Experiencing Very Strange Feelings and Episodes

Reader’s Question

I have been experiencing very strange feelings and the episodes are getting more frequent. It is like suddenly I am not here or I am suddendly in a dream and I am watching myself and my thoughts are seeing some other time or place. I get an awful feeling in my stomach and in my mind and I sometimes get dizzy and disoriented. Sometimes it is just a flashback and other times it lasts for a day or more. I don’t know what to do and I don’t understand what is happening to me.

Our Consulting Clinical Psychologist’s Reply

These episodes can be found in both medical conditions and psychiatric issues. Medically, hypoglycemia, hypothyroidism, and even complex partial seizures may produce episodes of awayness and dream-like states that you mention. Medical causes are often associated with additional medical symptoms such as a physical “aura” or early warning signs of a seizure disorder (upset stomach is common). Medical causes may also have no obvious link to our psychological state or history as when occurring suddenly when we have no significant mental health history. If the episodes occur within 90 minutes of eating, they may be associated with blood sugar or other medical factors. These episodes can also be produced by medications we use. Have you recently added, discontinued, or changed your medications for example?

From the psychological standpoint, you may be experiencing episodes of depersonalization which is a fairly common experience. Depersonalization will give you the sense that you are going through the motions of your life without a real connection with what’s going on, a sense that you are disconnected from your body, a sense that you are involved in a dream, or a sense of being out-of-body. If the cause is psychological, we would expect to find additional mental health symptoms such as a traumatic upbringing, severe anxiety/panic symptoms, depression, etc.

Some informal guidelines:

• I would first recommend a medical evaluation. As many medical conditions can create these symptoms, the first approach must always be medical consultation.
• If medical findings are within normal range, I would consider a psychological or psychiatric assessment. This is especially important if you have been under severe stress or having additional psychiatric symptoms. The surfacing of these episodes often tells us that our stress level is extremely high and in need of treatment and/or intervention.
• Prior to consultations, keep a diary of the episodes — listing all the details such as the 1) when, 2) where, 3) prior events related to the episodes, 4) how long they last, 5) what works to end them or make them worse, and 6) how we feel after the episode. You may be able to detect a pattern by such things as the time of day, time after eating, exposure to certain things in the environment, etc.

Right now, the major recommendation is for assessment. Obtain your consultations and decide what’s causing these episodes. Remember that any episode or “spell” that we experience is the body or brain trying to tell us something. You now need to find out what it wants you to know. The fact that they are getting more frequent tells us that the conditions causing the episodes are increasing.