Archive for the ‘Psychological Aspects’ Category

Understanding and Treating Depersonalization and Derealization

https://www.ruschellekhanna.com/blog/2017/8/4/understanding-and-treating-depersonalization-and-derealization

Ruschelle Khanna August 4, 2017

Imagine the feeling of being under water, trapped in a hole, being aware that you are speaking to your loved ones but unable to fully perceive or emotionally connect with them. Imagine living a life where you are fully aware that you used to have emotions but now feel blunted. Combine this with the feeling that you are somehow separate or distant from your experience and/or your own body.

I am a therapist who treats this experience. It’s name: Depersonalization-derealization disorder DPDR. I am also someone who once experienced this due to Lyme disease. I once described it as watching life through a straw. It is one of the more terrifying experiences I have personally ever had in my life.

WHAT DPDR LOOKS LIKE

An individual suffering from depersonalization may experience:

Detachment from emotions
Distorted body image
Difficulty recognizing their own reflection
Loss of sensation in parts of the body
Feeling unreal or like a spectator in their own lives
Sufferers of derealization may experience:

Feeling detached from their surroundings
Feeling that general life events are unreal
Perceiving objects as changing in shape, size or color
Feeling that people they know are strangers
Feeling that environments they know are unfamiliar(1)

WHAT THE RESEARCH SAYS ABOUT DPDR

There isn’t a ton of research exclusively done on DPDR. This is because mental health providers believe it is a symptom of another mental or physical illness such as anxiety or brain injury like epilepsy. There is no single known cause of DPDR, however it is generally understood that periods of severe stress or trauma as well as substance abuse can trigger DPDR.(2)

The National Association of Mental Health (NAMI) states:

Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual or emotional abuse. Natural disasters and combat can also cause dissociative disorders.

AVAILABLE TREATMENT OPTIONS

Psychotherapy

The literature tells us that there basically is no known, consistent , effective treatment for DPDR. However, there have been some examples of things that have worked for some people. The best tools therapists have to work with and treat DPDR revolve around the possibility the scenario in which DPDR is brought on by severe anxiety and trauma. In this case, there has been some success with Trauma Focused Cognitive Behavioral Therapy (TF-CBT). This involves taking a look at and slowing down the thoughts, feelings and emotions we are having on a daily basis that could be keeping us in a place of elevated stress.

Another option is assisting those who have chronic DPDR to live with the experience, much like chronic pain. Treatment like this includes mindfulness based interventions including breathing, meditation, journaling, and body oriented therapies such as yoga therapy and creative therapies.

Medications

The literature on effective medications for DPDR is also pretty inconsistent. I am generally not a practitioner that advocates for the use of pharmaceuticals right away, however, if someone has struggled with DPDR, I find that testing medications can be an indication of which direction to go in all aspects of treatment.

A small study conducted on 14 clients showed a reduction in symptoms of DPDR in in 4 patients with the use of Naltrexone.(3) There has also been some evidence that Lamictol as an addition to therapy couldreduce symptoms of DPDR.(4) It may be helpful to find a therapist and psychiatrist who are willing to experiment with some combination of medications and therapies.

Finding answers to complex medical and mental health issues can be very frustrating, overwhelming and leave us feeling defeated. I propose we take a step back, find a way to find relief right now, in the moment, with DPDR or not, then put together a plan to continue searching for answers. I fully understand if this were something I lived with on a daily basis it would probably be impossible to just say I could not recover. I would want answers and I would keep trying. However, just like chronic pain, I would not want to deprive myself of the present moment just because it’s there.

If you are seeking answers to DPDR or other chronic mental pain, please contact a healthcare provider today. Some options:

In need of emergency support: National Suicide Prevention Hotline 1.800.273.8255

A little Relief from DPDR: YouTube Video “Tapping to Reduce Depersonalization” – https://www.youtube.com/watch?v=4ANHr_T7GpA

Ongoing Therapy in NYC or Online Counseling in New York State: My office 347.994.9301

References:

1. Theravive. https://www.theravive.com/therapedia/depersonalization-or-derealization-disorder-dsm–5-300.6(f48.1)

2. Simeon, D. Depersonalisation disorder: a contemporary overview. CNS Drugs. 2004;18(6):343-54. Cited at: https://www.ncbi.nlm.nih.gov/pubmed?term=15089102 Date Accessed: 04/01/2017

3. Simeon D, Knutelska M. An open trial of naltrexone in the treatment of depersonalization disorder. J Clin Psychopharmacol. 2005;25(3):267-70.

4. Sierra M, Baker D, Medford N, et al. Lamotrigine as an add-on treatment for depersonalization disorder: a retrospective study of 32 cases. Clin Neuropharmacol. 2006;29(5):253-8.

**Comment**

I want to encourage any of you out there in Lyme-land that are experiencing this.  In my experience this horrible psychological phenomenon typically goes away with proper treatment for Lyme/MSIDS. Think of it as a passing symptom you will eventually conquer.  (This is true and often possible for nearly every symptom in the book)

I also caution you in regards to psychiatric medications as they often have unintended consequences in people with a pathogen invasion such as Lyme and coinfections.  I’ve known of many patients whose symptoms worsened or they developed new ones after taking these meds.  If they are truly needed – take them!  Many have to take sleep aids, anti-anxiety meds, and meds for depression.  Please, always work closely with a medical professional trained in this area – particularly in regard to Lyme/MSIDS.  

I must also give a plug for support groups at this juncture.  They have been a life-line to many as you can unabashedly share what you are going through and receive true understanding and acceptance.  Sometimes just knowing you are not alone or crazy can do more than any medication!  From the support group can spawn many meaningful relationships that blossom.  Many in my group meet together for coffee and other things as they have found true companionship with folks on a similar journey.

And as always, be kind, gentle, and understanding to the sickie (you!).  Find simple things you enjoy and do them – even if it’s a nap!  Find beauty and dwell on it.  In essence, stop and smell the roses.  The most helpful advice to me came from a patient who had made it to the other side of health when I was at my worst.  He said, “Don’t get depressed about being depressed.”  That may seem strange but many of us struggle with this new darkness that seems to cloud our lives and we feel guilty about it.  Personally, I found this depression went hand in hand with how I felt physically.  The worse I felt physically, the worse I felt emotionally.

You can overcome this.

It will take time, but you can overcome!

For more on psychiatric Lyme & other helps:

For a great article for on-line therapy:  https://www.ruschellekhanna.com/onlinetherapy

https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/

https://madisonarealymesupportgroup.com/2017/01/17/lymemsids-and-psychiatric-illness/

https://madisonarealymesupportgroup.com/2017/07/26/can-lyme-steal-your-mind/

https://madisonarealymesupportgroup.com/2015/09/16/bizarre-symptoms-msids/

https://madisonarealymesupportgroup.com/2017/01/11/sick-shaming-of-lymemsids-patients/

https://madisonarealymesupportgroup.com/2017/01/11/bug-that-hijacked-my-mind-part-1/

 

FREE: View “Under Our Skin” Best Primer on Lyme Disease

http://www.veoh.com/watch/v21055812yWtmpgB8  Approx. One hour forty five minutes.

If you have not watched the incredible documentary, “Under Our Skin,” please do so.  It reveals what patients and the doctors who dare to treat them go through.  It reveals the controversy up front and personally.  You will learn that Lyme is congenital, very probably a STD, and devastating.

The documentary covers so much ground but unfortunately doesn’t talk about the coinfections that typically come with Lyme (borrelia).

Can Lyme Steal Your Mind?

http://www.amenclinics.com/blog/can-lyme-steal-your-mind/?trk_msg=RV5QQ65CCVI4R57CV8PGKSB054&trk_contact=25HN640GN6IROQPP74BMQNTCPG&trk_sid=S1OO3ABQL8T30RUK21RS5028SG

Can Lyme Steal Your Mind?

can lyme steal your mindAdrianne was normal until the age of 16 when she went on a mountain vacation with her family. When they arrived at the cabin near Yosemite they were surrounded by 6 deer. It was a beautiful moment.

Ten days later Adrianna became agitated and started having auditory hallucinations. Her family brought her to a psychiatrist who diagnosed her as psychotic and prescribed medications, which didn’t help. The next 3 months were a torturous road of different doctors, multiple medications, and a cost near $100,000. Adrianna had become a shadow of her former self.

Desperate, her parents brought her to Amen Clinics for a scan. Her scan showed areas of unusually decreased activity. It caused our physician to look deeper at the potential causes of Adrianna’s symptoms, such as an infection or toxicity. It turned out she had Lyme Disease. After antibiotics, she got her life back.

Lyme Disease is on the Rise

The Lyme disease (LD) infection rate is increasing. It is the most commonly reported tick-borne illness in the United States.

Public health officials report between 30,000 and 36,000 cases of the disease a year. According to the Center for Disease Control, LD is now present in nearly half of U.S. counties in 43 states, a leap of nearly 45% since 1998.

What is Lyme Disease?

According to the CDC, “Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected black legged ticks.” These ticks are mostly found in the Northeast and Mid-Atlantic states, the northern Midwest and the West Coast, and are often found on white-footed mice and white-tailed deer living in woods and high grass areas. Interestingly enough, Lyme disease was named after Lyme, Connecticut in 1975, the town where it was first identified.

Lyme disease can be effectively treated and cured

Doctors faced with treating the disease in early stages can successfully cure it with the use of antibiotics. Unfortunately, LD can be misdiagnosed because some doctors are not familiar with it. For those who feel they may have the disease, it is best to be diagnosed and treated by a Lyme Literate Medical Doctor that may likely to be a member of ILADS, the International Lyme and Associated Disease Society.

Symptoms may start with flu-like feelings such as fever, chills, sweats, possibly muscle aches, fatigue, nausea or joint pain. Physical symptoms often begin with what may look like a bull’s eye rash and in some cases even Bell’s Palsy (facial drooping). An even bigger problem, there may be no indication of a bite at all, which is a reason why Lyme disease may not be suspected. See some of our research on LD, click here.

Lyme disease is hard to detect

The disease has a way of manipulating the brain into thinking you’re not sick, as it slowly starts to work on neurological functions. LD is known as the great imitator because it can mimic various disorders such as Arthritis, Chronic Fatigue Syndrome, Fibromyalgia, ALS, ADHD, and Alzheimer’s disease, just to name a few.

Even in later stages of the illness, LD can be treated. However, some may have symptoms that can linger for months or even years following treatment. In some instances, people experience memory loss, depression, anxiety, trouble focusing, emotional tantrums, or personality changes. Many find themselves suffering, not understanding why they can’t seem to get better until they are finally properly diagnosed and get the treatment needed to become healthy.

How to protect yourself from Lyme disease

Protect yourself, children and pets against LD by avoiding areas where deer tick live, such as wooded bushy areas with long grass. You can also decrease your chances of getting LD by covering up, using insect repellant, clear brush or tick enticing areas, and remove ticks immediately with tweezers. The ticks are most active in May, June, and early July.

Parents may have concerns because children are affected with the disease more often than adults, but neurological symptoms of late-stage Lyme disease are found to be rare in children.

The first step in any healing process is an accurate diagnosis. If you or someone you know may be experiencing symptoms of Lyme disease, call us today at (888) 288-9834 or visit our website to schedule visit and find out more about how we can help.

 **Comment**
I am so thankful that the psychological/psychiatric issues of Lyme/MSIDS are being discussed much more of late.  Unfortunately, many doctors and therefore the public believe that this complex illness is nothing more than a little fatigue and joint pain.  While some may present that way, there are many more that present with neurological, gynecological, cardiac, muscular, vision, psychiatric, GI, and tendon issues (and more I’m forgetting).  Probably the least talked about is the psychiatric aspects – which is probably the reason these patients in the past were told they were delusional and making things up.  The symptoms are so unbelievable that I like to tell folks,
“You don’t get Lyme until you GET Lyme.”
Confession time:  Before I became infected I viewed my husband through a different lens.  My workaholic, type A, responsible, strong husband cried frequently, sat on the couch for hours playing “Candy Crush,” and limped.  He started drinking vodka secretively at night to get to sleep.  He was flushed all the time and slept most of the day and roamed the house like a zombie at night.  His speech was slurred.  He heard voices.  Once, he opened his mouth to speak and complete gibberish came out.  He developed rage and could not handle any sort of stress.
Then I started with symptoms.  My lens shifted as I finally understood as it was happening to me.
If your spouse, loved one, friend, or patient opens up and starts telling you bizarre symptoms, please don’t write them off.  It is my belief that many commit suicide after years of being marginalized.  They aren’t listened to, believed and validated.  They become isolated and deal with anxiety.  Some are so afraid, they take hours to work up the courage to go to the grocery store.
https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/ An in-depth article on psychiatric symptoms.  Dr. Bransfield is an expert in this area.  Dr. Marke has done wonderful work as well.
https://madisonarealymesupportgroup.com/2017/01/17/lymemsids-and-psychiatric-illness/  Dr. Marke gives a lecture to psychiatrists which I highlight.
https://madisonarealymesupportgroup.com/2017/07/12/suicide-and-chronic-lyme-disease/  A therapist speaks who specializes in helping those with chronic Lyme/MSIDS.

Wisconsin – 117% Increase in Human Version of Mad Cow Disease

In a recent article by Dr. Mercola,  http://articles.mercola.com/sites/articles/archive/2017/07/25/chronic-wasting-disease.aspx?utm_source=dnl&utm_medium=email&utm_content=art3&utm_campaign=20170725Z1_UCM&et_cid=DM152228&et_rid=2092836335,  statistics reveal there is a a 117% increase in Wisconsin and an 85% increase in the U.S. of the human version of mad cow disease, Creutzfeldt-Jakob, which is a contagious neurological disease caused by eating beef contaminated with brain, spinal cord or other central nervous system tissue from infected cattle.

Now the Canadian Government is warning that chronic wasting disease (CWD), a similar disease found in the deer family may jump to humans as well.  Both mad cow disease and chronic wasting disease cause transmissible spongiform encephalopathies (TSE).

The deer family is also known to pick up hitchhiking ticks and carry them long distances.

This warning is due to a study which found CWD was transmitted to three out of five macaque monkeys infected with white tail deer meat.  There is also a systematic literature review showing CWD could also be transmitted to squirrel monkeys.

There is a potential for transmission to humans exposed to deer through diet, health products containing antler velvet, slaughter, velvet harvest, field dressing, preparing trophies and hunting lures.

The state of Wisconsin offers free CWD testing to hunters.

The Milwaukee Journal Sentinel states,

“Wisconsin Department of Natural Resources (DNR)] figures show that tens of thousands of hunters are killing deer in areas where CWD is prevalent and are not submitting them for testing. In 2016, in a CWD-prone area that the DNR describes as the southern farmland zone, 442 deer tested positive for disease out of 3,760 samples. More than 65,000 deer were killed in that zone and were not tested, according to DNR figures.”

Animals infected with CWD shed prions in saliva and urine and remain contagious for life and contaminate land and water.

Similar to Chronic Lyme Disease, CWD does not evoke a detectable immune response or inflammatory reaction. It is different; however, in that it is smaller than most viruses.  It also persists in the environment which is why animals raised in captivity are more likely to infect each other.  Avoid meat from those who force natural herbivores to eat animal parts (routine in concentrated feeding operations).

Researchers have also found an infectious protein (TDP-43) in Alzheimer’s patients is quite similar to prions in mad cow disease and CWD and was found in 200 of 340 autopsied brains of Alzheimer’s patients.  Patients with TDP-43 are 10 times more likely to have been cognitively impaired at death.

A 2005 study published in the journal Medical Hypotheses, stated:

“In the opinion of experts, ample justification exists for considering a similar pathogenesis for Alzheimer’s, Creutzfeldt-Jakob and the other spongiform encephalopathies such as Mad Cow disease. In fact, Creutzfeldt-Jakob and Alzheimer’s often coexist and at this point are thought to differ merely by time-dependent physical changes. A recent study links up to 13 percent of all ‘Alzheimer’s’ victims as really having Creutzfeldt-Jakob disease.”

**Please have your meat tested.  It’s free and it may save your life.**

Suicide and Chronic Lyme Disease

https://www.ruschellekhanna.com/blog/2017/7/10/making-sense-of-suicide-and-chronic-lyme-disease   July 10,2017

When I explain to strangers that I’m a therapist who specializes in Chronic Lyme Disease, most people respond by saying something like “Oh I didn’t know that a therapist can help Lyme. Isn’t that from a tick bite? What can you do for that?” 

For anyone who has suffered years of failed treatments, inability to work, unlived dreams, broken families, lost cognitive function and at times a lost sense of self, it’s pretty easy to understand the need for emotional support.

For everyone else, I generally begin with a shocking statement such as “Many people with Lyme disease have been or are suicidal, some even homicidal or both.” This usually grabs their attention long enough for me to provide some education about the fastest growing infectious disease in the country. It was this all too familiar interaction that persuaded me to write my first blog post explaining some reasons why chronic Lyme disease sufferers might opt for no life over the life they are currently experiencing. Before we dive into those reasons, let’s take a look at suicide.

Life is stressful.  Some of us are naturally more adept at coping with stress than others.  No matter how good we are at managing stress, all of us have a breaking point.  Whether that breaking point comes in the form of chronic long term stress, emotional pain, physical pain or a combination, the brain responds to help us find a way out.  When the mind has run out of options for preservation it turns to suicide as an answer.  Suicide is a symptom that things have become way too much.

There are two types of suicidal thinking. The are called: Passive suicidal ideations (thoughts) and active suicidal ideations. Passive suicidal thoughts do not have a plan of action toward actually harming oneself or others.  They sound like “I wish something bad would happen to me” or “I’d be better off dead.” On the other hand, active suicidal thoughts DO have at least the beginnings of a plan.  They sometimes sound like this: “I could take all the pills in the cabinet” or “I wonder where I could find a way to kill myself.” People often believe that active suicidal ideations are “worse” or more dangerous than passive ones.  However, some research suggests that people with passive suicidal thoughts are just as likely to proceed with attempted suicide as those that have active suicidal thoughts.

Individuals experiencing chronic Lyme disease can have either types of thoughts.  The nature of the illness encourages suicidal thinking for multiple reasons.  Let’s take a look at some below:

Lyme Disease is a brain infection. When Lyme bacteria enter the brain and spinal cord, they cause Lyme encephalitis. The infection causes classic symptoms of encephalitis including mood swings, paranoia, rage, hallucinations, and irrational behaviors including suicidality and homicidality in individuals with no previous history of these symptoms. (Bransfield, 2017)

Lyme Disease causes severe and disabling pain. Ask your neighborhood Lyme disease sufferer what types of pain they have experienced throughout the course of their illness.  The list might look something like this:

  • Shocking Nerve pain
  • Burning pain under the skin
  • Tremors
  • Muscle spasms
  • Excessive Itching
  • Feeling as if something is crawling under the skin
  • Bell’s Palsy (facial paralysis)
  • Severe arthritis
  • Stabbing pain in the eyes
  • Inability to take a full breath
  • Rapid muscle wasting
  • Extreme sensitivity to light, sound and touch

Individuals living with chronic pain have a higher rate of depression and attempted suicide than the general population.  This coupled with possible psychiatric symptoms of a brain infection is often a stress too great to manage for some.

Lyme Disease is Isolating. The nature of any severe and debilitating illness is the way it limits our daily lives.  Lyme is no exception.  In many cases, those impacted are no longer capable of maintaining their roles in the family or community.  Many become isolated to their homes and treatment facilities.  Life can become very small. Isolation is a major contributor to mental wellbeing and can often lead to feelings of worthlessness, helplessness and hopelessness.

If you or someone you love has been impacted by Lyme Disease, it’s reasonable to direct them toward resources to support their mental health and prevent suicide. It is important to remember, suicide is a symptom of feeling there is no other option. There is always another option.  If you need support, please contact National Suicide Prevention Lifeline

Provides help to those in suicidal crisis or emotional distress.

Call 1-800-273-8255

Available 24 hours everyday

For more information:  https://www.ruschellekhanna.com/lyme-chronic-illness/

More on TBI’s and Suicide:

https://wordpress.com/post/madisonarealymesupportgroup.com/16280  There are possibly over 1,200 LAD suicides in the US per year.  Besides suicides, Bransfield estimates around 14,000 incidents of self-harm and 31,000 suicide attempts may be attributed to Lyme and associated diseases each year.

https://www.lymedisease.org/lyme-sci-teen-suicide/