Can anyone tell me what's going on?
I am a 42 year old female, average height and weight. I have have a lifelong history of severe anxiety, depression, health anxiety/hypochondria, and endured some childhood abuse. Since age 16 until present I have experienced persistent intense trauma. I got married at 19 to someone who turned out to be a grandiose narcissist and was extremely verbally, emotionally and psychologically abusive. I developed intense Depersonalization and Derealization about 5 years into that relationship and have experienced DPDR 24/7 for the past 16 years. The severity did lessen over time and in the past decade or so, it had been relatively mild and I had been normal functioning. This relationship also caused me to develop severe CPTSD. I ended the marriage around the 7 year mark and ended up remarried to someone who ended up being a covert narcissist. He caused some of the same and some new and horrifying traumas. It became clear about 4 years ago that I would not survive if I continued in the relationship (either by his hand or my own) and made my escape. I did not feel at the time, that my mental health or nervous system was equipped to be able to take on working and self supporting but I forced myself to do so out of necessity. Since that point I have basically been living in functional freeze and high anxiety and have gone through 4 jobs. I would experience high anxiety at work and come home unable to get up off the couch for the rest of the evening. Weekends were often spent wiped out with fatigue. I have also been under a massive amount of psychological stress the past 2 years in particular and developed a potentially very scary health condition which I have been completely terrified of and have felt unable to cope with. I should also state that I have no support system, no close family or friends, so have been suffering under this weight feeling totally alone.
Over the past year and a half I started having frequent anxiety attacks while at work. I would feel like something was wrong with me physically, caused by a weird bodily sensation or thought and that would cause an anxiety attack. In August of last year I was laid off work for a month and was dreading going back to work. About a week before I was to return to work, my children and I went to stay in a cabin and when it came time to go to sleep that night, it felt like my brain was intensely alert. Every time I would start to drop off to sleep, I would have an intense adrenaline rush and jerk back awake. It happened over and over again. I ended up having to take Benadryl to sleep and was only able to sleep maybe 4 hours that night. I continued having these adrenaline rushes all day and night and ended up unable to sleep for the next 2 nights. I went to the ER and was given hydroxyzine, which did knock me out. I continued to struggle with the adrenaline and jerking awake for a few days and then it subsided. I do not believe that this was mania, as I have never experienced any bipolar symptoms and I did not feel energetic or happy. I felt extremely sleep deprived and kept trying to sleep but it was like my fight or flight was stuck on and falling asleep felt unsafe.
The same experience happened another 2 times, once in October and once in November. After the episode in October, I began experiencing the sensation like I didn't know where I was. I could name facts about where I was, it was just this overwhelming disorienting feeling of not knowing where I was. For several days afterward I also felt like I was in some kind of altered mental state and was very panicky. The incident in October was followed by several days of struggling to sleep. The incident in November was just one night.
In December, started to feel very poorly mentally and felt like I was on the edge of some kind of breakdown. I ended up having a massive panic attack while at work that lasted for upward of 45 minutes. I could not get it to stop. I left work, feeling completely disoriented and this massive panic attack triggered another episode that lasted about a month and a half. The first 8 days I experienced rolling panic attacks/adrenaline rushes and an intense fear of falling asleep. Again, every time I'd start to drift off I would experience hypnic jerks and jolt awake. I was only able to sleep for a few minutes to maybe an hour or two at a time. Every 4 days or so I would become so exhausted that I would sleep through the night and then the cycle of not sleeping would start over again for 5 or so nights. During the period of not sleeping I felt extremely detached from reality, had disjointed thoughts, felt disoriented/like I didn't know where I was almost constantly, experienced intense anxiety and panic and became fearful of developing psychosis. About two weeks into this I woke up with my heart racing into the 170's and for the next few months I experienced these episodes where it felt like an adrenaline rush would come over me, my heart would race, I'd shake violently, sweat, etc. A zio patch revealed that my heart was in normal rhythm so I believe that these episodes may have been autonomic in origin. Lastly, during the time period between August and December I was experiencing very high levels of anxiety.
The inability to sleep/fear of falling asleep/extremely intense fear and panic while awake did subside after about a month and a half but I have been in some kind of altered mental state and barely able to function since then. I am unsure if this is simply intensified DPDR or if the month and a half long episode triggered something additional. My symptoms have been intense episodes of disorientation/feeling like I don't know where I am that come and go. Feeling like my subjective experience of reality has been altered. I often feel like reality and thoughts of the past, present and future are distorted. I experience anxiety, fear, and disorientation when leaving the house. Sometimes I feel extremely numb. I have episodes of hyper awareness. I feel some level of disconnect from my sense of self. I often experience brain fog/daytime grogginess. I sometimes feel like everything is fake. I have trouble falling asleep and have strange dreams. Sometimes I feel so strange and detached that it's scary and difficult to communicate with my family members. I have to have other people drive me places and can barely leave my home, sometimes cannot leave my bed. I do have days or even moments in the day where I feel "normal" but then slip back into this altered mental state again. Sometimes I feel like I don't even know what reality I'm in or what planet I am on. Often, the good days I have are followed by several very bad days mentally and sometimes I have the sensation that I am mentally unstable. Sometimes, when I think of the city or state or even the world beyond my home, it feels distorted and strange. Through all of this, my reality testing has remained in tact. I am aware that it is not the world but my subjective experience that has changed. I am always aware of the facts about where I am like naming the room in my house, my address, etc and also know who I am and facts about myself. I do not think that I've developed any kinds of delusions and haven't had any hallucinations or anything like that.
Given that it's now been 6 months since the onset of these symptoms and I'm not making any kind of significant progress in feeling normal despite being able to sleep through the night consistently for a couple of months now, I am beginning to get concerned.
I would like to know first if anyone has any idea what those episodes were with the adrenaline rushes and inability to sleep for days and secondly, what I am experiencing currently with my altered mental state. Does this sound like just worsened DPDR or is there another condition that could be at play? Any suggestions for possible treatment?