Dissociative identity disorder (formerly known as multiple personality disorder) is believed to be a complex psychological condition that is likely caused by many factors, including severe early childhood trauma (usually extreme and repetitive physical, sexual, or emotional abuse).
What is Dissociative Identity Disorder?
Dissociative identity disorder is a severe form of dissociation, a mental process that results in a disconnect in a person's thoughts, memories, feelings, actions or sense of self. Dissociative identity disorder is believed to result from a combination of factors that may include trauma experienced by the person with the disorder. The dissociative aspect is believed to be a coping mechanism: the person literally disengages or dissociates from a situation or experience that is too violent, traumatic, or painful to assimilate with their conscious self.
Who is at risk for DID?
Research indicates that the cause of ID is likely a psychological response to interpersonal and environmental stress, particularly during early childhood when emotional abuse or neglect can interfere with personality development. Up to 99% of people who develop dissociative disorders have recognized a personal history of recurrent, overwhelming, and often fatal disorders or trauma at a sensitive stage of child development (usually before age 6).
Dissociation can also occur when there has been persistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Findings show that in families where parents are frightening and unpredictable, children can become dissociative. Studies indicate that DID affects approximately 1% of the population.
How to recognize dissociative identity disorder and its associated mental disorders
Dissociative identity disorder is characterized by the presence of two or more distinct or divided identities or personality states that continually have power over a person's behavior. With dissociative identity disorder, there is also an inability to remember important personal information that is too important to explain away as forgetting. With dissociative identity disorder, there are also very different memory variations, which can fluctuate.
While not everyone experiences DID in the same way, for some the "changes" or different identities have their own age,sex, or career. Each has their own distinct postures, gestures and ways of speaking. Sometimes alters are imaginary people; sometimes they are animals. As each personality reveals itself and controls the behavior and thoughts of individuals, this is called "change". The change can take seconds, minutes or days. Some seek hypnosis treatment where the person's different "alter" or identities can respond very well to the therapist's requests.
Other symptoms of dissociative identity disorder can includeheadache, amnesia, loss of time, trances and "out-of-body experiences". Some people with dissociative disorders are prone to self-harm, self-sabotage, and even violence (both self-inflicted and outward-directed). For example, someone with dissociative identity disorder may do things they normally wouldn't do, such as speeding, reckless driving, or stealing money from their employer or friend, but feel compelled to do so. Some describe this feeling as a passenger in their body rather than the driver. In other words, they truly believe they have no other choice.
There are several main ways in which the psychological processes of dissociative identity disorder change the way a person experiences life, including the following:
- Depersonalization.This is a feeling of being separate from one's body and is often referred to as an "out of body" experience.
- Derealization.It is the feeling that the world is not real or seems confused or distant.
- Amnesia.This is a failure to remember significant personal information that is so extensive that ordinary forgetfulness cannot be blamed. There can also be microamnesias in which the discussion that took place is not remembered or the content of a meaningful conversation is forgotten from one second to the next.
- mistaken identityoidentity change.Both involve a sense of confusion about who a person is. An example of identity confusion is when a person has difficulty defining the things that interest him in life, or his political, religious or social views, or hissexual orientation, or your professional ambitions. In addition to these apparent disturbances, the person may experience distortions of time, place, and situation.
It is now recognized that these dissociated states are not fully mature personalities but represent a disconnected sense of self. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a "host" personality within the individual who is identified by the person's real name. Ironically, the host personality is often unaware of the presence of other personalities.
How is dissociative identity disorder diagnosed?
Making the diagnosis of dissociative identity disorder takes time. It is estimated that people with dissociative disorders spent seven years in the mental health system before receiving an accurate diagnosis. This is common because the list of symptoms that lead a person with dissociative disorder to seek treatment is very similar to many other psychiatric diagnoses. In fact, many people who have dissociative disorders also have coexisting diagnoses of borderline or other personality disorders.depression, youanxiety.
The DSM-5 provides the following criteria for diagnosing dissociative identity disorder:
- Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and the self.
- Amnesia, defined as gaps in recall of everyday events, important personal information, and/or traumatic events, must occur.
- The person must be distressed by the disorder or have problems functioning in one or more major areas of life because of the disorder.
- Disturbance is not part of normal cultural or religious practices.
- The symptoms cannot be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such aspartial seizures).
Different personalities can play different roles in helping the individual deal with life's dilemmas. For example, there are an average of two to four personalities present when the patient is initially diagnosed. So, there is an average of 13 to 15 personalities that can be known in the course of the treatment. Environmental triggers or life events cause a sudden shift from one alter or personality to another.
What other psychiatric illnesses can occur with DID?
Along with dissociation and multiple or split personalities, people with dissociative disorders may experience a variety of other psychiatric problems, including symptoms:
- Mood changes
- suicidal tendencies
- sleep disorders (insomnia,Nightmares, yousleepwalk)
- Anxiety,panic attacks, youphobias(flashbacks, reactions to stimuli or "triggers")
- Alcohol and drug abuse
- Compulsions and rituals
- Psychotic-like symptoms (including auditory and visual disturbances)hallucinations)
- Eating disorders
Are there famous people with dissociative identity disorder?
Famous people with dissociative identity disorder include comedian Roseanne Barr, Adam Duritz and retired NFL star Herschel Walker.
Walker wrote a book about his struggles with TID, along with his suicide attempts, explaining that he had a sense of disconnect between his childhood and professional leagues. To deal with this, he developed a tough personality that didn't feel loneliness, wasn't afraid, and wanted to express the anger he'd always bottled up. These "alters" were able to withstand the abuse he felt; other alters came along to help him achieve national fame. The treatment helped Walker realize that these alternate personalities are part of the dissociative identity disorder he was diagnosed with as an adult.
What is the treatment plan for dissociative identity disorder?
Currently, there are no formal evidence-based guidelines for the treatment of DID. Many treatments are based on case reports or are even controversial.
While there is also no "cure" for dissociative identity disorder, long-term treatment may be helpful if the patient remains hospitalized. Effective treatment includes:
- Psychotherapy:Also called talking therapy, the therapy is designed to work on what triggers and triggers DID. The goal is to help "blend" the separate personality traits into a consolidated personality that can control triggers. This therapy usually includes family members in the therapy.
- hypnotherapy. Used in conjunction with psychotherapy, clinical hypnosis can be used to help access repressed memories, control some of the troublesome behaviors that accompany DID, and help integrate personalities into one.
- Adjuvant therapy.Therapies such as art or movement therapy have been shown to help people connect with parts of their minds that have been shut down in dealing with trauma.
There are none establishedmedicinetreatments for dissociative identity disorder, making psychology-based approaches the mainstay of therapy. Treatment of concomitant disorders such asdepressionor substance use disorders, is critical to overall improvement. Because the symptoms of dissociative disorders often occur with other disorders, such as anxiety anddepression, medications to treat these concurrent problems, if present, are sometimes used in addition to psychotherapy.