This complex mental health condition can be distressing and challenging to manage. Once known as multiple personality disorder, dissociative identity disorder causes gaps in memory, the presence of two or more personalities. It produces intense psychosocial stressors that can make it almost unbearable to live. Let’s explore what you need to know about dissociative identity disorder, its treatment, and prognosis.
What is Dissociative Identity Disorder?
This condition, previously known as multiple personality disorder, causes a severe dissociation that produces a lack of connection in someone’s thoughts, memories, feelings, and sense of identity. When identities switch, people may change their personal preferences in food, activities, clothes, and even sexual orientations. Some people may also change the way they talk, walk, and overall manner.
Dissociative identity disorder could respond to trauma during early childhood, with the dissociative aspect being the body’s coping mechanism. Someone with this condition essentially shuts down or dissociates themselves from a stressor. People with dissociative identity disorder may suddenly change their own speech and feel as if their bodies are different. Sometimes they may feel like a small child, like the opposite sex, or feel ultra strong.
Dissociative identity disorder (DID) has several classifications, including:
- Possession: in this case, the different personalities are evident to other people, and the person with the disorder almost disappears when the new identity takes over. People may change the way they talk, walk, and behave when they have an episode.
- Non-possession: while identities or personality states vary, the difference isn’t always noticeable. Instead, they experience most symptoms internally. In this case, the person may feel like they’re watching themselves from a distance and seeing a different person.
Symptoms and Causes
There’s an average of two to four personalities present when the patient is initially diagnosed. Then there’s an average of 13 to 15 characters that can become known throughout treatment. Symptoms of dissociative identity disorder can change tremendously. Some people experience intense headaches, self-mutilation, and unexplained risky behavior.
The switch of personalities is by far the most recognizable symptoms, which happens as each personality reveals itself and controls the individual’s behaviors and thoughts. This can take seconds or minutes, but it can also be progressive, taking days to be noticeable.
The most common symptoms of dissociative identity disorder include:
- Distinct identities or personalities with the presence of two or more personalities
- Gaps in memory or memory loss for past events
- Derealization or a feeling as if the world isn’t real
- Out of body experiences of depersonalization
- Identity confusion or alteration
While there isn’t a specific cause of DID, almost 99% of individuals who develop the condition have personal stories with life-threatening disturbances and traumatic experiences at an early age. Dissociation may also happen after persistent emotional abuse or neglect, no need for physical or sexual abuse. In families with parents that are unpredictable or frightening, children have a greater risk of becoming dissociative. Still, DID affects about one percent of the population.
Though complex, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) specifies the following criteria to be diagnosed with DID:
- Noticeable presence of two or more distinct personalities
- Dissociative amnesia or memory gaps in the recall of everyday events, personal information, and even traumatic events
- Distress by the disorder and have trouble functioning in one or more areas of the disorder
- The disturbance is not part of any cultural or religious practices
- The symptoms are not a direct result of a substance or general medical condition
Relationship with Substance Abuse
Along with dissociative identity disorder, people may experience several co-occurring psychiatric problems, including anxiety, eating disorders, and alcohol and drug abuse. There is minimal data about the co-occurrence of dissociative identity disorder and addiction.
However, one study found high levels of dissociation in patients with drug dependence. The researchers noted that more than the type of substance abuse, emotional abuse made a statistically significant difference. Even after controlling disorders like PTSD and other potential onset causes, childhood trauma was the one marker related to dissociative symptoms.
Dissociative Identity Disorder Treatment Options
There is no cure for DID. Treatment aims to relieve symptoms, keep patients safe, and find a way to integrate the different identities or personalities into a well-functioning one. Of course, if other conditions like substance use disorder, depression, or anxiety are present, these would also have to be addressed simultaneously. Psychotherapy is the main form of treatment for DID, with specific methodologies being used to treat the disorder’s different aspects.
One of the most proven therapies, CBT, helps recognize and address dysfunctional thought patterns, feelings, and behaviors. CBT is based on recognizing these automatic thoughts and behaviors and regulating these distressing emotions using alternative thinking ways. This type of treatment is also helpful for addressing substance abuse, anxiety, and other mental health disorders.
Since DID is so strictly related to past trauma and PTSD, EMDR can help ease some of these symptoms. During EMDR therapy sessions, the patient relives traumatic or triggering experiences while the therapist directs their eye movements. During some of these phases, eye movements help to link neural pathways and alleviate adverse cognitive reactions.
Similar to CBT, dialectical behavior therapy helps with dissociative symptoms related to past trauma. DBT focuses on mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation. It also helps manage personality disturbances by teaching people techniques to recognize and address different symptoms.
With no cure, most people learn to live and manage the disorder. Alternative therapies like meditation, yoga, breathing techniques, and hypnosis can help people with dissociative disorders. They help safely explore their feelings and memories associated with trauma without experiencing a dissociative episode.
Although there isn’t an approved medication for dissociative identity disorder, sometimes antidepressants or anti-anxiety medications can help. These drugs will help treat some of the symptoms associated with DID. However, medication-assisted treatment is needed to prevent or fuel any underlying substance use disorder.
Family members of those with DID often feel isolated, lost, and confused. With family therapy, everyone can learn more about the disorder and find ways to better cope with the illness.
Finding Help Near Me
Although rare, dissociative identity disorder can be a life-threatening condition. More than 70 percent of outpatients with dissociative identity disorder have attempted suicide. Even without a cure, treatment can help manage co-occurring conditions and help people live a meaningful life.
At Lighthouse Recovery Institute, our mission is to help people live substance-free lives filled with joy and purpose. If you or someone you know is struggling with substance abuse or a mental health disorder, reach out for help.
Our therapists and specialists can help you find the right treatment plan to support your needs. Don’t let mental illness rob you of the opportunity to enjoy life and build memories with those around you. Start your recovery journey today. We’ll be walking by your side every step of the way.