This is the third psychiatrist I’ve seen regarding my condition, I was given a dissociation questionnaire for the first time. From the questionnaire I can tell you dissociation is a wide spectrum and complicated. It seems like normal people experience dissociation quite often, it’s just part of the brain. For example, you’re talking with someone and your mind wanders off into blankness and two minutes later you have no idea what was said. One of the questions was similar to this and this is actually dissociation but of course it happens time to time with normal people.

My perception of psychiatrists have greatly improved recently because every one of them I’ve met are nice and honest so far. They DO NOT just give you drugs unless they really feel like they help and they are optional, you are not forced to take any medications. Please keep that in mind, it’s OK to seek help.

We started with getting to know me, very patient doctor that genuinely wanted to know my background and my culture. We spent probably 15-20 minutes on my background and my family. Then we went to the symptoms part, when I described the symptoms that I had experienced, he said they are symptoms of dissociation. I said not many doctors know much about dissociation and he agreed but he said they should know about it, it is more common than people think. We then went through the timelines of how my condition started to present in details. Like all doctors, they are looking for any triggers.

I asked him “I really want to find out what’s going on in my brain and if you have seem anyone like me?”. He replied “sometimes why is not always clear.” which is sad but true and it is the limitation of psychiatry in today’s world. Then I asked “do you think I should do more physical scans?”. He replied “No, It’s not at the physical structure level, it’s really at the chemical level.”. Like I mentioned before, we do not have proof or brain scan to proof this, hopeful our kids and grandkids will have access to these technology in the future.

Then he said dissociation is on a spectrum, on the less severe end we have Derealization, then Depersonalization and then others and finally on the severe side we have Dissociative Idenity Disorder. Derealization is really a brain response to stress at a subconciousness level, a form of protection that your brain shuts down at a subconciousness level. Another important and interesting thing he mentioned is memory time confusion which is common in dissociation. He said he understands it’s frustrating but use that as motivation to get better.

Then we talked about medication, he mentioned that medications in my case can be used as supporting role to help with anxiety, normally SSRI with a small dose of atypical antipsychotics but he said he wouldn’t give me anything at this point as he felt like I don’t need it. But the combination is usually used to treat anxiety. I told him that I have fear for medication and he asked why? I mentioned that from the forums and internet, they can have severe side effects. He said this is why sometimes reading too much can be bad. I think it is very true. Google lasik eye surgery side effects and it will scare the shit out of you, it is the same for psychiatric medications. With Internet, there more negative stories than positive stories, there are side effects to everything. My perception of medication is starting to change for the good, the most important thing is a good doctor that you trust to take care of you long term and not some doctor that you see once and get these type of medications.

Going back to Derealization, he said since it’s at a subconciousness level, to get to the subconiousness level, we have two therapeutic approaches, hypnosis and journal writing. Since they do not practice hypnosis clinically he suggested that I start writing journal, write down every thought, behavior, feeling and actions. I didn’t understand the logic behind journal writing but google it and you will find many benefits, it gives you access into your subconciousness. Clearly this doctor knows a thing or two about dissociation. My support friend who has fully recovered from Derealization indeed kept a journal during his illness, interesting eh?

Then he mentioned an article he read recently about dissociation, he asked “from your research, what’s the most common thing that causes dissociation?”. I replied “trauma”, then he went on to tell me that he somewhat disagrees, he said genetic predisposition has a huge factor in dissociation and but it’s being overlooked because everyone thinks trauma is the only cause and they don’t focus on other causes.

Anyways you get the point, I think as far as a good psychiatrist with knowledge in dissociation, he is as good as you can.

With that I would like to wish everyone Merry Christmas and happy holidays! Cheers! Get better!