Dissociative Identity Disorder

Do you remember an incident where you tried to stay calm and suddenly acted out of character due to a trigger? We may joke about having several personalities. But, dissociative disorders, particularly dissociative identity disorder, are real issues.

• What is dissociative identity disorder (DID)?
• What are the signs of dissociative identity disorder?
• What causes dissociative identity disorder?
• Can drugs cause dissociative identity disorder?
• What is the difference between DID and dissociative disorder?

Define Dissociative Identity Disorder

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Dissociative identity disorder (DID), previously called multiple personality disorder, occurs when a person has two or more personalities. These identities seem entirely different, with their names, memories, traits, and even health problems. Alters are the different identities. One alter can't remember what the other alters do most of the time, resulting from amnesia when other identities take over. This disorder happens most commonly to victims of childhood abuse.

Dissociative disorders are a group of mental health disorders that involve unintentional dissociation with one's ideas, self-awareness, and memory (e.g., amnesia).

Dissociative disorders cause personality changes. Psychoanalysts say that people with dissociative disorders try to hide bad feelings like anxiety from traumatic events.

Dissociative identity disorder is one type of dissociative disorder, along with dissociative amnesia and dissociative fugue. Among the three dissociative disorders, dissociative identity disorder is the most controversial. Numerous theorists in the social learning field hold that DID sufferers are playacting. Since books and movies have made people more aware of the disorder, they wonder why it is becoming more common.

Dissociative Identity Disorder Symptoms

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Dissociative Identity Disorder signs and symptoms include mental health-related behavioral problems that affect daily functioning. These symptoms involve multiple identities, amnesia, hallucinations, and other mental health concerns.

Multiple Identities

Dissociative Identity Disorder manifests itself in the following ways: possession and non-possession.

Multiple identities in possession are evident within the person in which the identities appear to have taken over, changing his speech and behavior. In this type of dissociative disorder, the other personality could be that of a deceased loved one, a demon, or a god, which is usually unwanted and occurs unintentionally.

In non-possession, a person may experience depersonalization, in which he is no longer the agent but rather a viewer of his behavior, words, thoughts, and feelings caused by an abrupt shift in his identity. Body and mental disconnection occur, causing confusion characterized by having spontaneous ideas and emotions that don't seem to be one's own. Although more subtle than possession, people may be able to see some manifestations.

A sudden shift in identity may intrude on daily life while another personality is at work. A trance-like state with eye movements (e.g., blinking and rolling) and postural changes are signs of an identity change.

Dissociative Amnesia

Sufferers of Dissociative Identity Disorder also experience dissociative amnesia, in which they struggle to remember different memories, such as the death of a loved one or how to do specific tasks. They forget daily and stressful events. In some cases, they also have no recollection of doing things even if they discover proof of what they have said or done. Patients who know they have amnesia try to disguise it, but it sometimes shows, especially when they forget personal details.

Hallucinations and Other Symptoms

This disorder can have sensory experiences originating from an alternate identity, which can cause hallucinatory symptoms. Along with depression, suicidal and anxious thoughts, hearing voices is also a characteristic of this dissociative disorder. Drug use and self-harm are common, as well as sexual disorders and nonepileptic seizures. Even though substance abuse is quite prevalent in those with this disorder, substance abuse doesn't cause dissociative identity disorder. It could, however, make people switch to different alters more often.

Dissociative Identity Disorder Causes

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People have tried to figure out what causes this form of dissociative disorder by looking at childhood trauma, extreme stress, and predisposition factors.

Dissociative disorders are often linked with severe abuse and trauma in childhood. A child's identity emerges over time due to multiple influences and experiences. When a child faces a significant amount of adversity (e.g., abuse or a severe medical condition), the foundation of his identity remains in pieces, which can lead to identity creation. Eventually, a child may attempt to escape the situation or resort to his thoughts. Each stage of development or traumatic incident becomes an opportunity for a new identity. People who suffer from this dissociative disorder are more vulnerable to hypnosis and have increased tendencies towards dissociation.

Even though substance abuse is quite prevalent in those with this disorder, substance abuse doesn't cause dissociative identity disorder. It could, however, make people switch to different alters more often.

Dissociative Identity Disorder Examples

Although a rare disorder, this type of dissociative disorder doesn't exempt even famous personalities. Here are a few examples of real-life cases of dissociative identity disorder:

Roseanne Barr

Roseanne Barr, a comedienne, admitted to having a dissociative identity disorder in 1994, with seven personalities, which she named Somebody, Nobody, Baby, Cindy, Susan, Joey, and Heather. She described her personality as parts that don't get along, explaining her symptoms. But after ten years, she learned to manage these personalities. Her alternate identities remained for a few seconds to several years. She stated that her mental health disorder stemmed from the abuse she suffered at the hands of her mother's hired German neighbor.

Herschel Walker

Herschel Walker, a famous athlete who won the Heisman Trophy in 1982, wrote a book on dissociative identity disorder. He shared that some of his alternate personalities made him violent, which caused the end of his marriage. He also revealed that he had a competitive identity where he played Russian roulette, which posed a danger to himself. He'd had fits of anger and thoughts of killing someone, realizing he needed help from this disorder. During his football career, his alters helped him become an outstanding athlete, but when he retired, he had coping struggles, and that's when the disorder became troublesome again for him. His wife recalls the resurfacing of his bad alters where, at one point, he had a razor to her throat.

Dissociative Identity Disorder Treatment

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Treatment of this dissociative disorder involves three phases:

• The first phase includes safety and management of symptoms as sufferers of this disorder have mental health issues such as suicidal ideations.

• The second phase includes addressing and processing painful memories to help integrate them with the other identities.

• The third phase includes integration and recovery, where restoration of the self and relationship with the world is the primary focus.

The treatment goal is to help the patient integrate his multiple personalities into a single, coherent self. In cases where integration is unachievable, the aim is to find a way to bring the different personalities together in harmony.

Psychotherapy is the most common treatment strategy for this disorder. In psychotherapy, traumatic memories are addressed and processed to help promote emotional stability. The therapist attempts to unite the alternate identities through negotiation. Psychotherapy also helps prevent patients from additional harm, emphasizing the importance of good partnership during therapy. In cases of emotional crisis, patients may need psychiatric hospitalization to help them move forward from their trauma and further improve their mental health.

Hypnosis is another mode of treatment where the focus is to stabilize emotions and adopt a new perspective regarding the traumatic events. This treatment can help facilitate closer relationships with identities by increasing access, engagement, and switching management.

Drug therapies include antipsychotics, mood stabilizers, and stimulants to target symptoms. The problem with drug therapies is that each alter experiences different symptoms with varying levels of compliance.