National Alliance on Mental Illness
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Dissociative Identity Disorder
What is dissociative identity disorder (DID)?Dissociative identity disorder (DID), previously referred to as multiple personality disorder, is a dissociative disorder involving a disturbance of identity in which two or more separate and distinct personality states (or identities) control an individual's behavior at different times. When under the control of one identity, a person is usually unable to remember some of the events that occurred while other personalities were in control. The different identities, referred to as alters, may exhibit differences in speech, mannerisms, attitudes, thoughts and gender orientation. The alters may even present physical differences, such as allergies, right-or-left handedness or the need for eyeglass prescriptions. These differences between alters are often quite striking.
A person living with DID may have as few as two alters or as many as 100. The average number is about 10. Often alters are stable over time, continuing to play specific roles in the person's life for years. Some alters may harbor aggressive tendencies, directed toward individuals in the person's environment or toward other alters within the person.
At the time a person living with DID first seeks professional help, he or she is usually not aware of their condition. A very common complaint in people affected by DID is episodes of amnesia, or time loss. These individuals may be unable to remember events in all or part of a proceeding time period. They may repeatedly encounter unfamiliar people who claim to know them, find themselves somewhere without knowing how they got there or find items that they don't remember purchasing among their possessions.
What are the symptoms of DID?Often people living with DID are depressed or even suicidal and self-mutilation is common in this group. Approximately one-third of individuals affected complain of auditory or visual hallucinations.
While the causes are unknown, statistics show that DID occurs in 0.01 to 1 percent of the general population. DID is a serious mental illness that occurs across all ethnic groups and all income levels. It affects women nine times more than men.
In addition to experiencing separate identities, individuals living with DID may also experience many other symptoms. Some of these symptoms include:
What does treatment for DID look like?
Treatment for DID consists primarily of psychotherapy with hypnosis. The therapist attempts to make contact with as many alters as possible and to understand their roles and functions in an individual’s life. In particular, the therapist seeks to form an effective relationship with any personalities that are responsible for violent or self-destructive behavior and to curb this behavior. The therapist aims to establish communication among the personality states and to find ones that have memories of traumatic events in an individual’s past. The goal of the therapist is to enable the individual to achieve breakdown of the patient's separate identities and their unification into a single identity.
Retrieving and dealing with memories of trauma is important for a person living with DID, because this disorder is believed to be triggered by physical or sexual abuse in childhood. Young children have a pronounced ability to dissociate and it is believed that those who are abused may learn to use dissociation as a defense. In effect, the child slips into a state of mind in which it seems that the abuse is not really occurring to him or her, but to somebody else. In time, such a child may begin to emotionally and cognitively split into alternate identities. Research has shown that the average age for the initial development of alters is 5.9 years old.
In individuals where dissociation is thought to be a symptom of another mental illness such as borderline personality disorder (BPD) or posttraumatic stress disorder (PTSD), treatment of the primary cause is of upmost importance.
Children affected by DID may experience a great variety of symptoms, including depressive tendencies, anxiety, conduct problems, episodes of amnesia, difficulty paying attention in school and hallucinations. Often these children are misdiagnosed as having schizophrenia. By the time the child reaches adolescence, it is less difficult for a mental health professional to recognize the symptoms and make a diagnosis of DID.
What can a friend or family member do to help someone who lives with DID?