Dissociative identity disorder (DID) is a profoundly misunderstood and sometimes stigmatised mental health condition like many other mental illnesses.
Dissociative identity disorder used to be called ‘multiple personality disorder’ until around 1994, when the name of the disorder was changed to reflect a much better understanding of the condition. (Dissociative Identity Disorder, Multiple Personality Disorder, Psychology Today.)
Individuals presenting with DID have two or more different identities or alternative personalities, sometimes called ‘alters’.
These separate identities may control a person’s behaviour and decisions at different times, with each identity having its own likes, dislikes, personality traits, and personal history.
Extensive research has shown a significant correlation between dissociative identity disorder and psychological trauma.
In addition, studies show that many individuals with DID also have co-occurring mental health disorders, including the following:
- Substance use disorders
- Post-traumatic stress disorder (PTSD)
- Depression
- Anxiety disorders
- Borderline personality disorder (BPD)
Speaking to a professional about your concerns
This article explores dissociative identity disorder, its symptoms, and various treatment options that can help.
If you are concerned that you or a loved one may be experiencing symptoms of dissociative identity disorder, you must speak to a mental health professional who can help.
The most important thing for you to know is that you are not alone.
Speaking about your worries or concerns with someone who understands can be profoundly helpful, allowing you to get a handle on your symptoms and work towards lasting recovery and resilience.
Contact a friendly specialist at Centres for Health and Healing who can advise you on the next steps.
What is dissociative identity disorder (DID)?
According to research, dissociative identity disorder is a rare condition in which two or more identities or personality states are present in, and alternatively take control of, an individual. (Dissociative Identity Disorder, Multiple Personality Disorder, Psychology Today.)
An individual with DID has two or more distinct personalities, with the ‘core’ identity being the person’s usual personality. This ‘core’ is the identity the person had before they developed DID and ‘alters’. ‘Alters’ being the person’s alternate personalities. (Dissociative Disorders, Cleveland Clinic.)
Someone with DID may experience sudden, extreme memory loss that may be so monumental that it cannot be put down to every day (innocuous) forgetfulness that most of us experience from time to time.
A person with DID may not remember their name, where they live, and their likes and dislikes, which can be highly confusing and frightening for the individual and their loved ones.
One fascinating piece of literature describes a woman who suddenly exhibits a profound fear of dogs.
While walking with her husband one afternoon, the couple came across a friendly puppy that happened to be passing by with its owner. The woman became so distressed at the sight of the dog that she and her husband had to cross the street to create some distance between her and the animal.
Later that night, her husband mentioned that he wasn’t aware of her fear of dogs, to which the woman replied that she “loves dogs and isn’t afraid of them”.
Confused, her husband reminded her of how she had reacted to the friendly puppy earlier that day, and to both of their dismay, the woman had no recollection of such an event.
In this case, the woman’s ‘alternate personality’ or ‘alter’ intensely disliked dogs. In fact, she was terrified of them. However, her core identity could not resonate with this fear. Thus, she had a completely different opinion and reaction to the animal!
Each ‘alter’ is different
According to studies, each alter has a specific set of attitudes, behaviours, memories, preferences and ways of thinking that differ from a person’s other alters and their core identity (or usual personality).
It is common for people with DID to have profound gaps in memory related to personal information, identity, daily events, and past traumatic experiences.
In addition, a person with DID may oscillate from one alternate personality to another, where the transition between different identities occurs suddenly and involuntarily.
Some researchers describe DID as a severe disruption within a person’s:
- Identity
- Memory
- Behaviour
- Consciousness
- Sense of self
- Perceptions, opinions and views
According to researcher Kate Bettino, a person’s alters have distinct characteristics and personality traits, which can include:
- Gender
- Age
- Name
- Memories
- Behaviours
- Skills and attributes
Bettino also explains that alters may or may not be aware of each other and often emerge involuntarily in response to various stressors, such as the death of a past abuser, additional traumatic experiences, and drug and alcohol abuse. (What Are The Symptoms of Dissociative Identity Disorder? PsychCentral, Kate Bettino, March 13, 2021.)
Diagnostic criteria
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that for a person to be diagnosed with DID, they must exhibit the following two symptoms:
- Recurrent episodes of amnesia, or gaps in short- or long-term memory, involving learned skills, personal information, or past traumatic experiences. (What Are The Symptoms of Dissociative Identity Disorder? PsychCentral, Kate Bettino, March 13, 2021.)
- The presence of two or more distinct personality states or an experience of possession. (What Are The Symptoms of Dissociative Identity Disorder? PsychCentral, Kate Bettino, March 13, 2021.)
Symptoms of dissociative identity disorder
Bettino says that the symptoms of DID can be broken down into either ‘positive’ or ‘negative’.
Let’s explore these symptoms further.
Positive symptoms
According to Bettino’s research, individuals may experience positive symptoms of dissociative identity disorder, which may include:
- Fragmentation of one’s identity and sense of self.
- Feeling detached from your mind or your body. This is called depersonalisation.
- Intrusive emotions, thoughts or impulses.
- Feeling detached from the world around you. This is called derealisation.
Negative symptoms
The negative symptoms of DID include the following:
- Loss of control over mental functions.
- Amnesia or memory loss.
- Inability to access information.
The research may need to be more explicit about why these symptoms may be viewed as ‘positive’ or ‘negative’ to help create more awareness and understanding of the condition.
However, one interpretation could be that the positive symptoms, for example, depersonalisation and derealisation, can be helpful during a crisis or traumatic event as they ‘protect’ a person against distressing information or profound physical or emotional pain that may be too much for the individual to handle at once.
Thus, the body goes into survival mode and dissociates to protect the individual against severe harm until they feel safe enough to process the traumatic experience.
In contrast, the negative symptoms of DID may be viewed as unhelpful as the person loses agency over their mental functioning and memory, some of which can help in the short-term to protect a person against distressing information or physical or emotional harm but can create various complications in the long-term.
Additional symptoms
As well as the above, individuals with dissociative identity disorder may experience other symptoms, including:
- Profound and extreme shifts in mood
- Self-harm and suicidal thoughts/ideation
- Flashbacks
- Non-epileptic seizures
- Anxiety
- Depression
- Substance addiction
- Problems with functioning, including personal, occupational and social
Are there other types of dissociative disorders?
As well as dissociative identity disorder, researchers have identified two other types of dissociative disorder.
They include:
- Depersonalisation/derealisation disorder: This condition involves an individual feeling detached from their feelings, thoughts and body (depersonalisation) and disconnected from their surroundings (derealisation).
- Dissociative amnesia: Occurs when an individual cannot remember vital information about themselves and their life. For example, people may forget specific aspects of their life or much of their history, sense of self and identity.
Although the symptoms of dissociative identity disorder share similar features to dissociative amnesia and depersonalisation/derealisation disorder, all three conditions are separate and have distinct presentations and sets of diagnostic criteria.
Understanding how dissociative identity disorder develops
A fantastic piece of research written by Psychology Today explains how dissociative identity disorder may emerge.
It suggests that DID is characterised by fragmentation or splintering of one’s identity, going against more antiquated views that suggest DID is a growth of separate personalities.
“Dissociative identity disorder reflects a failure to integrate various aspects of memory, identity, and consciousness into a single multidimensional self. Usually, a primary identity carries the individual’s given name and is passive, depressed, and guilty.
When in control, each alter may be experienced as if it has a distinct history, identity and self-image; for example, the alternate personality’s characteristics, such as name, gender, age, language, skills and mood, conflict or contrast with those of the primary identity.
Interestingly, some identities may deny knowledge of one another, be in direct conflict, or be critical of one another.” (Dissociative Identity Disorder, Multiple Personality Disorder, Psychology Today.)
Moreover, other studies have highlighted that specific triggers like stress or additional trauma can cause a particular alter to materialise.
Causes
Dissociative identity disorder usually develops in response to significant trauma or adversity. These traumatic experiences can include the following:
- Physical, emotional or sexual abuse
- Childhood trauma
- Military combat
- Exposure to violence, such as domestic abuse or witnessing a physical assault
- Natural disasters
- Severe bodily injury, including being involved in a car accident or other serious incident
- The sudden death of a loved one
What is meant by a traumatic event or experience?
Traumatic events are experiences that overwhelm a person’s brain and nervous system to the extent that they may dissociate or disconnect from themselves and their surroundings to cope with whatever is happening in their environment.
It is common for traumatised individuals to experience symptoms of derealisation, memory loss and flashbacks.
Such symptoms are natural survival responses that may help an individual get through a crisis or period of intense stress.
For instance, becoming numb during a crisis or disconnecting from your surroundings can help you get through a traumatic event.
These responses help shut out anything that could cause severe physical or emotional pain and psychological overwhelm.
However, if these responses continue in the long term, they may begin to interfere with an individual’s daily functioning, causing complications in their relationships, health, career and life in general.
The American Psychological Association (APA) estimated that around 90% of individuals with DID experienced chronic abuse or neglect in childhood.
In addition, further research states that those who experience ongoing abuse in adulthood are more likely to develop DID.
What does dissociation feel like?
Each person experiences dissociation differently. However, many report feeling as though they are watching someone else experience whatever disturbing event is happening or that they are watching from a distance.
Many explain dissociation as a feeling of disconnection from themselves, their environment and others.
While other people report feeling as though they are watching distressing events unfold from a bird’s eye view or feel as though they are standing beside their own body – which may help us understand the old saying, “I was beside myself with worry”.
Disconnecting and dissociating from our surroundings during moments of crisis or intense stress can be incredibly helpful, but it may cause complications further down the line.
Treatment for dissociative identity disorder
Fortunately, various treatments are available to those with dissociative identity disorder, many of which address the symptoms, root cause, and unhelpful behaviours that a person may have developed to cope with their traumatic past (such as drug or alcohol abuse).
Dissociative disorders (including dissociative identity disorder) are commonly treated with psychotherapy, which can include a combination of the following treatments:
- Cognitive behavioural therapy (CBT)
- Dialectical behaviour therapy (DBT)
- Eye movement desensitisation and reprocessing therapy (EMDR)
Researcher Kate Bettino states that the common goal of treatment is to integrate the alternative personalities or alters, thus blending their identities and memories into a single ‘personality’ more reflective of the person’s authentic self. (What Are The Symptoms of Dissociative Identity Disorder? PsychCentral, Kate Bettino, March 13, 2021.)
It can be challenging for an individual to confront past traumatic experiences and memories through therapy, as these interventions often involve reliving and facing up to past adversity, which is never an easy process.
However, treatment is essential to reduce symptoms and any other complications your dissociative identity disorder may be causing you.
Recognising your triggers
Because alters often emerge due to environmental factors such as stress or additional trauma, identifying what may trigger your dissociative identity disorder symptoms can be extremely helpful and may allow you to manage your condition better.
For example, if you notice that your symptoms increase due to work stress, it might be worthwhile speaking to your supervisor or manager about any strategies or available resources that may help reduce your exposure to these triggers.
In addition, if you find that alcohol or specific drugs increase your DID symptoms, it’s essential that you are aware of this and cut back or quit your use of these substances.
Finding recovery at Centres for Health and Healing
We know how challenging reaching out for help and treatment can be. However, the Centres for Health and Healing team are always here to listen and offer support.
We provide personalised addiction and mental health treatment to clients in Toronto and surrounding regions.
Our compassionate, experienced multidisciplinary team treats and diagnoses various mental health conditions, including anxiety, depression, substance use disorder, trauma and dissociative disorders.
In addition, our luxurious surroundings provide the perfect foundation for lasting healing and recovery, offering serene landscapes, various outdoor activities and a supportive, compassionate space for you to relax and recover.
If you would like to speak to one of our friendly specialists about your mental health concerns or seek treatment specifically for dissociative identity disorder, contact our recovery centre today to learn more about treatment options and how we can help.
You do not have to suffer alone. Recovery is possible with proper treatment, care and support.
And we are here to guide you every step of the way.
Additional resources
- What Are The Symptoms of Dissociative Identity Disorder? PsychCentral, Kate Bettino, March 13, 2021.
- Dissociative Identity Disorder (Multiple Personality Disorder) Psychology Today.
- Dissociative Disorders Cleveland Clinic, last reviewed October 24, 2022.
