Dissociative Identity Disorder (DID)
Updated: Jan 31
Dissociative identity disorder, formerly known as multiple personality disorder, is characterized by two or more distinct personality states that continually have power over a person's behaviour. It is a severe form of dissociation, a mental process that produces a lack of connection between a person's thoughts, memories, feelings, actions, or sense of identity. The cause of DID is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood years when emotional neglect or abuse may interfere with personality development.
Patients diagnosed with DID recall the most prominent symptom of their disorder being amnesia or significant gaps in their memory. This occurs as a result of one of their alters taking charge of the body, typically because of triggering circumstances and emotions. An alter refers to one of the distinct personality states present in a DID patient. Most patients have varying levels of awareness of their alters, however, most often a person is completely unaware when an alter surfaces, leading to the aforementioned memory loss. Each of these alters has distinct backstories, personality traits, ages, genders, and races with their gestures or distinct way of talking. Sometimes alters are people, sometimes they are animals or even inanimate objects. Regardless, the alter takes the shape of a protector of a patient or trauma victim. As each personality reveals itself and controls the individuals' behaviour and thoughts, it's called 'switching'.
Currently, the major issue faced in this field of mental health is misdiagnosis. It's estimated that individuals with dissociative disorders have spent seven years in the mental health system before accurate diagnosis. This is primarily because many of the symptoms experienced by DID patients are similar to that of Schizophrenia and other more commonly occurring psychiatric disorders. It is not uncommon for these disorders to accompany DID. Many people who have dissociative disorders also have coexisting diagnoses of borderline or other personality disorders, depression, anxiety, and consequently, substance abuse. Moreover, DID is probably the least extensively studied and most debated psychiatric disorder in the history of diagnostic classification. There is also a notable lack of a consensus among mental health professionals regarding views on diagnosis and there are no universal, evidence-based guidelines to treat DID as of yet.
While there is a lack of 'cures' for DID, there are some effective long-term treatments including psychotherapy, hypnotherapy, and adjunctive therapy. The goal of psychotherapy or talk therapy is designed to work through the trauma which is the root cause of the diagnosis and hopefully 'fuse' the separate personality traits into one consolidated personality that can control the triggers. Hypnotherapy, usually more effective along with psychotherapy, is used to access repressed memories, control some of the problematic behaviours which accompany DID as well as help integrate the personalities into one. Adjunctive therapy, on the other hand, uses creative outlets such as art or movement to help people connect with parts of their mind that they have shut off to cope with trauma. There are no established medication treatments for dissociative identity disorder, making psychologically-based approaches the mainstay of therapy. However, since there is often a presence of co-occurring disorders that can act as triggers for 'switching', treatment for those, with medication or not, is fundamental to the overall improvement of the patient.
Personal recounts of DID patients have reflected difficulty coping with such a disorder. Patients often face a detached sense of reality and an unclear sense of identity. It is also difficult to be optimistic when modern psychology has not found a cure for DID as of yet. For this reason, as a DID patient or as someone who cares for one, sensitivity and patience are integral to a recovery process. Beyond a shadow of a doubt, dealing with DID is a struggle, and hence it is suggested to seek out support groups and a caring community in times of dire need. It is important to remember that there is still a long way to go but technology is enabling groundbreaking research that fosters hope for patients and professionals alike.
Writer: Lara Nambisan