Definition

What is dissociative identity disorder ?

Dissociative identity disorder (previously known as multiple personality disorder) is thought to be a complex psychological condition that is likely caused by many factors, including severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

Most of us have experienced mild dissociation, which is like daydreaming or getting lost in the moment while working on a project. However, dissociative identity disorder is a severe form of dissociation, a mental process which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from a combination of factors that may include trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self.

How common is dissociative identity disorder ?

Dissociative identity disorder has always been considered to be quite rare but it may be more common than previously thought and some estimate it to affect 1% of the population. This higher estimated prevalence may be due to the millions of now reported incidences of childhood abuse (Causes of DID). Please discuss with your doctor for further information.

Symptoms

What are the symptoms of dissociative identity disorder ?

The common symptoms of dissociative identity disorder  are:

  • The individual experiences two or more distinct identities or personality states (each with its own enduring pattern of perceiving, relating to, and thinking about the environment and self). Some cultures describe this as an experience of possession.
  • The disruption in identity involves a change in sense of self, sense of agency, and changes in behavior, consciousness, memory, perception, cognition, and motor function.
  • Frequent gaps are found in memories of personal history, including people, places, and events, for both the distant and recent past. These recurrent gaps are not consistent with ordinary forgetting.
  • These symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Particular identities may emerge in specific circumstances. Transitions from one identity to another are often triggered by psychosocial stress. In the possession-form cases of dissociative identity disorder, alternate identities are visibly obvious to people around the individual. In non-possession-form cases, most individuals do not overtly display their change in identity for long periods of time.

People with DID may describe feeling that they have suddenly become depersonalized observers of their own speech and actions. They might report hearing voices (a child’s voice, the voice of a spiritual power), and in some cases, these voices accompany multiple streams of thought that the individual has no control over. The individual might also experience sudden impulses or strong emotions that they don’t feel control or a sense of ownership over. People may also report that their bodies suddenly feel different (like a small child, huge and muscular), or that they experience a sudden shift in attitudes or personal preferences before shifting back.

Sometimes with DID experience dissociative fugues, where they discover they have traveled but have no recollection of the experience. People vary in their awareness of their amnesias, and it is common for people with DID to minimize their amnestic symptoms, even when the lapses in memory are obvious and distressing to others.

More than 70 percent of people with DID have attempted suicide, and self-injurious behavior is common among this population. Treatment is crucial to improving quality of life and preventing suicide attempts.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes dissociative identity disorder ?

Why some people develop DID is not entirely understood, but they frequently report having experienced severe physical and sexual abuse, particularly during childhood. Among those with the DID in the U.S., Canada, and Europe, approximately 90 percent report experiencing childhood abuse.

The disorder may first manifest at any age. Individuals with DID may have post-traumatic symptoms (nightmares, flashbacks, and startle responses) or post-traumatic stress disorder. Several studies suggest that DID is more common among close biological relatives of persons who also have the disorder than in the general population. As this once rarely reported disorder has grown more common, the diagnosis has become controversial. Some believe that because DID patients are highly suggestible, their symptoms are at least partly iatrogenic—that is, prompted by their therapists’ probing. Brain imaging studies, however, have corroborated identity transitions.

Risk factors

What increases my risk for dissociative identity disorder ?

As with other mental disorders, having a family member with DID may be a risk factor, in that it indicates a potential vulnerability to developing the disorder but does not translate into the condition being literally hereditary.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is dissociative identity disorder  diagnosed?

Making the diagnosis of dissociative identity disorder takes time. It’s estimated that individuals with dissociative disorders have spent seven years in the mental health system prior to accurate diagnosis. This is common, because the list of symptoms that cause a person with a dissociative disorder to seek treatment is very similar to those of many other psychiatric diagnoses. In fact, many people who have dissociative disorders also have coexisting diagnoses of borderline or other personality disorders, depression, and anxiety.

The DSM-5 provides the following criteria to diagnose dissociative identity disorder:

  1. 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 self.
  2. Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.
  3. The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.
  4. The disturbance is not part of normal cultural or religious practices.
  5. The symptoms can not 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 as complex partial seizures).

How is dissociative identity disorder  treated?

While there’s no “cure” for dissociative identity disorder, long-term treatment can be helpful, if the patient stays committed. Effective treatment includes talk therapy or psychotherapy, hypnotherapy, and adjunctive therapies such as art or movement therapy. There are no established medication treatments for dissociative identity disorder, making psychologically-based approaches the mainstay of therapy. Treatment of co-occurring disorders, such as depression or substance use disorders, is fundamental to overall improvement.

Because the symptoms of dissociative disorders often occur with other disorders, such as anxiety and depression, medicines to treat those co-occurring problems, if present, are sometimes used in addition to psychotherapy.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage dissociative identity disorder ?

The following lifestyles and home remedies might help you cope with dissociative identity disorder :

  • Get to know your system.
  • Become more comfortable with your diagnosis.
  • Build a support system and capable treatment team.
  • Once you have recognized at least one or two other parts, work on building communication with these parts.
  • Connecting with your internal landscape.
  • Working on limiting or preventing self-destructive impulses and self-injurious behaviors.
  • Live in a safe place both inside and out.
  • Start building options for positive self-comfort, self-soothing activities.
  • Create healthy options to express feeling and emotion.
  • Create your own personal space.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: July 31, 2017 | Last Modified: July 31, 2017

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