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Summary
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A reader reports six months of concentration problems, unwanted memories, a changed sense of identity, and fear in public places. Previous psychiatric consultations have not provided an explanation.
The response identifies several possible areas for assessment, including mood, anxiety, dissociation, and other conditions, while emphasizing that the description is too limited to distinguish them.
Its main recommendation is another professional evaluation to establish what is actually happening before selecting a treatment plan, rather than treating any of the possibilities as a diagnosis.
Question
Reader · Identity withheldIt has been 6 month since it started. I just can’t understand whats going on with me, i can’t concentrate seems like my mind blowing away and it doesn’t belong me anymore, all sort of pictures keeping coming up in my mind from my past.
\nIt’s seems like i can’t control it and it irritates me. I lost my feeling of wholness and belonings.
\nDue to it the fear of public places concerns me most, because i’m starting to sweat, blush etc. without any reason for it. I consulted with few psychiatrists but they didn’t help me, i did some self analysis still can’t figure it out.
\nCould you please give me some clue before I totally lost the taste for life?
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Answer
Mark Vigil Dombeck, Ph.D.You don’t give enough information to really say what is happening to you, but I can offer you some ideas about things to look into.
\nThe basic complaints you articulate are: difficulty concentrating, loss of feeling of control over life, alteration in the sense of identity, unwanted past memories, irritation, fear of public places.
\nThese symptoms suggest multiple possible conditions, including depression, agoraphobia, dissociation, and early-stage psychosis. Not very helpful so far, I don't think because there is no way to reject one for the other. Here is why I suggest these categories however.
\nI suggest that depression may be occurring because of the concentration problems, the feeling of loss of control, and the sense that you’ve lost wholeness.
\nYou may also be describing rumination when you talk about unwanted past memories coming into your mind to plague you. We’re not necessarily talking about a Major Depression here, mind you. Just a moderate depression that is more about irritability than melancholy.
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Dissociation occurs when your memories become fragmented and parts of them become hidden from your regular recall abilities. I suggest dissociation may be occurring, because of your description of the loss of personality wholeness.
\nVery mild cases of dissociation frequently involve a condition variously known/experienced as Derealization or Depersonalization wherein people get the strange feeling that they are no longer themselves (or the world is no longer normal) in some intangible but deeply felt way. You could just be describing regular withdrawal from activities when you say that your personality is getting less whole, but you may also be describing this process of depersonalization too. Hard to say.
\nI suggest early stage psychosis may be occuring, becuase the sense of derealization/depersonalization is sometimes also experienced during the begining of an illness that will involve psychosis, such as schizophrenia. There is nothing to suggest that this is happening besides your interesting use of language about “losing personality wholeness”, but that is how early-stage psychosis patients sometimes talk, so I’ll mention it.
\nFinally, Agoraphobia is an anxiety disorder that occurs when people start getting panic attacks (severe sudden episodes of disabling anxiety) in public places, and then start being frightened of going back to those (now unsafe-feeling) public places.
\nIn advanced stages, agoraphobics end up becoming shut-ins, unable to leave their own homes without assistance. You don’t mention that your live has become restricted by anxiety in the manner of agoraphobia, but you do mention a fear of public places, so this is worth mentioning.
\nNone of these disorders or diagnoses are mutually exclusive. You can have all of them at once, although that would be rare.
\nI’m sorry to learn that psychiatrists (is that what you mean when you write “psyhiatres”) were unable to help you, but really the only good suggestion I can make to you is that you go back to see another psychiatrist or to see a psychologist.
\nOnly these two sorts of mental health doctors are capable of accurately diagnosing you and figuring out what is actually happening. You need an accurate diagnosis of what is wrong before you can come up with any useful treatment program.
\nPlease go to see a mental health doctor for a diagnosis and subsequent treatment recommendations – that will be the best and most useful thing you can do for yourself with regard to feeling better.
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