Dissociative Identity Disorder: Symptoms, Causes, And Treatment

Medically reviewed by Melissa Guarnaccia, LCSW
Updated October 17, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Dissociative identity disorder (DID) is a mental disorder characterized by the existence of multiple identities in one individual. The existence of these alternate personalities can affect an individual’s memory, behavior, emotion, perception, and selfhood, potentially impacting their cognitive and emotional health in significant ways.

Once called multiple personality disorder, DID is one of three dissociative disorders. Ahead, we’ll discuss the different types of dissociative disorders and cover the symptoms, causes, and treatment of DID.
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Dissociative identity disorder can be difficult to experience

Types of dissociative disorders

Most of us experience times when we lose touch with our emotions, let our thoughts drift, or feel slightly disconnected from our physical beings. In fact, you may engage in similar forms of dissociation on a daily basis without realizing it. If you’ve ever had the feeling of being “lost” in a memory while you were doing something else, you’ve experienced a form of dissociation. 

While these disconnects can be harmless, if they become intense and persistent, they may signal the existence of a dissociative disorder. There are three types of dissociative disorders: dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder. While all three have similarities, they also have several important differences.

Dissociative amnesia

People who have dissociative amnesia may forget certain events that have happened to them or experience more general memory loss. Dissociative amnesia typically lasts a short period of time and may cease when an individual’s memory is prompted by a stimulus in their environment. This disorder is thought to be caused by traumatic or otherwise stressful experiences, such as a natural disaster, an accident, or combat. Dissociative amnesia is also thought to have a genetic component. 

Depersonalization-derealization disorder

With depersonalization/derealization disorder, an individual may feel separated from the things happening around them, including their actions, thoughts, and feelings. Some have described it as watching a movie, because they feel detached from what's around them. On average, the disorder develops around the age of 16, but it's possible to experience the first episode earlier or later. 

Depersonalization/derealization disorder can be a distressing and disruptive condition, potentially interfering with a person's ability to work, study, and maintain relationships. Though the exact causes of the disorder are unknown, substance use, trauma, and comorbid mental health conditions—like post-traumatic stress disorder (PTSD)—are considered potential sources.  

Dissociative identity disorder

With dissociative identity disorder, an individual typically experiences multiple separate identities, which can be present only in the mind or take control of the individual's mind and body. The identities likely have distinct names, mannerisms, patterns of speech, and idiosyncrasies. It is estimated that 1-5% of the global population experiences dissociative identity disorder. Because it is so closely associated with trauma, dissociative identity disorder is often comorbid with post-traumatic stress disorder (PTSD). Additionally, studies suggest that 30-70% of individuals who live with DID also experience borderline personality disorder. Other co-occurring mental health conditions include depressive disorders, substance use disorders, and eating disorders. 

Dissociative disorders can have serious long-term effects, potentially impacting an individual’s mental health, physical well-being, and ability to function. If you believe you’re living with a dissociative disorder, a mental health professional can provide you with screenings and determine whether further testing, a diagnosis, and treatment are necessary. 

What are the symptoms of dissociative identity disorder?

Experiencing multiple identities can lead to several complications when it comes to an individual’s mental, physical, and emotional health. The following are common symptoms of dissociative identity disorder:

  • The development of two or more entities or identities, each of which relates to the world in a different way

  • A change from one identity to the other also includes shifts in behavior, memory, perception, motor function or cognition

  • Memory gaps which can include events, places, and people

  • Distress in personal or professional life 

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Movies and TV shows sometimes portray people with DID as having "split personalities”, often with a "good side" and a "bad side”, when this is often not the case. Dissociative identity disorder does not typically appear as personalities entirely separate from one another. Rather, the personalities may be distinct but in different ways. The secondary identity (or identities) may only be present for short amounts of time, and they are often triggered by specific stimuli.

Those who live with DID typically report that they're aware when something out of character is happening to them. Some feel that they are pushed into the background while someone else takes control of their body. Some hear voices and experience alternate personalities that have their own consciousness and ideas. Many people experience strong impulses and emotions without knowing where they came from. Individuals with DID may feel a shift in their body, their personality, or their attitude—which can shift back just as suddenly.

On the other hand, some people with dissociative identity disorder do not know what is happening to them. They may realize that they have suddenly arrived somewhere different from where they remembered being, with no recollection of how they got there or what may have happened in between. These disconnects between an individual’s typical emotions, thoughts, behaviors, and characteristics and those of alternate personalities can be distressing and confusing. 

What causes dissociative identity disorder?

There are a number of reasons why this disorder may occur, but one of the most common is physical, emotional, or sexual abuse. Dissociative disorders typically develop in response to traumatic events, allowing individuals to cope with challenging thoughts and feelings. Within the United States, Canada, and Europe, as many as 90% of people who have been diagnosed with the disorder experienced some type of abuse as a child. DID is also thought to have a genetic component—those who have a biological relative who has the disorder are more likely to be diagnosed with it. 

Those who do not have a family history of DID or have not experienced abuse can also develop dissociative identity disorder. If you believe you may be living with DID, consider consulting with a professional who can evaluate you and, if necessary, provide a diagnosis and treatment. 

Treatment for dissociative identity disorder

The treatment process for dissociative identity disorder generally focuses on distinct identities and how to join them into one cohesive entity. Therapy is typically the modality used to break down the walls between each personality and help prevent the alternate personalities from taking control. 

A widely utilized therapeutic modality for dissociative identity disorder is cognitive behavioral therapy. Cognitive behavioral therapy can help a participant integrate the identities by addressing the source of the disorder. If a traumatic experience is the cause of an individual’s mental illness, processing that trauma through cognitive behavioral therapy may help them avoid using dissociation as a coping mechanism. 

While there are no drugs that can alleviate the symptoms of DID, a professional may prescribe a medication that treats symptoms of comorbid mental health conditions, such as depression, post-traumatic stress disorder (PTSD), anxiety, or panic attacks. 

How online therapy can help

Recent studies show that online therapy can be a useful method of treating dissociative identity disorder. In a study published in the Journal of Traumatic Stress, researchers examined the effectiveness of online interventions for 111 individuals diagnosed with DID, finding that participation was associated with reductions in dissociation and PTSD symptoms, improved emotional control, and higher adaptive capacities. Additionally, the study notes the increased convenience online therapy platforms can provide. 

Online therapy can be a convenient way of experiencing emotional support and helpful guidance as you navigate dissociative identity disorder or similar mental health challenges. With an online therapy platform like BetterHelp, you can connect with a therapist who can help you navigate the effects of dissociative identity disorder remotely, which may be more comfortable than doing so in person. BetterHelp works with thousands of mental health professionals—who have a range of specialties—so you’ll have a good chance of matching with someone who can help you develop healthy coping mechanisms as you address trauma, DID, or other struggles. Read below for reviews of BetterHelp therapists, from those who have sought help for similar challenges in the past.

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Dissociative identity disorder can be difficult to experience
"Shaun listens very well and is compassionate, kind, and empathetic! She takes the time to go through your problems and offers great help."
— BetterHelp member’s review of their therapist

Takeaway

Dissociative identity disorder is a complex mental health condition that often arises out of trauma and can interfere with several different aspects of an individual’s life. Despite the challenges it can create, its symptoms can be managed, and its negative effects are limited. If you’ve experienced dissociation, trauma, or similar mental health concerns, consider reaching out to a licensed therapist. With the right support and guidance, you can cope with a dissociative disorder and take the next steps on your mental health journey.
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