Emotional Turmoil: Navigating Depression and Dissociation

I feel quite strange?

Hello, doctor.
I was diagnosed with depression two to three years ago, and later stopped treatment because I didn't want to continue taking medication.
During that time, my emotions were relatively stable.
However, recently, for some unknown reason, I have been experiencing intense emotional reactions.
To summarize, I often find myself crying uncontrollably at night, shaking all over, and I sometimes laugh until I suddenly start crying but hold back from crying out loud.
I have a severe tendency to self-deprecate, and I am becoming increasingly irritable.
When someone gets close to me, I feel like they might hit me; when someone calls my name, I think they are going to scold me.
I am afraid of loud noises and feel disgusted when someone touches my body.
When others compliment me, I suspect they have ulterior motives.
A doctor once suggested that I might be experiencing dissociative symptoms, as I sometimes feel protected when being scolded, and when I cry to a certain extent, I feel as if I am being held.
At times, I feel like an observer, watching my own body act.
Since school, I have been bullied, possibly because of my honest nature.
Since no one played with me, I buried myself in my studies, achieving top grades in all subjects.
However, because of this, my parents and teachers do not allow my grades to decline.
After my first year of high school, I became a person who has to take medication every day.
Now, I find myself in a very confused state, even feeling a bit detached from my body, and I don't know what this state really is...

Nìmíng, 20~29 year old female. Ask Date: 2023/01/07

Dr. Qiu Junda reply Psychiatry

Hello.
The text reveals predominantly negative emotions.
Regardless of the underlying condition, due to the distress it has already caused to your mental and physical well-being, it is advisable for you to seek evaluation at a mental health clinic as soon as possible to help stabilize your situation.

Reply Date: 2023/01/07

More Info

Understanding emotional turmoil, particularly in the context of depression and dissociation, is crucial for anyone experiencing these symptoms. Your description suggests a complex interplay of emotional distress, anxiety, and possible dissociative experiences, which can be overwhelming and confusing.

Firstly, it’s important to clarify what depression and dissociation are. Depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in activities once enjoyed. Symptoms can include emotional numbness, fatigue, changes in appetite or sleep patterns, and feelings of worthlessness. On the other hand, dissociation is a mental process used as a coping mechanism, where a person may feel disconnected from their thoughts, feelings, or sense of identity. This can manifest as feeling like an observer of oneself or experiencing a sense of detachment from reality.

From your account, it seems you are experiencing a resurgence of depressive symptoms, including severe emotional reactions such as crying spells, self-deprecation, and heightened sensitivity to your environment. The feelings of being overwhelmed by others' presence or sounds, as well as the fear of being judged or criticized, can contribute to a sense of paranoia or hyper-vigilance, which is not uncommon in individuals with a history of trauma or bullying.

Your mention of being bullied during school years may have left lasting psychological scars, leading to a heightened state of anxiety and emotional dysregulation. The feelings of being a "bystander" to your own life and the sensation of being "protected" during distressing moments could indicate dissociative symptoms, which often arise as a defense mechanism against overwhelming emotions or memories.

It’s also noteworthy that you have previously been diagnosed with depression and have stopped treatment. This can sometimes lead to a resurgence of symptoms, especially if the underlying issues have not been fully addressed. The emotional instability you are experiencing—crying unexpectedly, feeling agitated, and perceiving threats in benign situations—suggests that your mental health may need reevaluation.

Here are some steps you can take to navigate this challenging period:
1. Seek Professional Help: It’s crucial to reconnect with a mental health professional. A psychiatrist or psychologist can provide a comprehensive assessment of your current mental state and help determine if you are experiencing a depressive episode, dissociative symptoms, or both. They can also discuss the possibility of reintroducing medication or exploring therapy options like cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), which can be particularly effective for emotional regulation.

2. Practice Self-Care: Engage in activities that promote well-being, such as regular exercise, a balanced diet, and sufficient sleep. Mindfulness practices, such as meditation or yoga, can help ground you in the present moment and reduce feelings of dissociation.

3. Build a Support Network: Surround yourself with supportive friends or family members who understand your struggles. Open communication about your feelings can alleviate some of the burdens you carry.

4. Journaling: Writing down your thoughts and feelings can provide an outlet for emotional expression and help you identify triggers for your emotional responses.

5. Educate Yourself: Understanding more about depression and dissociation can empower you to recognize your symptoms and develop coping strategies. There are many resources available, including books, articles, and support groups.

6. Avoid Isolation: While it may be tempting to withdraw from social interactions, try to engage with others, even in small doses. Social support is vital for recovery.

7. Emergency Plan: If you ever feel overwhelmed or have thoughts of self-harm, it’s essential to have a plan in place. This could include contacting a trusted friend, a mental health professional, or a crisis hotline.

In conclusion, the feelings you are experiencing are valid and deserve attention. It’s essential to approach this situation with compassion for yourself and to seek the help you need to navigate through these turbulent emotions. Remember, recovery is a journey, and taking the first step towards seeking help is a significant move towards healing.

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