[30M] Experiencing severe anxiety and derealization

Question

[Small note I'm 30 about to be 31 and trans (mtf), previously misdiagnosed as bipolar 2, recent trip to my psychologist had yielded the possibility that it may infact be bipolar (specific one yet to be named) I don't really know what to ask, other than can anyone else relate? Or just share your stories in general. Please and thank you. 💜

Patient Description

A 30-year-old male has been experiencing severe anxiety and derealization, with symptoms worsening over the past 3 years despite medication. The patient reports episodes of anxiety lasting 4 to 7 hours, with fluctuating intensity, which have recently begun occurring in private settings as well as public. These episodes have led to missed work days. The patient also describes experiencing mood swings, brief thoughts of self-harm, and concerns about possibly having Dissociative Identity Disorder (DiD). Current medications include 100mg Spirolactone, 2mg Estradiol, 15mg Buspirone, and 50mg Hydroxyzine as needed. The patient has been on these medications for anxiety, and no significant relief has been noted recently. Past medical history includes occasional cold sores.

Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

Severe Anxiety Disorder: This is characterized by excessive, long-term worry and fear about everyday situations. These feelings are often accompanied by physical symptoms such as fatigue, headaches, muscle tension, or trembling. Your description of episodes lasting 4 to 7 hours, with ups and downs in intensity, is consistent with this diagnosis.
- Treatment often includes a combination of psychotherapy (cognitive-behavioral therapy is often effective), self-care strategies, and medication. Your current medications, buspirone and hydroxyzine, are commonly used to manage anxiety.
Dissociative Disorders: These are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity. Your description of experiencing derealization and dissociative episodes could be indicative of this.
- Treatment typically includes psychotherapy, with a focus on helping patients develop coping strategies to deal with dissociative symptoms and regain control of their identity.
Mood Disorders: These are characterized by a significant disturbance in a person's persistent emotional state or mood. Your mention of experiencing what felt like mania and mood swings could be indicative of a mood disorder, such as bipolar disorder.
- Treatment typically includes a combination of medication and psychotherapy.

Please note that these are potential explanations based on the information you've provided, and they are not definitive diagnoses. It's important to consult with a healthcare provider for a formal diagnosis and treatment plan.

What you can do

Seek help from a mental health professional: They can provide a formal diagnosis and create a treatment plan tailored to your needs. This may include adjustments to your current medication regimen, psychotherapy, and other interventions.
Reach out to your support network: This can include friends, family, or support groups. They can provide emotional support and help you navigate your treatment journey.
Practice self-care: This includes eating a balanced diet, getting regular exercise, ensuring you get enough sleep, and taking time each day to relax and do things you enjoy.
Crisis resources: If you're feeling suicidal, it's very important that you reach out to a mental health professional immediately. In the U.S., you can reach 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.

What you should look out for

Please seek immediate medical attention if:

Your anxiety symptoms worsen or become unmanageable
You experience a severe mood swing or manic episode
You have thoughts of harming yourself or others

Remember, it's important to reach out to a healthcare provider who can provide a formal diagnosis and treatment plan. This information is intended to be educational and should not be used as a substitute for professional medical advice.

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7 mo ago

People Also Ask

What are the common symptoms of severe anxiety disorder?

Common symptoms of severe anxiety disorder include excessive worry, restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. Episodes can vary in intensity and duration.

How is derealization related to dissociative disorders?

Derealization is a symptom of dissociative disorders where individuals feel detached from their surroundings, as if the world around them is not real. It can be accompanied by depersonalization, where one feels detached from their own body or thoughts.

What treatment options are available for mood disorders like bipolar disorder?

Treatment options for mood disorders like bipolar disorder typically include a combination of medication (such as mood stabilizers, antipsychotics, or antidepressants) and psychotherapy. Cognitive-behavioral therapy and other forms of counseling can help manage symptoms and improve coping strategies.

What should I do if I have thoughts of self-harm?

If you have thoughts of self-harm, it's crucial to seek immediate help from a mental health professional. You can also contact crisis resources such as 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 for support.

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Daisy#15667

7 mo ago

I'm not sure if my story is at all the same as yours but in my late 20s i was pursuing corporate law at a large firm, with insane and very few similar-age colleagues especially not women. It took me almost 10 years of doing nothing but working before ambition and suffering mentally and physically because of it, to realize that my ambition had grown out of control. I knew my work had been impeding in my happiness but I don’t know how to reign it in my workaholic attitude. Perhaps it was propelled by an internal sense of insecurity or perhaps it was just a desire to show the world that a young woman with no family connections could make it in a field dominated by old men.

Ultimately, after turning to increasingly strong drugs to calm my nerves, risky behaviors, and a suicide attempt in 2005, I finally realized that I was so far from where I really wanted to be. For me, I found myself again through Church, a partner, and eventually a wonderful daughter. I continued to practice law but it was no longer all that defined my life. I was back in control of me.

When looking back at that time, an analogy I like to think of is skiing. When you go really fast when skiing down a tall mountain, it’s euphoric with the wind and trees and snow and panoramic view, but then when you go even faster, and reach an unexpected patch of ice, you start to loose control, the skiis start jiggering. If you stop suddenly, you will surely crash, if you don’t stop, you could fall even harder, but if you snap out of it at just the right time, you end the trail unscathed, victorious, and improved. That was me and my career. Unfortunately I did take a tumble, but I would like to think that I came out of it all improved and more in tune with who I wanted to be.

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[30M] Experiencing severe anxiety and derealization

What might be happening

What you can do

What you should look out for

Experiencing symptoms?