QUESTION:
Dear Dr. Heller,
I just realized that I was having dysphoria (saw your definition) when I went to the emergency TM. I told them I was not suicidal but they admitted me anyway. They thought I was having a psychotic episode (I believe I was also). It started off as depersonalization and derealization (I have PTSD) but turned into dysphoria when they isolated me with no human contact in a sound proof room. I have Zyprexa that I was told to take (this was 3 months ago) if I feel myself starting to dissociate - would this be considered that?
ANSWER:
Yes, Zyprexa is good for dissociation - whether from PTSD, BPD (borderline personality
disorder), or other causes or combinations. Dysphoria (anxiety, rage, depression and
despair) usually means the BPD. I do believe in using antipsychotics on an as needed basis
for dysphoria and dissociation. Borderlines who have persistent flashbacks with
dissociative symptoms can respond to ReVia (naltrexone). These symptoms can be prevented
or markedly reduced by adding the epilepsy medication Tegretol, particularly to Prozac.
I usually recommend fast acting antipsychotics like low doses of Haldol, because they work
quickly with a minimum of side effects. Zyprexa takes longer to work, and can cause
profound weight gain. Many people complain of having "no feelings" while on
Zyprexa.
