QUESTION:
Dear Dr. Heller,
Hello, I am 19 years old and have a question. Since I was 12, I started experiencing these strange feelings of being unreal, like I could not understand myself or recognize myself and the reality around me. The world seems unreal and I question it. It stopped for awhile and I've been having these feelings more frequently.
My dad has passed away recently and I was very close to him. It usually happens at night, when I am "introspective". I get kind of desperate and shaky. Sometimes I do unpredictable things like screaming or praying. I feel too that I might be going crazy. Usually when I feel this I tend to desire to be around family and stuff. I tend to overeat sometimes.
Do you have any clues to what I am feeling? Is that panic disorder? One night I really got these strange feelings, with my chest feeling cold, my mind feeling so strange, sometimes I can feel my brain tingling, lightheaded.
Thank you very much.
ANSWER:
The most likely explanation is the BPD with dysphoria (anxiety, rage, depression and
despair) and dissociative symptoms. Other disorders can cause dissociative symptoms
including panic disorder, temporal lobe seizures and psychosis. The BPD seems the most
likely.
This is what I do for my patients: If the BPD is present, once on an SSRI medication for a
week (I believe Prozac is the best), the addition of the epilepsy medication Tegretol will
stop these sensations in 3 hours. Following the directions on the
dysphoria instruction sheet can control these symptoms quickly
should they show up again.
