Is this dissociation or structural damage?

[Opus132]

Around 15 years ago i had an episode where i woke up one day and suddenly my entire reality felt completely obliterated. It's like i was suddenly plunged into near darkness. Experiences felt vague and distant, memories faded out quickly and whatever i could recall was also faint and distant, sort of like memories during an alcohol blackout. When this happened i went through a lot of travail, had all kinds of tests done to me, but the result was always that there was no structural damage, thus the only diagnosis left was some kind of dissassociative condition (a psychologist even fished out a schizophrenia diagnosis from somewhere). Keep in mind that prior to this i've been suffering from anxiety and depression for most of my life, had social phobia as far as back as my earliest childhood memory, and prior to the onset of those symptoms i was going through one of the worst years of my life, where i was experiencing constant stress and anxiety.

Now, for the record, my symptoms did not fit what i read about dissociative disorders 100%. For instance, i didn't feel dissociated from my own self in the sense even looking on my body or my reflection feels strange or alien, it's just that my own sense of reality feels diminished, and i feel disconnected from my enviorments in the sense my experience of them is reduced and does not imprint strongly in my memory, but my surroundings are not distorted or alien at all, that sort of thing. I also have no memory laps about traumatic events or anything like that. While i do have huge gaps, both in my short term and long term memory, there's no selective nature to the kind of memories i have lost and it's less of an issue with recall and more about the fact whatever i do rember is faint, distant and almost non-existent.

So because of an inhability to find a cause, the fact that despite the gabs i could still "function" in a sense (nothing that would give away i had some sort of structural damage, for instance inventing memories, repeating the same conversation etc), albeit in a vastly reduced way, i sort of "let it go", my existing depression already making me quite fatalistic even before this happened, and for over 15 years i've been living like this, with occational "episodes" where my symptoms would permanently become worse which compounded my fatalism as it felt like there was no point in even trying if i would just get worse seemingly and often out of nowhere.

And so we come to this last year, where again i've been put through a great deal of stress much like the year where all this started (a combination of illness in the family and financial struggles) and due to the pressure i ended up picking up alcohol for the first time in years. I was a binge drinker in my teens but i quit around my early 20s and only had a brief relapse 15 years when those symptoms first appeared (around my late 20s) but i quickly gave it up becuase it made things worse. This time however i didn't feel any immediate worsening of the symptoms which i guess lulled me into a false sense of security. Well, after several months of this (keep in mind i'm not talking about anything crazy, just three small beers every couple of days or a glass and a half of wine at the most, which was usually enough to make me drunk), i now got hit with the worse episode since this started, which begun with an even more drastic inhability to form memories. I held out around two weeks, which was longer than usual (in past episodes i would recover within a week tops and afterwards it was just a matter of reajusting myself to my "new" reality), and then got hit again and this time everything broke to a degree where it actually feels i've been brain damaged, like something physical actually occured. It's so bad i'm struggling to even retain any sense of who i am. It's like i'm a different person altoghether. My memories are at their faintest, almost to the point of near total non-existence, and everything feels remote and unfamiliar. Like when i look at my hobbies, i barely even remember them or recognize the feeling i had associated with them. I used to play video games as a way to escape my anxiety but now i can barely feel anything when i play them and i struggle to even remember what i just played right after putting down the game. The same goes for everything else. Hell, even the things that gave me so much worry like my financial struggles don't seem to matter anymore since they aren't even there in my consciousness anymore except as vague, fragmentary memories.

Basically, it feels like i'm dead, almost completely. Even writing this took effort as going back to the beginning to check for errors or maybe add some things felt alien and distant and i struggled to remember what i wrote even though i JUST wrote it. Right now i'm going crazy about the possibility i may have incurred some structural damage (thiamine deficiency, cortisol damaging my brain, maybe something like a silent stoke who the hell knows), and my anxiety is through the roof since i'm no position to do anything about it (i have 10 bucks in my bank right now) and the feeling that "time is of the essence" is driving me crazy. But the fact it may be just another dissociative episide isn't any less stressful since i never got better in the past 15 years (worse actually), so what are the chances i could revover now that the problem has gotten 10 times worse? Be that as it may, i'd like to at least have my brain shut up about the possibility of ongoing structural problem.

 

[Dark.Green.Feathers]

I can’t say anything medically for sure.

But you don’t have to fit every potential symptom for it to be dissociation.
I don’t often get the 3rd person/out of body view of myself (Sometimes my memories are formatted that way but not in the moment)

it's just that my own sense of reality feels diminished, and i feel disconnected from my enviorments in the sense my experience of them is reduced and does not imprint strongly in my memory

Can relate to this a lot.
I do experience environments/reflection feeling strange, but equally often (maybe more often, nowadays) life just feels like this. Very disconnected, out of it, just going through and not retaining much. Things retain familiarity but I feel dimmed out or distanced despite standing right there.

When my dissociation’s bad I struggle to read and write well and be comprehensive, too. Can feel like I’m falling asleep while awake, as well.

While i do have huge gaps, both in my short term and long term memory, there's no selective nature to the kind of memories i have lost and it's less of an issue with recall and more about the fact whatever i do rember is faint, distant and almost non-existent.

It's so bad i'm struggling to even retain any sense of who i am. It's like i'm a different person altoghether. My memories are at their faintest, almost to the point of near total non-existence, and everything feels remote and unfamiliar. Like when i look at my hobbies, i barely even remember them or recognize the feeling i had associated with them. I used to play video games as a way to escape my anxiety but now i can barely feel anything when i play them and i struggle to even remember what i just played right after putting down the game. The same goes for everything else. Hell, even the things that gave me so much worry like my financial struggles don't seem to matter anymore since they aren't even there in my consciousness anymore except as vague, fragmentary memories.

Basically, it feels like i'm dead,

Relate or have strongly related to all this, too.
Sometimes I feel I have to get things done very urgently because I know they will stop mattering/existing at all to me once I’ve been removed from the source of urgency. Despite it still existing.


That’s what I relate to as someone who dissociates a lot and has had long periods of severe/chronic dissociation.

 

[Movingforward10]

Have you had any psyhcial health tests? If you have been to mental health people and they haven't been able to diagnose a mental health condition I am wondering about a hormonal issue or neurological issue. It's worth asking?

I don't know how old you are or what your sex is, but lack of memory, and feeling distant from emotions are things I experienced with peri menopause. Hormonal imbalances or vitamin deficiencies can really impact us so worth checking out.

 

[Opus132]

Is there a part of the brain that controls not just the presence of memories but their intensity as well? Because on the side of structural damage i can only find references to situations where memory loss is very apparent to other people (I.E., confabulation, or repeating conversations one already had) but to the degree the person remembers the memory it appears to be at least a normal one.

Right now i'm trying to think what i did today and i can ALMOST remember certain key moments but it's extremely faint and weak, where i feel i'm almost on the verge of losing them. What i did yesterday, God only knows as i don't remember anything at all. I assume it's going to get worse over time since i'm going to slowly lose the memories i made the past few weeks before where things weren't so bad yet.

I tried to play a video game again, one i already played, and not only i could not recall any of the feeling and sensations i had when i played the game, feeling unfamiliar and alienated by everything i was experiencing, but my memory loss started to trail behind me, so that at some point i forgot what i experienced earlier in the gaming session. So what i did is i retraced my steps but instead of strenghening the memory it almost felt i would remember even less. It almost feels like i can't "write" the memory or the material upon which memories are written on isn't even there. Usually when one tries to memorize something there's a certain sensation something is being impressed into the mind but in my case all i feel is a hole.

I also tried to continue with the TV show i was watching before this started and now i tend to forget the episodes i just watched or sometimes i even forget the first part of the episode i'm currently watching, though curiously i can still remember the "facts" of the show if they come up (if there's any continuity in the story for instance). Reading meanwhile feels a little better for some reason, though i'm only reading short stories i haven't tried picking up a full length novel to see if i can actually go through with it with memories of earlier chapters fading along the way.

Oh, i also can barely conjur up any fantasies in my mind, or picture imaginary events, except in the faintest manner possible. I used to make up entire movies in my head with ease, now i can barely even conjur up short scenes.

All in all i'd say the strangest part for me is this sense of unfamiliarity with things i knew before, which may sort of be tied to my inhability to imagine things since i guess part of recalling a memory is being able to hold it in your mind, which i can barely do. For instance, if i think of something like a musical genre, i still know what the genre is but i cannot bring out the various characteristics in my head so that the mental association i had with the genre isn't fully there, giving me this sense i'm dealing with something uknown, even i still do know. It sort of feels like when one struggles to find words or remember facts during a conversation, except this is happening between me and my head trying to recall things, but it is more like the mental association and the whole memory of the experience surrouding a certain fact that i struggle to recall, not so much the raw fact itself. So for instance if we are talking about classical music, i still know what sonata form is, what counterpoint is etc. But when i think of "sonata form" i struggle to remember the various mental images and feelings i used to have associated with that concept. So in a sense the recall of facts is difficult much like the recall of events.

BTW, as extreme as all this feels in my head, none of this is apparent when interacting with others. If i get asked a technical question i may struggle a bit but i can still carry a conversation normally, much like i can still write this normally.

Anyway, sorry for the long posts but i'm trying to document everything with as much detail as i can so i can have a record of my symptoms, just in case things get worse. A family member is now helping me go through some doctor appointments and soon i guess i'll have some tests done but i'm still wondering whether dissociation could account for all of this. I also guess the idea of dissociation is easier to swallow than some kind of irreversible structural damage.

 

[Sideways]

There’s a tonne of overlap between dissociation and depression - emotional numbing/flatness and zoning out, poor concentration, poor memory are features of both. Given you have a history of depression, then I’d apply Occam’s razor - even if these aren’t depressive symptoms you’ve experienced previously.

Is there a part of the brain that controls not just the presence of memories but their intensity as well?

Not really. Most of the brain is involved in “storing” memory, although the hippocampus is particularly important.

But in terms of the clarity of memory, and the ability recall memories, that’s more about the connections between all the billions of neurons in your head.

…which is heavily influenced by depression. The fMRI pics of normal brain activity, compared with the reduced brain activity commonly seen depression? Is full on.

Which is not to say you don’t have something else going on. But…

BTW, as extreme as all this feels in my head, none of this is apparent when interacting with others. If i get asked a technical question i may struggle a bit but i can still carry a conversation normally, much like i can still write this normally.

This is telling.

There’s really nothing subtle about organic memory impairment. It’s not something confined to internal experience. It’s usually pretty obvious. It typically impacts every conversation. Awareness by others is typically higher than awareness of the sufferer.

I’m not a neurologist, so take that with a grain of salt. But, again, if you have a known condition which explains these symptoms? That’s the one I’d go with.

I assume it's going to get worse over time since i'm going to slowly lose the memories i made the past few weeks before where things weren't so bad yet.

Or it may resolve over time and go away. Or it may resolve with treatment.

You have a history of depression and anxiety. Both conditions can leave a person profoundly disabled, with massive impairments to cognition on all sorts of levels. Not being able to think? Depression can do that, in a big way. Memory, concentration, emotions, planning, motivation - core, essential brain functioning that we rely on to function even on a basic level can all be majorly impaired by depression.

And then you add anxiety. Anxiety and depression are best buddies - you see one anywhere for long enough and the other tends to start to show up as well. And also, all by itself, profoundly disabling. The level of distress alone that anxiety causes? Cannot be understated.

Which is not me saying this isn’t a big deal, or this is ‘all in your head’. What you’re experiencing sounds very real. New symptoms like this? It’s worth ruling out other causes. Speak to your GP, maybe talk about seeing a neurologist or doing a full blood work up.

But maybe also speak to your treatment provider about your depression and anxiety. Depression and anxiety both have treatment that can be incredibly effective. If the presentation of your symptoms has changed, it may be worth speaking your treatment provider about exploring new treatment options.

If you can? Extend yourself some compassion. If you have depression, this can be exactly what depression is like. It can be this profound. It is frightening. But you have good reason to be optimistic that, particularly with treatment, this will resolve.