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Dissociative identity disorder (DID) is where an individual has developed two or more distinct identities, also called personalities, typically resulting from a history of severe childhood trauma. The dissociated state that accompanies alternate personalities is unwanted and involuntary. Dissociation is the body’s way of coping with intolerable conditions.
DID used to be known as multiple personality disorder. The current science surrounding DID considers advances in our deeper understanding of the symptomology, where the person’s dissociative state is largely mentally and emotionally detached from the alternate personalities, feeling as if their alter-personalities are taking over, and the patient is passively observing how the prominent personality interacts. Most people with DID suffer from depression and extreme anxiety. Their condition is often accompanied by hallucinations of any or all of the senses.
DID is usually the result of overwhelming childhood trauma or stress. Most often, it is directly resulting from physical, sexual, and/or emotional abuse, but also neglect. Some individuals who develop DID have experienced an important early loss or suffered a serious, traumatic medical illness.
In place of the typical biological childhood development, they learn to integrate complex information and experiences they cannot process into distinct personalities that help them cope by compartmentalizing the experience. Sexual and physical abuse that occurs during development disrupts a person’s natural growth into a single identity, including the need to trust the parent or caregiver who is usually the abuser.
They experience trauma as a result of betrayal from caretakers. The individual becomes separated from the emotional and mental pain as personalities stand in their place, causing a sense of lost time and fragments of life experiences they can’t remember.
What Are the Signs and Symptoms of Dissociative Identity Disorder?
People suffering from dissociative identity disorder (DID) often lose time; they experience a form of amnesia specific to DID. Simultaneously, they have two or more identities that overtake and disrupt their sense of self. Gaps of missed time can occur daily, going back to initial traumatic events that developed into their condition.
They are typically distressed by their symptoms and take on a sense of shame about them, making it difficult to function socially. It is also challenging to treat the condition until a long period of trust is built with therapists and other experts.
Their multiple, distinct identities, also called personality states, can exhibit different behaviors, compartmentalized memories, and their own thinking. These personalities may have completely different tastes in clothes, food, entertainment, friends, and relationships and may be of different ages or genders. The individual’s entire personality is transformed into the personality that takes hold of them, causing the patient to feel as if they are watching a movie of themselves, unable to break through to win back control over their consciousness and physical actions.
Research has found that people with DID are more likely to harm themselves, and over 70% of outpatients with DID have attempted suicide. Individuals experience identity confusion and have difficulty understanding their true core personalities, interests, goals, values, and beliefs.
Memory lapses can leave the individual confused about the time, often finding items missing or foreign items in their living space they don’t remember having. They can become confused about how they arrived at their location or why they are wearing uncharacteristic attire.
Diagnosing dissociative identity disorder is not an easy task for multiple reasons. Because there is a significant societal fascination with DID, physicians and psychiatrists need to be able to rule out people with other disorders who are seeking attention by attempting to mimic commonly known characteristics of DID. At the same time, people who suffer from DID likely will try to hide or mask it and, even when seeking professional help, won’t want to discuss their painful past or admit they are losing touch with reality. This is because their symptoms don’t fit the majority of accepted cultural, regional, or societal behavioral beliefs or expectations.
Because DID involves amnesia-like periods of memory loss, professionals need to rule out tumors, lesions, sleep deprivation, substance abuse, head injury, and other, more common causes of memory loss.
When it becomes clear that the patient is suffering from DID, a lengthy review of their life history and medical history is necessary. This review will include their cultural and religious beliefs because many of their symptoms will incorporate what they believe should explain their behavior. People will integrate what they believe into how DID plays out, offering religious explanations or parameters for identities or alter-personalities.
Some people with DID experience depersonalization as part of a meditative process, where their focus on mindfulness, centering themselves, or seeking self-calming, further detaches them from consciousness, pursuing distance from the undesired overtaking from their personalities.
Treatment for DID is emotional and difficult for the patient. It centers on talk therapy. During these therapy sessions, they will recall traumatic details and learn to understand and manage dissociative episodes.
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An inpatient stay may last several days or several weeks, depending on the pace of progress and severity of the patient’s condition. Treatment focuses on developing trust with the patient’s therapist, helping them recognize and face the source of their trauma and stabilize intense emotions. It means working through memories, focusing on overall wellness, physical care, rest, and healthy eating.
Outpatient care will likely continue for months or years, with psychotherapy and medications to treat co-occurring disorders. For those living with dissociative identity disorder, the individual benefits from a lifetime of maintaining their psychiatric care, as new challenges in life can develop, each a potential stressor to the original traumas they endured. Lifelong outpatient therapy is about helping to fulfill the whole person, avoiding a regression into their previous life as a victim.
Psychotherapy for DID can include daily sessions of cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
Treatment aims to integrate the patient’s separate personalities and the characteristics each represents while coming to recognize, remember, and relive memories of the trauma to develop effective and healthy coping mechanisms. Over time, the individual experiences longer stretches without memory loss and is increasingly more able to cope during the times when personalities take over.
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Interviews may be lengthy and involve hypnosis or even a sedative when necessary. Psychiatrists who work with DID will use techniques to interact with the patient’s alter-personalities, often speaking directly to them.
Medications such as antidepressants, anti-psychotics, and anti-anxiety treatments are often prescribed to help with accompanying symptoms but not as a cure for DID. There are no medicines to treat DID directly.
Psychotherapy for DID can include daily sessions of cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
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In addition to psychotherapy, numerous other Dissociative Identity Disorder Treatment in Irvine are found to be helpful, including neurofeedback, meditation, yoga, or other calming, self-directed exercise regimens. Eating a healthy diet and getting daily exercise are part of every DID extended treatment in one form or another, personalized to the individual.
Patients learn life-management skills to incorporate healthy eating and sleeping habits and better cope with moments that could otherwise lead to a shift in personalities.
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