of vagus nerve reaction or simply a relaxation aid I wouldn't like to say, but for many the results are significant. Blow this up to full screen, set resolution to 720p and relax as best you can while looking at the centre for 20-30 minutes:
https://www.listenonrepeat.com/watch?v=BF7bNe1il0M#Hypnosis_Spiral
Phase two methods
These carry more risk and so are best left until a person has had DPDR for at least 18 months, has tried everything above, and is no longer making further progress. They will not be covered in detail here until the main site is released as there is a lot of safety consideration and process consideration, but are a three stage process involving many sessions with MDMA and psychedelics to unravel the DPDR one onion peel at a time. In the meantime please spend your time on the above phase one methods.
We do not recommend psychiatric drugs as the success rate is very poor, poor outcome rate very common, and generally more likely to lead to longer term worsening of DPDR than any improvement. Where there is improvement it will likely be time limited in some way. If you do however go down this path, the studies say that your chances may be better with lamotrigine or naltrexone. Avoid all antipsychotics with the possible exception of aripiprazole - general experience with all the rest is very consistently for worsening. Do not get yourself a benzodiazapine or pregabalin/gabapentin dependency - any benefits you may experience with these drugs will likely not last more than a couple of months and trying to stop them will drive you into the worst DPDR and excesses of madness you have ever felt. There are no solutions there, only danger.