DrYes, That is the single best description of this I have ever read! That is it precisely! What a way you have with words, my friend. Several years ago one of my stepsons called me in a dread filled panic. I was at his place in no time flat and he described what was happening to him. It was depersonalization and derealization. I told him I understood and that I had suffered from the same thing. He didn't, couldn't, believe me. I totally understood. It's so hard to believe that anyone else has ever felt that way but it is actually fairly common, as hellish experiences go. And, like you, it stayed around at a simmer for a long time until it finally went away except for the odd outbreak. Xanax did help him (.5 to 1 mg. when it hit hard - followed by a nice nap ) and time helped him even more. I think that anxiety increases this symptom somehow but I do believe it is seizure activity - probably temporal lobe. When they started treating people with Xanax for Panic Disorder - after the ME/CFS flu experience, and my decision to cut out dairy (calcium) combined with my stupid exercise bike rehab efforts pushed my symptoms of deper. and dereal. into overdrive - I was prescribed 2 mg. 3x per day. That pretty much ensured 3 major naps so I cut back right away to 1 mg. 3x per day which did the trick but still brought on some napping! But, the horror was gone almost completely almost right away. Soon enough I was cutting back even further but I always, always, had Xanax in my pocket, just in case I tell you this so that you have an idea of how we were treated and what worked for us in case it's helpful in any way. This is classic. I'm so sorry! Did you know that a test for panic disorder is to inject the patient with lactic acid? If they have classic panic disorder, they will panic. If they don't, nothing will happen. Lactic acid metabolism is also part of the ME/CFS picture. I found the same thing with most benzo.s. It's such a shame that Xanax doesn't work for you but I wonder what drugs are used to treat temporal lobe epilepsy. Anti-epileptics tend to be pretty potent drugs - I've taken them for neuropathic pain and had lots of side effects. But, a look into the treatment of TLE may be useful. I do think that anxiety plays into this. I was not a bit anxious when I had my first attack. It came out of the clear blue. The first several did as did the terrible ones that followed the "flu". But, once I was vulnerable, anxiety could trip me over into it. I remember that, too. It's as though one gets a look at something that is so traumatic, so existentially shocking, that it leaves one's psyche bruised. This goes away, eventually, and being as unafraid as one can helps it on it's way. My gut says this is true. That's what it feels like to me. Thank you for being so concerned about triggering. You are a lovely fella! I hope it reassures you when I tell you that I can contemplate all of this now without fear. None. In fact, the only time I get an actual hit of the dreaded D&D now is when I have used medical marijuana for ME/CFS symptoms. (It stopped working, unfortunately, so I don't use it any more.) But, when I did, I would experience D&D, intensely, first and could wait it out with much more equanimity (and a little Xanax ) than in the past and no lasting sense of dread. I would be surprised, each and every time, at how horrible a feeling it was, though. Oh yeah, I do! I remember vividly discovering that it was not my personal hell. It feels like one's personal hell. Thank you, DrYes, for sharing this because it has brought all kinds of interesting thoughts and ideas into play for all of us! I am astonished at how much we learn from each other when we share what we feel is a private torment and find it is shared! You're a brave guy, DrYes. You are managing this with guts and grace. And, no, you are not alone! Neither are the rest of us! Thanks for that!