Q: I’ve been seeing many doctors over the last 3 weeks and no one seems to be able to conclusively decide what exactly I’m going through. Perhaps, someone here can give some helpful words.

Here’s the back-story. About 3 weeks ago, during a routine day at work, with nothing out of the ordinary, I experienced an “episode” where I was suddenly overcome with fear, panic, and feeling as if I was passing out or dying. I did not black out, however my heart began to race, I felt fevered, my hands trembled like I have never seen in my life, I was sweating, and I was unable to stand.

After a few minutes, these initial symptoms began to subside…however, I felt completely disoriented and disconnected from what was going on around me. I began to cry because the feeling was so disorienting and unfamiliar that I was completely panicked. I can only equate the feeling afterward to when smoking marijuana but without any sort of euphoria. Just very fuzzy/dreamy feeling. I just remember I kept saying “Something is not right with me. Something is not right.”

I left work only to return the next day fearing that the same thing was about to happen. I left work to see a doctor. She assessed that it was most likely a panic attack. She prescribed me Xanax and blood pressure medicine being that my BP was very elevated. Then she took an EKG of my heart just to make sure, of I don’t know what.

SOOO…the EKG came back irregular….so she referred me to a cardiologist. During the course of the next week or two I continued to feel like I was consistently walking or floating around in a dream state and felt very disconnected from myself. Very surreal. Also, a couple of days I suffered from pretty severe depression which eventually went away.

Soooo…I saw the cardiologist…he took another EKG of my heart, an ultrasound of my heart, and a 24 hour urine collection. All of which came back perfect. He concluded that the irregular EKG must have been because the nurse incorrectly administered the test. I also returned to the first Dr. who took blood work to rule out hypoglycemia or a thyroid disorder. Which came back perfect. Then I explained to her how I was still “trapped in this state” and began to experience weird head pressure near the front of my head which made my eyes sore. I also began to notice that the way I perceived light and dark and indoors and outdoors was somehow different, things were altogether just kind of foggy and it was hard to visually focus on things.

SOOOO…she sent me to a neurologist who administered some sort of weird sobriety-like test where I had to follow her finger and walk in a straight line and stuff. After an interview and revealing to her that I had a history with drug experimentation (which I will get into) that I should go in for an MRI. She also did some sort of test on my head where I had to wear this weird sort of hairnet thing with electrodes and she flashed lights in my eyes. In the end both the MRI and other test came back normal.

NOW here is where I’m worried. She now wants to rule out a condition she called “Partial Temporal Complex Epilepsy.” She wants me to go in for an MRA and stay inpatient for 2 days to monitor my brain. Now the experience I’ve had with this particular specialist has been AWFUL! She is consistently late for appointments and sometimes misses them all together, often leaves the room to attend to the mailman, whatever… it’s pretty ridiculous. I’m actually considering getting a second opinion.

The week before she suggested these things I was feeling MUCH better. No head pressure, the fogginess was much better, and I just felt more “in tune” with myself. I was only taking the Xanax maybe once a week when I felt like I may have another panic attack. So that is why I’m really questioning her diagnosis, which the next day I feel like I’m right back in that weird dream state.

After doing some research online I’m not totally convinced. And came across a condition called Depersonalization or Derealization, and am pretty surprised she didn’t bring this up as a possibility, considering I feel it described my symptoms to a “t”.

Now…..In college I experimented with a few drugs (Marijuana, Cocaine, Ketamine, Ecstacy, Shrooms)…however it was never habitual use, maybe once or twice, and was about 5-6 years ago. However, I was a habitual pot smoker for probably the last two years (I would smoke later in the evening to help relax me and to fall asleep). Since, the first episode I have quit smoking.

Soooooo….what does everyone think? I felt pretty relieved before meeting the Neurologist for my MRI results as I was pretty much writing it all off as stress and anxiety, and then as soon as I left it was like it started all over again. If anyone has some words of advice or expertise please pass it on. This is beginning to get very tiring.

A: I don’t mean to simplify this but my words of advice would be to get all the tests they recommend to rule out a physical condition just so you know what you don’t have. It sounds like your doctors are being very thorough, which despite the hassle, is nice. I have many clients who get shrugged off and told it’s anxiety without ruling other possibilities out. Your symptoms very well could be anxiety. Sounds like a classic panic attack but why not make sure it’s not something else. I would think it would reduce your anxiety to know you don’t have a heart condition or epilepsy.

Depersonalization and derealization are symptoms of other disorders, such as PTSD and Panic Disorder. They are not stand alone diagnoses. I’m sure your drug usage could have something to do with your symptoms as well. I’ve dealt with clients who never had anxiety until using drugs and then had trouble recurrently. I’d say your next step should be to find a good therapist to help you learn to manage all that’s been going on. I hope it ends up being anxiety because it is very treatable. I’m also glad you stpped using marijuana when all this started. That alone may help tremendously. I wish you luck with all this and hope you start feeling better soon.

 

 

Last reviewed: By John M. Grohol, Psy.D. on 16 Aug 2007

APA Reference
Counts, H. (2007). Possible depersonalization/derealization, anxiety or physical health?. Psych Central. Retrieved on December 22, 2014, from http://psychcentral.com/ask-the-therapist/2007/08/16/possible-depersonalizationderealization-anxiety-or-physica-health/