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What could be wrong with me?

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What could be wrong with me?

Postby MarcoAurelio1370 » Tue Sep 22, 2020 11:52 am

I'm a 52-year-old male who was diagnosed with a Pure-O Obsessive-Compulsive Disorder (OCD) psychiatric disorder since the age of 25. I have no family history of psychosis or schizophrenia.
My medical treatment for my OCD has included antidepressants and benzodiazepines, with no illegal drugs neither alcohol consumption.
However, my symptoms over the past few months are not related to my typical OCD symptoms. These new symptoms include emotional numbness, -almost- no thought process, lack of speech/language, since I haven’t much to say, i.e., my mind is very blank, amnesia and cognitive impairment. No anxiety neither OCD symptoms. They have gone. I have not hallucinations neither delusions.
My psychiatrist argues that I have never been psychotic (and/or schizophrenic) and his diagnosis is Depersonalization/Derealization (DP/DR). Since I was/am not sure that this new condition was DP/DR a second medical opinion was required. The new diagnosis was a Psychotic Disorder; more specifically a Delusional Disorder. I do not know if my new condition is a psychotic one, but I believe that it can’t be a Delusion Disorder without delusions.
Hence, I do not know what’s wrong with me. Additionally, I don’t know which is/are the cause(s):
- long term effects of psychoactive (antidepressants and benzodiacepines) prescribed drugs,
- organical cause (the results of my neurological tests were OK),
- functional cause, i.e., a new mental disorder, as a Psychotic Disorder, DP/DR, some kind of dementia,…,
- some mix of the above.
Thanks in advanced for your opinion(s) (and sorry for my English level, since I’m not a native guy).
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Re: What could be wrong with me?

Postby Snaga » Tue Sep 22, 2020 5:49 pm

I'd be tempted for a third opinion, to break the tie, as it were.

I could see DP/DR being a possible explanation. Certainly your post was well written, and doesn't show any cognitive decline, on the surface- double so, if English isn't your first language- it's impeccably written.

As far as Delusional Disorder... the accepted wisdom used to be, that us with OCD (I am OCD, and also that forum's moderator) is marked by us knowing that our thinking isn't rational, at least, not completely. But I've read where that isn't quite always the case, and I know I've read at least one case where the person retained a diagnosis of OCD, yet had crossed the line into delusional thinking.

I'm not completely sure, that I haven't crossed over into outright delusion, a time or two. There's a very, very fine line between that and OCD, sometimes.

Maybe I'm wrong, but isn't delusion, by its very definition, something that the person having it can't see it as delusion, while they're experiencing it? We have a DD forum, yet few people with active delusions post to it- most of the posts, are, I think, from family members- which seems a reasonable outcome, since if I'm having a delusion.... how would I know it?

The thing that would make me wonder if the Delusion diagnosis was correct, is that the Wikipedia entry for Delusional Disorder, seems to say it's not usually accompanied by a flattening of effect. And you mention emotional numbness.

I'm wondering if it's the medications, myself. I've heard of (and just looked it up again, to make sure) emotional blunting associated with antidepressants, and I did find a pubmed paper, the summary of which is that antidepressant use can sometimes cause cognitive impairment. Which I'm reluctant to report, given that you previously were diagnosed with OCD (my own OCD would be rhetorically running naked in a field screaming gibberish right now, with information like that). But it is what it is.

https://pubmed.ncbi.nlm.nih.gov/28029715/

However... with a good result of your neurological tests, AND the eloquence of your post, I lean towards the first diagnosis, with the antidepressants maybe playing a factor in it. That's just coming from someone who don't know nothing, but it sounds reasonable. It seems to me off the cuff, that I've read complaints of your symptoms, from folks on antidepressants. Perhaps changing the dosage, or switching to a different med, would help with this.
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Re: What could be wrong with me?

Postby MarcoAurelio1370 » Wed Sep 23, 2020 6:14 pm

In the first place, I would like to thank you for your reply.

My original post is well written because it was made within several days... and with a online translator help. :)

I think that you're right with the link between antidepressants use and cognitive impairment (CI). Additionally, CI may be due to the long-term use of benzodiazepines (see, for example, https://www.benzo.org.uk/vot4.htm).

With respect to the Delusional Disorder diagnosis, I think that I have no delusions, unless a very blank mind self-perception might be considered a delusion. Besides, the contents of my previous OCD have not lead to delusions. Obsessions (and anxiety) -my old symptoms- have gone.

I have met an appointment with a third psychiatrist (2020/10/14). I hope he could help me.

Many thanks once more time! :-)
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Re: What could be wrong with me?

Postby TheGangsAllHere » Fri Sep 25, 2020 12:01 pm

Did something traumatic or upsetting happen recently? Or something that reminded you of a past trauma? Usually DP/DR is a kind of escape response.
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Re: What could be wrong with me?

Postby MarcoAurelio1370 » Thu Oct 01, 2020 7:13 pm

Trauma? It may be possible, since my father died several months before my new symptoms (blank mind, emotional numbness, cognitive impairement,...) appeared and the old symptoms (anxiety/obsessions) went away. My father was very important in my life.
I know there'are trauma induced dissociations. However, since I've been in a long-term consumption of antidepressants and benzos, it's difficult to know if the (possible) dissociation is trauma induced or it's prescribed drugs induced.
Thanks anyway! :)
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