Existential panic and derealization

[jharden]

Hi,

25-year-old healthy male. Great diet and regular exercise/yoga. I don't smoke, drink alcohol or take drugs, and I also avoid caffeine and high sugar foods. I started having panic attacks in October '13, which gradually turned into periods of time where I'd be anxious for days on end and break down completely. My anxiety was a still bit all over the place though. Some days I couldn't leave the house and other days would be totally fine.

I started on 20mg of citalopram four weeks ago for anxiety and depression. I felt it helped me a fair bit in the first three weeks, but the fourth week has been really bad for anxiety. How long should I give the citalopram before I think about upping the dose or trying to new medication?

Anyway, I've been having the most trouble lately with derealization and existential panic. Derealization has been common during the last few months, though the existential thoughts that accompany it now are awful. What is all this? Why am I here? Am I real? Is the world real? Is it all my imagination? What is the meaning of life? etc. etc. I can't get a break from them and it's making my life extremely difficult! It feels like I don't know who I am anymore. It also feels like I'll never feel normal again. It's like the thoughts have been so awful and disturbing that I'll never be able to feel alive and normal agan.

I know the thoughts are irrational and unresolvable, but that doesn't make them go away. Is this just a symptom of my anxiety? The derealization seems to be at its worst after periods of high anxiety. I don't have any history of OCD behaviour in terms of rituals or actions, but the thoughts themselves feel very obsessive. I've had the same existential thoughts plenty of times before in my life, but they didn't cause me any pain.

I guess it'd just be nice to hear from people who've had similar thought patterns and come out the other side. It's such an isolating experience to go through these feelings. Any advice would be great.

[Abi-Skinner]

Hi

I have suffered from anxiety and depression on and off for the last 8 years and I can assure it does ease and can totally disappear, the derealisation is the symptom that plagues me the most, followed by the negative thought cycle.

I suffered a total break down about 9 weeks ago and I went through everything you have described above, I went back on to 20mg of citalopram for 4 weeks then up to 30mg which I've been on for the last 5. I was feeling a bit better until I lost my job 2 weeks ago, which set me back to square one, HOWEVER, I've been feeling not too bad the last week, very little to no derealisation, and no negative thought cycles.. so the long and short of it is, yes it can/will pass. It feels awful now, but just try and find comfort in the fact it's only temporary.

If you have any questions, feel free to ask, happy to help if I can.

[xrachykinsx]

Totally sympathise hun. I had a breakdown due to a build up of stress last October. I went through it all...depersonalisation was the worst. I too questioned 'am I real? what is the point of life? whats the point of everything?' It was the absolute worst time of my life. Generally, I've come a way on from the depersonalisation now but tiny glimmers of it do resurface ocasionally but it literally lasts a few seconds. It will get better hun, it seems hard now but it will and can improve xx

[jharden]

Thank you both for the kind words

It feels so strange to think that it will pass. The feeling is so awful it can make you feel a bit helpless. I'm looking forward to feeling like myself again!

Rachel and Abi - did either of you ever find anything in particular that helped you through these periods? Maybe a specific article, book etc.

[xrachykinsx]

Urmm I guess things like TV..light hearted programmes such as big bang theory, how I met your mother and I spend a lot of time on facebook- it takes my mind off my life..., and eBay! lol and occasionally clinging to my husband and waiting for it to pass.

You asked about how long you should give citalopram before throwing the towel in...definitely not yet! I tried citalopram and lasted 5days on it..but that was just down to the insomnia it gave me. I had 0hours sleep over 5 whole bloody days! lol Generally they say 4-6weeks to feel benefit. I think it can take longer though really...we are all different. I'm on week 12 of Mirtazapine and although Its got me to a stable point. I'm still not 100% perfect but I think the rest is for me to take care of really. I still have bad days..have been having a bad week actually! But being a woman.....hormones don't help at certain times of the month! lol xxx

---------- Post added at 22:12 ---------- Previous post was at 22:05 ----------

Oh I forgot to add...It will get better for you. You've come so far and so you can ride out atleast a few more weeks to get through to the other side Citalopram works great for lots of people- I wish I could have coped through the initial insomnia but unfortunately..insomnia was the cause of my anxiety so it wasn't helpful and I'm now on a sedative antidepressant that helps me ever so slightly to nod off. The depersonalisation is just a symptom of the anxiety and although you really do think you're going crazy..You are NOT, you are still here..you are still you, and it will pass xx

[jharden]

I know what you mean about the insomnia with citalopram.

By the sixth day I had no choice but to take a heavy sleeping pill. I was so tired from lack of sleep that I felt delirious! Luckily, that feeling passed after the first two weeks and now I sleep fine.

Thanks for your suggestions. I do my best to distract myself and live a normal life during these times. The internet is both a blessing and a curse when it comes to anxiety. I'm doing my best to make it work in my favour

It's nice to hear from people who've gone through these feelings and come out the other side. It calms me down and increases my motivation. Thanks again!

[xrachykinsx]

That's okay. Glad you settled down on the citslopram for sleep. It won't be long before you start to feel better. I'm not really better yet, I'm better then I was but still struggle at times but I've not long increased my dose and it can take a month to settle down again xx

[Abi-Skinner]

It's probably one of the harder symptoms to deal with.
I just try to accept it and try not to focus on it too much, but combined with negative thought patterens, it can be quite difficult. Fighting it and stressing about it just fuels your anxiety and makes it worse :(

But like Rachel says, distractions are a life saver, I also find watching tv/films helps, as does reading books and playing games that require focus on my phone/ipad.

Relaxation also helps, I swear by this guy http://www.withandrewjohnson.com he's a hypno therapist
You can find his apps on Google play and Apple app store. They have been a life saver for me. I love his relax app and the don't panic app, but he has heaps to choose from, very much worth a look.

[lisa0406]

Hey.
Are u still having trouble with this @jharden?
I really really really know how u feel! I'm going through exactly the same shitty thoughts after I had trouble with derealisation for months! The DR is more or less gone by now but left me with this "existencial panic" - what is real? How can I go on and think about all this normal stuff now that I want through the horrible experience of derealisation? etc.
And also everything you wrote!!

"Anyway, I've been having the most trouble lately with derealization and existential panic. Derealization has been common during the last few months, though the existential thoughts that accompany it now are awful. What is all this? Why am I here? Am I real? Is the world real? Is it all my imagination? What is the meaning of life? etc. etc. I can't get a break from them and it's making my life extremely difficult! It feels like I don't know who I am anymore. It also feels like I'll never feel normal again. It's like the thoughts have been so awful and disturbing that I'll never be able to feel alive and normal agan.

I know the thoughts are irrational and unresolvable, but that doesn't make them go away. Is this just a symptom of my anxiety? The derealization seems to be at its worst after periods of high anxiety. I don't have any history of OCD behaviour in terms of rituals or actions, but the thoughts themselves feel very obsessive. I've had the same existential thoughts plenty of times before in my life, but they didn't cause me any pain."

Also, I'm studying cultural studies and philosophy, well u can probably imagine how this isn't helping at all when it comes to this DR-induced existential panic and panic thought fear spiral.
I even had to take a study break, some days I was just panicing for hours over all this questions and thoughts - I just couldn't snap out of it and it really made my life hell.

What really helps me is medication to calm (passion flower), also I'm taking Saint John's Worts as natural antidepressant and I'm in therapy.
And I have to say, what really helps me is knowing I'm not alone in this! It is so hard explaining other people how you feel. And as if Derealisation isn't traumatising enough it leaves you with those existential questions and the absolute panic that results from them.

But u know - it's not like we didn't have those thoughts before you're right. It's just now that we experienced these thoughts from another perspective (Derealisation). So it's acctually quite logic what happens to us now. It's just really ****ed up and I want my life back, it's just so hard now that I'm experiencing all this crap. Sometimes then I wonder how can ever get "back to normal" now that I experienced all this!

What helps me, too is meditation and awareness exercises (as done in DBT therapy). It really calms me. Also, I try to find a way to deal calmy with what I'm experiencing right now. The medication helps me to stay calm.
I just hope that in time things will settle a bit and my mind will calm down.
U know, Kierkegaard was one of the first to describe existentialism and existential angst. Most philosophers see it as a natural human characteristic. I think what hits us so hard with this is the mixture of existential thoughts and derealisation. Kind of logic don't you think?
I really hope u did overcome this hell. If so (and even if not) I would be happy if u would reply to my message.

Best wishes to you, L

[Missythedalek]

I'm fifteen and over the summer I very suddenly started having intense existential derealization to the point where I can't function. These thoughts initially stemmed from a fear of nonexistence but have grown to questioning things like whether I have free will and why humans are the way they are and whether all I am is just chemicals and electrical impulses. I was put on mess a few weeks ago and they worked for a while but I just had a major collapse and I'm basically back at square one. I don't know what to do. I feel like I'm trapped inside of my senses, as if all I am is a sensory processing unit. It's hell. I've tried everything. I went to go see a therapist who told me that my best bet is just distracting myself, but that just seems to lead to more anxiety. Please help me. I'm not eating and barely sleeping, and lately I can hardly get through a class period without crying. I feel like there's no way out.