Dissociative Identity Disorder: Symptoms, Causes, And Treatment
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.
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
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.
Takeaway
What are the three main symptoms of dissociative disorder?
Dissociative disorders have many symptoms, but some tend to surface more frequently than others. These include:
- A sense of disconnection from oneself and one’s surroundings.
- Memory lapses about specific events, personal details, and periods of time.
- Feelings of uncertainty about one’s identity.
Can you live a happy life with DID?
Though the symptoms of dissociative identity disorder (DID) may be difficult, with appropriate treatment and support, it is possible to live a happy, productive life.
How do I know if I am dissociating?
Signs of dissociation may include the feeling that the people, environment, and circumstances around you are distorted or unreal. You may have a sense of separation from your emotions or a distorted sense of identity.
Does a person with DID know they have it?
Although some do know they have it, many people with DID aren’t aware they have it until they first seek treatment. The same is often the case with other dissociative disorders, such as dissociative amnesia, depersonalization-derealization, and dissociative identity disorder.
How can you tell if someone is faking dissociative?
It’s extremely difficult to tell for certain if someone is “faking” a dissociative identity disorder (DID), and accusations of such can be damaging. However, for mental health professionals, it is sometimes necessary to understand the signs of pseudogenic DID.
Malingering (the intentional production of false or over-exaggeration of physical or psychological symptoms) and factitious disorder (a mental health disorder where a person acts like they have a psychological or physical health disorder) are somewhat common, with up to 17% and 14% of cases identified as such in inpatient care, and higher rates in outpatient and online care.
Psychologists often use a structured clinical interview (SCID-D) and other assessment tools to diagnose dissociative identity disorder and identify potential cases of pseudogenic DID. During the interview and subsequent talk therapy, a psychologist may look for certain behaviors to determine if a patient is malingering or has a factitious disorder.
While they are in no way “proof” of pseudogenic DID, here are a couple of things a mental health professional may note:
Exaggeration of symptoms, particularly during observation.
People attempting to feign DID often model behaviors of the disorder based on stereotypical portrayals in popular culture, such as a rapid, dramatic emergence of multiple distinct personalities. These rarely accurately portray the natural behavior typical for people with DID.
Unusual candor about one’s traumatic personal history and experience with the disorder.
While some people are more comfortable discussing past trauma, many are not. People with DID typically feel some reluctance and discomfort in discussing traumatic memories of physical, sexual, or emotional abuse.
This excessive candor may be present within the clinical setting, but some people attempting to falsify a DID diagnosis will go to great lengths to discuss their experiences with other people. Some even use social media to discuss intimate details about their “trauma” and how it’s manifested as DID.
Pronounced identification with a DID diagnosis.
Many people who want others to believe they have DID do an excessive, thorough amount of research to establish a self-diagnosis. They may cite certain personality traits as examples of “multiple personalities.” (Along with the term “split personality disorder,” “multiple personality disorder” is no longer used by the scientific community to reference DID).
Looking for ways to “prove” they have the disorder.
Recruiting friends, family, or others to “testify” that they have witnessed the individual develop dissociative disorders or symptoms of DID over time. They may or may not have previous interactions with a mental health professional for other conditions such as depression and anxiety, but they’ll likely claim the therapist strongly suggested that they have the disorder.
Anger or disappointment when DID is ruled out as a diagnosis.
Regardless of an individual’s potential motive for falsifying symptoms of DID, most become upset when they are informed that they don’t meet the criteria for diagnosis outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Often, these individuals seek treatment elsewhere in hopes of obtaining a diagnosis.
What are the four stages of dissociation?
There is some controversy over the nature of dissociative disorders, and not all mental health professionals agree that dissociation can be categorized into four stages-- but some posit there is a four-stage model including:
Stage 1: Minor detachment. This stage may include absorption in a vehicle for inner escape, such as a book, movie, or TV show. Daydreaming is also a typical characteristic of this stage.
Stage 2: Moderate detachment. During this stage, the patient may “zone or space out” and display a more pronounced withdrawal from their surroundings.
Stage 3: Severe detachment. This stage is typically marked by depersonalization and a sense of separation from the self.
Stage 4: Extreme detachment or dissociation. During this stage, individuals might experience amnesia and identity confusion where they don’t recognize their surroundings or themselves.
Some clinicians include a fifth stage of identity alteration when diagnosing dissociation. During this phase, patients may experience significant amnesia and potentially the presence of alternative identities, as in DID.
What celebrities have dissociative identity disorder?
Famous celebrities who have revealed their life history with DID and mental illness include Herschel Walker, Roseanne Barr, and Marilyn Monroe.
Is schizophrenia the same as DID?
DID and schizophrenia are different conditions, although they may exhibit similar symptoms such as depression, delusions, and suicidal ideation, possibly including suicide attempts. Some personality disorders also have symptoms in common with DID, including dissociation and amnesia.
If you or a loved one are experiencing suicidal thoughts, seek help immediately. The National Suicide Prevention Lifeline can be reached by calling 1-800-273-TALK (8255) or 988 and is available 24/7.
Is dissociation a symptom of ADHD?
While the latter stages of dissociation are not considered symptoms of ADHD, both disorders may feature a distinctive lack of focus, daydreaming and mind wandering, and poor memory/forgetfulness.
What triggers dissociative disorder?
Dissociative disorders are believed to develop as a way of coping with long-term abuse and severe trauma (usually experienced in early childhood). Triggers are described as sensory stimuli the individual may associate with such traumatic events; therefore, what “triggers” dissociative episodes depends entirely one’s own personal history and unique experiences.
- Previous Article
- Next Article