Derealization 'attacks', what can I do?

Hi Druun,

Sounds like this might be some kind of temporal lobe phenomenon. The "butterflies at the top of the stomach" feeling was the give-away for me. That's exactly the sensation I get immediately before experiencing the sleep disorder Nick describes - which is also caused by a glitch in the temporal lobes of the brain. I still get it even now, in my 70s, btw, though it has decreased with age and no longer worries me even when it does happen.

When I was younger, I also had similar experiences to yours, though not as bad. However, I would describe them more as episodes of hyper-realism. In my case, I would sometimes experience déjà-vu, but more often the classic "freeze-frame" sensation, as if time stopped around me for a few seconds. During these periods, I'd often feel a terrible sense of foreboding, as if something terrible was about to happen. (Though it never did, of course.)

However, it sounds to me - as a former neuro nurse - as if your condition might be slightly more disruptive of your life than mine was, as you mention going into a kind of absence which others noticed, and you dropped the book you were holding. As far as I'm aware, no one else ever realised I was experiencing this.

I definitely don't think this is a psychiatric condition, but I am wondering whether it's a mild form of temporal lobe epilepsy. This can be a relatively minor condition, not provoked by a brain tumour or anything like that, which often starts around puberty (you say you were 11) and clears up once you get into your 20s. I suspect Nick is on the same tack as me, as he asks how old you are.

Can you identify any triggers? Although not a mental illness, it can be triggered by anxiety, especially if that causes low-level hyperventilation. I note you say you were reading aloud on the occasion you described. Did you feel slightly nervous about doing this, and is it possible you hyperventilated without realising it?

I'm inclined to agree with Nick that this is nothing to worry about, as I suspect it will clear up with age. I do, however, have one caveat. Do you drive a car or motor-bike? I'm reluctant to over-medicalise such a relatively minor condition, but if you really find you're having absences which are noticed by others, and during which you seem not to be fully responsive to your surroundings, the dangers of driving are obvious.

See how this goes. From what you say, it sounds as if you've only had one real episode of absence, and the other experiences were more subjective. If, on the other hand, this starts happening more often, I think you should ask your GP to refer you to a neurologist for investigation. But I wouldn't advise going on benzos or antidepressants. Sadly, too many GPs don't fully understand conditions like this, and are way too keen to hand out pills.

I personally feel that those of us with a temporal lobe glitch are slightly privileged, in that we sometimes have experiences that other don't. (Though most of us learn quite early in life to keep them to ourselves!) For this reason, it's difficult to assess what percentage of the general population is affected, but some estimates are as high as 5%.

To reiterate: if you continue to have real absences that affect your ability to function consciously - however briefly - stop driving and ask for referral to a neurologist. This can be treated by medication. If this isn't the case, stop worrying about yourself and enjoy your difference. You might find other interesting things start happening too. I'd love to know how you get on with this.

Hi, I'm 16 now. I know it shouldn't affect my life but I just always feel miserable afterwards because I know it's happened again and I have no control over it. Hopefully it'll get sorted out soon as I'll try and see a doctor about it. Thanks a lot for your advice, I appreciate everyone's replies.

Hi,

Thanks a lot for your reply, it has been very helpful. In regards to temporal lobe epilepsy, I did have what appeared to be a generalized seizure almost 1 year ago now. When I went into the hospital, they did an eeg a few days afterwards which they said was alright with a few small 'non specific' abnormalities. They didn't give me any medication because they said it was only my first one.

I don't know if it's connected but I did experience this 'attack' thing right before I passed out when I had the fit. I don't know if they are related though, since I've never had any more after the first one (thank goodness). So this might not be a psychiactric issue? If I go to to a neurologist, they won't just tell me I'm depressed?

 

Hi Druun, I have to say that generalised seizure you describe is a bit of a game-changer, especially as they didn't find anything specific on an EEG. You're clearly very bright, so look up "pseudo epilepsy" and related topics, if you haven't already. I can't diagnose you, of course, but see if you think any of it fits. Many highly-intelligent people suffer from this stress-related condition, and there's a small possibility you might be one of them.

This could lead to your GP simply fobbing you off with antidepressants, though CBT (cognitive behavioural or "talking" therapy) is much more effective in treating this condition - if this is what you have. A friend of mine suddenly started having seizures in her 60s, having never had them before. She was put through a whole battery of neuro tests, including an MRI, but when nothing was found she was finally diagnosed with pseudo epilepsy. Fortunately, she's a very pulled-together person with good self-knowledge, and she agreed to start CBT. That was a couple of years ago, and she's had no seizures since. She told me recently that she now accepts that suppressed anxiety caused her attacks.

The effects of our mind are all quite subtle, and sometimes there are grey areas between psychogenic and organic conditions. It's impossible for me (and, without firm evidence of brain disease, wouldn't be much easier for a neurologist) to say whether you have a psychogenic condition, a temporal lobe glitch or some combination of the two. And they do often co-exist.

Once again, I'm with Nick on this one - or at least with what I perceive to be his position, from reading between the lines of his post. You still haven't said how old you are but I suspect you're in your teens. That's an age when it's very easy to get unduly worried about yourself - we've all been there.

Clearly, if these attacks get worse and start interfering seriously with your life you're going to have to go back to your doctor, even at the risk of being put on antidepressants. However, my gut instinct is to say hang in there, don't get too concerned about yourself, and see whether the attacks tail off over the next couple of years. It's depressingly easy for young people to get pushed into the psychiatric "system" by GPs who feel they're being pestered into taking action, and not always as easy to get out again. 

Hi,

Okay, I'll look into that and I am 16 by the way.

Thankyou very much for your reply, it was extremely helpful.