What is Dissociative Identity Disorder?
This post provides an overview of dissociative identity disorder (DID), formerly known as multiple personality disorder (MPD).
DID is a mental disorder that can cause people to have two or more personalities, each with their own distinct traits, qualities, likes, and dislikes. It is a type of dissociative disorder that can make people feel detached from their surroundings and themselves. As of 2022, roughly 1.5% of the global population have been diagnosed with DID.
While DID is not universally accepted as a diagnosis, it is listed in the DSM-V, so it is important for people working in medico-legal services to be aware of it. Here we summarize some of its potential causes, symptoms, and treatments.
Causes of Dissociative Identity Disorder
It has been proposed that DID might be a psychological response to excessive stress and a traumatic childhood. People who suffer from DID “escape” their personality as a way of distancing themselves from their traumatic memories.
People who go through traumatic experiences may be more susceptible to the disorder during their childhood as they are still in the early stages of developing their personality. When they experience an extremely stressful situation, they may separate themselves from who they are, so as to avoid having to deal with it.
Symptoms of Dissociative Identity Disorder
The major symptom of DID is that patients have multiple personalities. Their main personality is called their “core identity,” while their other personalities are referred to as “alters.” These alters typically develop between the ages of 5 and 10, and DID patients can report up to 16 alters by the time they are adults.
The DSM-V lists the following other symptoms of DID:
Memory loss – People with DID may have a hard time remembering things about themselves, other people, and certain events. Sometimes they might not be able to remember the actions of their alters, and they may often find themselves in places without being able to remember how they got there.
Detachment – People with DID may feel as if everything around them isn’t real. Things may appear blurry or foggy, and they may feel like time is moving faster or slower than usual.
Out of body experience – People with DID may feel detached from their own body. They can feel like their own body parts are not real or belong to someone else. They may also feel estranged from their thoughts and feelings, which can make it increasingly difficult for them to maintain a sense of identity.
Hallucinations – The hallucinatory symptoms that people with DID experience tend to be different from the ones experienced by people with a psychotic disorder. People with DID experience hallucinations because of their alters. For example, they may hear their alters’ voices in their heads.
Anxiety, depression, and suicide ideation - Patients with DID might also suffer from anxiety, depression, and suicide ideation because of their traumatic and stressful experiences.
Different handwriting – The handwriting of people with DID can sometimes change, depending on which personality is in control. Patients may sometimes find notes written by their alters in a different handwriting to the one they recognize as their own.
Diagnosis of Dissociative Identity Disorder
In the DSM V, the diagnosis of DID is based on the presence of the following symptoms:
The patient has two or more personalities that prevent them from having a sense of self or identity.
The patient experiences memory gaps and finds it difficult to remember traumatic memories, everyday events, and important information about themselves.
The patient’s symptoms make it challenging for them to socialize and form meaningful connections with the people around them.
Treatment of Dissociative Identity Disorder
Psychotherapy is generally the most effective treatment of DID. Medication may also be used to treat some symptoms, such as depression and anxiety, but these are unlikely to help a patient cope with the other symptoms.
Treatments of DID often attempt to merge personalities. However, it has been argued that patients may not like to integrate their personalities because this is “disrespectful of the important role they have played in their survival.”
Psychotherapy
In a psychotherapy session, patients talk to a trained therapist about their thoughts and feelings, and the therapist helps them understand how they can change them to improve their life. Two types of psychotherapy are used in the treatment of DID.
Cognitive behavioral therapy (CBT) — The goal of CBT is to get rid of negative thoughts and feelings and replace them with something that’s more rational and grounded in reality.
Dialectical behavioral therapy (DBT) — The goal of DBT is to eliminate self-sabotaging behaviors such as self-harm and substance abuse. DBT helps patients come to terms with their traumatic memories and equip them with healthy coping methods so they can start living a peaceful life.
Medication
Medication is sometimes used in the treatment of DID. Selective serotonin reuptake inhibitors (SSRIs), such as citalopram and sertraline, are sometimes used to treat depression and anxiety.
As mentioned, though, these medications will not cure the disorder itself. They will only help patients cope with the symptoms of depression and anxiety.
Summary
DID is a type of dissociative disorder that can cause people develop multiple personalities. It can cause people to feel detached from everything and experience memory loss when their other personalities are in control.
The most effective treatment of DID is psychotherapy, but medications may also be prescribed if patients suffer from depression and anxiety.
The disorder can make it hard for patients to live a happy life and make meaningful connections with friends and family, but with the right treatment and a support system, they can improve their lives and prevent the disorder from disrupting their daily routines.
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