How To Live With A Depersonalization-Derealization Disorder

Content warning: This article includes references to trauma and other topics that may be considered triggering. Please proceed with discretion. If you are experiencing or witnessing any form of abuse, you can contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233). 

Depersonalization-derealization disorder (DPDR) is a mental health condition that can leave a person feeling detached from themselves, others, or their environment. Needless to say, this condition can be incredibly challenging, and it can have a range of impacts on romantic relationships—both for those who experience it and for their partners. 

In this article, we will explore what depersonalization-derealization is, how it can affect relationships, and how couples can best navigate the challenges of this disorder together. 

What is depersonalization-derealization disorder?

Often abbreviated as DPDR, depersonalization-derealization disorder is a type of dissociative disorder characterized by ongoing or recurring feelings of depersonalization and/or derealization. According to the NHS, depersonalization is defined as “the feeling of being outside yourself and observing your actions, feelings, or thoughts from a distance,” while derealization is defined as the feeling that your world or surroundings are “unreal.” Symptoms of depersonalization and derealization may include, but are not limited to:

• Feeling like you’re outside of your body or mind
• Feeling as if you are in a dream
• Distortions in your perception of time, space, or your body
• Feeling as though you are not in control of yourself
• A feeling of “numbness" toward your surroundings or the people around you

It’s important to note that experiencing these symptoms from time to time can be normal for most people. However, an individual with DPDR might experience depersonalization, derealization, or some combination of the two frequently—often to an extent that their symptoms interfere with their day-to-day lives. 

Although the causes of DPDR aren’t well understood, it is theorized that factors such as extreme stress, recreational drug use, and previous trauma may all play a part in its development. 

How can depersonalization-derealization disorder affect relationships?

No matter the cause, when a person has DPDR, it can have impacts on their interpersonal relationships—including romantic ones. Due to the ability of depersonalization and derealization to make an individual feel disconnected from the people around them, they may find themselves struggling to maintain physical or emotional intimacy with their partners. This, naturally, can be confusing, frightening, or even frustrating to their loved ones. The partner of someone with DPDR might find themselves unsure of how to help when they experience an episode, or perhaps even wonder whether they are somehow responsible. 

All of these impacts can make it difficult for couples to connect and put a strain on romantic relationships. 

How can couples manage the effects of depersonalization-derealization disorder? 

As confusing and intimidating as DPDR can be, there are a variety of ways that couples can work to manage its symptoms and mitigate its effects on their relationship. For an individual experiencing depersonalization-derealization, these can include:

• Practicing mindfulness to reconnect with their bodies and ground themselves in the present moment
• Taking their focus off their symptoms by engaging in physical exercise and enjoyable activities
• Breathing deeply to encourage the nervous system to calm down and mitigate feelings of anxiety or panic
• Avoiding substances that may make symptoms worse, including alcohol and recreational drugs like hallucinogens
• Seeking out support from a therapist, healthcare provider, or friends and family

The partners of those with DPDR can also take steps to help their significant others manage their symptoms. Some examples of these include:

• Listening to and validating their partner’s experiences, should they choose to share them 
• Avoiding jumping to conclusions about what their partner is feeling based on how they are acting, as DPDR can affect a person’s ability to express their emotions
• Offering support, such as comforting physical contact, a safe environment, and reassurance when a person is having an episode of derealization or depersonalization
• Practicing self-care and seeking support when needed—whether via support groups or friends and family
• Doing research on DPDR, how it manifests, and what it can feel like for the person experiencing it

These tips can all contribute to fostering a supportive and empathetic dynamic for couples who are being affected by DPDR. That said, some couples may also choose to seek outside help in managing the effects of DPDR on their relationships. In these situations, therapy can be a valuable resource. Working with a licensed counselor can allow those with DPDR to express their emotions and learn the skills for managing their symptoms when they arise. Meanwhile, couples may also benefit from the help of a relationship therapist, who can help them develop strategies for navigating the challenges that come with dissociative disorders and implement them in a healthy and understanding way. 

Because depersonalization-derealization disorder can be associated with symptoms of anxiety, depression, and panic, commuting to a therapist’s office for counseling may not always be feasible. In these cases, individuals and couples affected by DPDR may instead opt for online therapy, offered through a platform like Regain (for couples) or BetterHelp (for individuals). The ability to attend counseling from the comfort of home, and to send messages to a therapist outside therapy hours, may make virtual therapy an appealing alternative to visiting a counselor in person. 

Online therapy has been found to yield similar benefits to in-person therapy, for both individuals and couples. A study from 2022 found that online couples therapy resulted in similar improvements to in-person counseling when it came to relationship satisfaction and symptoms of stress, anxiety, and depression. Furthermore, a 2017 study found that internet-based cognitive behavioral therapy was effective at treating a range of mental health conditions, including generalized anxiety disorder, bipolar disorder, depression, and others. 

Takeaway

Also known as DPDR, depersonalization-derealization disorder is a mental health condition characterized by feelings of unreality or detachment from oneself or one’s surroundings. This can have a variety of impacts on relationships and may cause distress for couples. However, there are a variety of ways for couples to manage the effects of DPDR on their relationships, including seeking support when needed. For those who would like outside help, therapy can be a valuable resource for learning to navigate the challenges of DPDR and foster a healthy, supportive relationship dynamic. 

If you would like to explore online relationship counseling, you can connect with a licensed therapist via Regain (for couples) or BetterHelp (for individuals).