DeepSummary
The episode starts with the host, David Pewter, introducing Paul Molyneux, a registered nurse in the UK who had experienced depersonalization derealization disorder for about two years. They discuss the diagnostic criteria and symptoms of the disorder, with Paul sharing his personal experience and insights. Paul explains how he initially had dissociative episodes as a child but developed the persistent disorder after a panic attack in 2006-2007.
They delve into the various treatment options, including psychotherapy, particularly cognitive behavioral therapy (CBT), and medications like fluoxetine, lamotrigine, and opioid antagonists. However, the evidence for pharmacological interventions is limited, and therapy combined with lifestyle changes like exercise seems to be the most promising approach. Paul emphasizes the importance of normalizing the dissociative experiences and providing hope for recovery.
The discussion also touches on the cognitive model of the disorder, where catastrophic thinking about the symptoms can exacerbate anxiety and perpetuate the cycle. Paul shares how engaging in intense exercise and reducing stress levels helped him recover after about two years. The host and Paul both stress the importance of adopting a more positive narrative about dissociation and seeking professional help.
Key Episodes Takeaways
- Depersonalization derealization disorder involves persistent and recurrent experiences of feeling detached from oneself (depersonalization) or one's surroundings (derealization).
- The disorder is relatively common, with up to 70% of people experiencing dissociative episodes at some point in their lives, but it becomes problematic when it persists and causes distress.
- Catastrophic thinking and negative appraisals about the dissociative experiences can exacerbate anxiety and perpetuate the disorder.
- Cognitive-behavioral therapy (CBT) and lifestyle changes like exercise can be effective in treating the disorder by challenging negative thought patterns and reducing stress levels.
- Normalizing the dissociative experiences and providing hope for recovery through sharing success stories is crucial in alleviating anxiety and promoting a positive mindset.
- While there are limited pharmacological options with robust evidence, some medications like fluoxetine, lamotrigine, and opioid antagonists may be considered as adjunctive treatments, but with caution due to potential side effects and limited data.
- Adopting a positive narrative and seeking professional help are essential steps in the recovery journey from depersonalization derealization disorder.
- The episode emphasizes the importance of understanding the disorder, providing empathy, and promoting a hopeful outlook for those experiencing these dissociative experiences.
Top Episodes Quotes
- “So I became convinced that I'm experiencing this symptom. That must be a sign that I've done some irreversible damage to my brain. Clearly that appraisal is going to make me more anxious because there's very little I can do about it. It's something that's happening to me. It's permanent damage to my brain. There's no going back from this.“ by Paul Molyneux
- “I think we should also be trying to normalize recovery. That recovery is very possible and that we can point to several recovery stories. And like I said, I'm more than happy to add my story to the list.“ by Paul Molyneux
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Episode Information
Psychiatry & Psychotherapy Podcast
David Puder, M.D.
7/26/23
In this week’s episode of the podcast, we are joined by registered mental health nurse, Paul Molyneux, to discuss depersonalization/derealization disorder and his personal experiences and recovery from the disorder.