[18F] Experiencing detachment and overwhelmed feelings with ADHD

Patient Description

An 18-year-old female has been experiencing feelings of detachment, described as a disconnection from thoughts and emotions, for over 8 months. These feelings are sometimes triggered by loud noises, shouting, and conflicts with loved ones, but also occur spontaneously. The patient finds some relief in connecting with someone or something. Alongside detachment, the patient reports anger, frustration, overstimulation, mood swings, and a significant challenge in opening up to people. The patient has ADHD, diagnosed in March, which contributes to feelings of helplessness and difficulty calming down in their own environment. This has also affected their social interactions and sleep schedule. The patient has had thoughts of self-harm and harm to others, with some plans or steps taken towards these thoughts. There are no known allergies or adverse reactions to medications, and the patient is not currently on any medication.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your feelings of detachment, being overwhelmed, anger, frustration, overstimulation, and difficulty opening up to people include:

  • Depersonalization-Derealization Disorder: This is a type of dissociative disorder that consists of persistent or recurrent episodes of depersonalization, derealization, or both. Depersonalization is described as feeling detached or disconnected from oneself, observing oneself from an outside perspective, or experiencing a sense of unreality. Derealization involves experiencing the world as unreal, dreamlike, distant, or distorted. Your description of feeling like your thoughts and emotions aren’t your own could be indicative of this disorder.

    • Treatment typically involves psychotherapy, with cognitive behavioral therapy being particularly effective. Medication can also be used to manage any co-occurring conditions such as depression or anxiety.
  • Adjustment Disorder: This is a short-term condition that occurs when a person has great difficulty coping with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. Your symptoms started around the time of your ADHD diagnosis, which could have been a significant stressor.

    • Treatment typically involves psychotherapy, cognitive behavioral therapy, and sometimes medications.
  • Anxiety Disorder: This is a group of mental health disorders characterized by feelings of anxiety and fear, including generalized anxiety disorder, panic disorder, and various phobia-related disorders. Your feelings of being overwhelmed, overstimulated, and having difficulty opening up to people could be indicative of an anxiety disorder.

    • Treatment typically involves psychotherapy, cognitive behavioral therapy, and sometimes medications.

Please keep in mind that these are possibilities based on the information you've provided, and only a healthcare provider can provide a definitive diagnosis.

What you can do

  1. Seek immediate help if you're feeling suicidal or have thoughts of harming yourself or others. You can reach out to a trusted individual in your life, a mental health professional, or a local emergency department. In the U.S., you can also contact the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741.

  2. Schedule an appointment with a mental health professional, such as a psychiatrist or psychologist, to discuss your symptoms. They can provide a formal assessment and discuss potential treatment options with you.

  3. Try to identify and avoid triggers that intensify your feelings of detachment, being overwhelmed, and other symptoms.

  4. Practice self-care, including regular exercise, a healthy diet, adequate sleep, and relaxation techniques such as deep breathing or meditation.

What you should look out for

  • If your symptoms worsen or if you start to feel suicidal or have thoughts of harming yourself or others, seek immediate help.
  • If you develop new symptoms, such as significant changes in appetite or weight, difficulty sleeping, feelings of worthlessness or guilt, or loss of interest in activities you once enjoyed, these could be signs of a depressive disorder and you should seek medical attention.

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for a definitive diagnosis and treatment.

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8 mo ago


People Also Ask


What is depersonalization-derealization disorder and how is it treated?

Depersonalization-derealization disorder is a dissociative disorder characterized by persistent or recurrent feelings of detachment from oneself (depersonalization) or the world around (derealization). Treatment often involves psychotherapy, particularly cognitive behavioral therapy, and sometimes medication to manage co-occurring conditions like anxiety or depression.


How can ADHD contribute to feelings of detachment and difficulty in social interactions?

ADHD can contribute to feelings of detachment and difficulty in social interactions due to challenges with attention, impulsivity, and emotional regulation. These symptoms can make it hard to connect with others and manage stress, leading to feelings of frustration and isolation.


What are some effective strategies for managing anxiety and overstimulation?

Effective strategies for managing anxiety and overstimulation include practicing relaxation techniques such as deep breathing or meditation, engaging in regular physical activity, maintaining a healthy diet, ensuring adequate sleep, and seeking therapy to develop coping mechanisms.


What should someone do if they have thoughts of self-harm or harming others?

If someone has thoughts of self-harm or harming others, it is crucial to seek immediate help. They should reach out to a trusted individual, a mental health professional, or contact emergency services. In the U.S., they can call the National Suicide Prevention Lifeline at 1-800-273-TALK or text HOME to 741741 for support.


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