What is dissociative identity disorder?

Dissociative identity disorder (DID) used to be called multiple personality disorder. "Dissociative" means not connecting with things around or even inside you. It can mean you don't have a connection with your thoughts and memories. Maybe you're removed from your feelings and actions. Many kinds of dissociative orders exist, but each one is different. DID is the most severe form of dissociation.

With DID, there are two or more personalities (or identities) in one person. The main personality is known as the "host." The personalities can take over at different times. They may make you act very differently. That can make it hard for you to remember things that happen when another personality was in charge. It also means that memories or thoughts about what happened can be different. They depend on which personality was dominant at the time. 

Each personality has its own identity. They can have different ages, races or genders than you do. Different personalities are often called "alternate personalities" or just "alters."

Causes of DID

In most cases of DID, trauma causes the condition to develop. DID works as a coping tool to help people deal with with extremely stressful or terrifying life events. When these events happen, a person may start to view them as though they're happening to a different person — or a different personality. Feeling as though the frightening event didn't happen to them allows people to avoid the negative emotions the event caused.

Risk factors for DID

DID often comes from childhood trauma. Children who grew up with extreme childhood abuse or who were repeated abused are most likely to show symptoms. The abuse could be physical, sexual or emotional.

DID also can appear in children or adults who've suffered other types of trauma. These events can include:

  • War
  • Torture
  • Kidnapping
  • Natural disasters

Symptoms of DID

The main symptom of DID is split or multiple personalities. Other signs include:

  • Trouble sleeping or doing things like sleepwalking and having nightmares
  • Losing time and not remembering where you were or what happened
  • Doing things you don't want to do but not being able to stop
  • Anxiety and panic attacks
  • Alcohol and drug abuse
  • Suicidal thoughts
  • Eating disorders
  • Hallucinations
  • Mood swings
  • Depression
  • Amnesia

Many people who have DID feel like they're just watching the world around them. They may not feel like they're living in the world that they're watching. 

Diagnosis of DID

If your doctor sees some of the symptoms of DID, the first thing they may do is run tests to rule out a physical health condition. This includes testing for something like a head injury, lack of sleep, brain diseases and other possible conditions. Some of these other conditions might cause symptoms like memory loss that also happen with DID.

If your doctor doesn't find a physical problem, they may refer you to a mental health professional. Their diagnosis is based on some of the following things:

  • What kind of symptoms you show
  • How well you function at work, home or school
  • Questions about your thoughts and feelings on certain things

Your mental health professional might also ask your permission to talk to family members or other people close to you. This can help them get a better idea of what's going on in your life. They then use guidelines from a book that the American Psychiatric Association publishes. This helps them see if you have DID. Meeting some or all of the guidelines is how you're diagnosed.

Treatments for DID

Treatment for DID often takes a long time. There's not a set cure for it. But you can feel better with effective help. Some of the treatments include:

  • Hypnotherapy, where you're in a relaxed state that can help you be more receptive to suggestions that help you with your behaviors
  • Psychotherapy or talk therapy, where you talk to a therapist who helps you overcome behaviors and thought patterns
  • Other forms of therapy, like art therapy

There aren't any medications that treat DID. Your doctor might prescribe drugs to help control some of the symptoms you're having. These could include anti-anxiety medications, antipsychotic drugs or antidepressants.

Recovery from DID

There's no cure for DID. That means you may need treatment in some form for life. It's important to stay committed to your therapy routines. It's also important to find a therapist who you feel comfortable around. Don't be afraid to interview a few to find the right fit.