This article was co-authored by Noel Hunter, Psy.D. Dr. Noel Hunter is a Clinical Psychologist based in New York City. She is the director and founder of MindClear Integrative Psychotherapy. She specializes in using a trauma-informed, humanistic approach for treating and advocating for people diagnosed with mental disorders. Dr. Hunter holds a BA in Psychology from the University of South Florida, an MA in Psychology from New York University, and a doctorate in Psychology (Psy.D) from Long Island University. She has been featured in National Geographic, BBC News, CNN, TalkSpace, and Parents magazine. She is also the author of the book Trauma and Madness in Mental Health Services.
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Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder, is a disruption of identity where the person has at least two distinct states of consciousness.  X Research source DID often arises as a result of severe childhood abuse. This can cause both the sufferer and the people around them discomfort and confusion. If you are worried you might have DID, you can successfully find out by getting evaluated by a professional, identifying your symptoms and warning signs, understanding the basics of DID, and dispelling common misconceptions about DID.
There are hundreds of articles describing what dissociative identity disorder (DID) is, but there aren’t many articles describing what DID is not. With all of the misconceptions and stigma out there about DID, it is just as important to write about what DID is not as it is to write about what DID is. Let us clear the air about DID.
Dissociative Identity Disorder Is Not a Made Up Illness
There are still many people, including professionals, who believe that dissociative identity disorder is a made up illness and that people fake their DID symptoms, either consciously or unconsciously, for a variety of reasons. This is not the case. DID is a legitimate disorder, just as real as depression or bipolar disorder. Dissociative identity disorder is recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases (ICD).
Dissociative Identity Disorder Is Not Acute
DID is chronic. Unlike some other illnesses or psychiatric disorders, dissociative identity disorder doesn’t run its course and resolve itself within a short amount of time. Dissociative identity disorder is for life. Treatment often includes long-term therapy, sometimes even life-long therapy. Even if the person chooses integration, they will always be susceptible to dissociation and still be affected by DID — just not to the degree they were before.
Dissociative Identity Disorder Is Not a Psychotic Disorder
There has been a huge misconception over the decades that DID is related to schizophrenia, a disorder that includes symptoms of auditory and visual hallucinations. People with DID often experience auditory hallucinations, as they can hear the voices of their alters inside. These auditory hallucinations are not the same as those experienced in psychotic disorders.
While some people with DID also have a comorbid diagnosis of schizophrenia, the two disorders are unrelated. Schizophrenia is a psychotic disorder with a genetic component that is treated primarily with medication, while DID is a dissociative disorder caused by trauma that is treated primarily with therapy.
Dissociative Identity Disorder Is Not Dangerous
Another misconception people have is that DID makes a person violent. In the media, people with DID are portrayed as serial killers, murderers, and violent people who should be avoided at all costs. The truth is that DID is not a violent disorder. People with DID are not inherently dangerous or abusive; in fact, people with DID are just as, if not less likely, to engage in violent behavior as people without psychiatric conditions.
Dissociative Identity Disorder Is Not Easy or Lucky
I’ve come into contact with a few people who, upon finding out about my DID diagnosis, said that I am lucky to have all these alters to do the work for me. While I understand where they would get that idea, having DID is definitely not lucky, nor does it make life easier. Dissociation complicates everything: relationships, work, school, family, and life.
Dissociative identity disorder is not a benefit, nor is it a curse. It’s a disorder, a real disorder, and a lifelong disorder. But it is a disorder that can be managed with the right support, and more understanding of what DID is and is not.
Matulewicz, C. (2017, October 26). What Dissociative Identity Disorder Is Not, HealthyPlace. Retrieved on 2021, October 26 from https://www.healthyplace.com/blogs/dissociativeliving/2017/10/what-dissociative-identity-disorder-is-not
Author: Crystalie Matulewicz
Crystalie is the founder of PAFPAC, is a published author and the writer of Life Without Hurt. She has a BA in psychology and will soon have an MS in Experimental Psychology, with a focus on trauma. Crystalie manages life with PTSD, DID, major depression, and an eating disorder. You can find Crystalie on Facebook, Google+, and Twitter.
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:
- Anxiety, panic attacks.
- Alcohol and drug abuse.
- Memory problems.
- Flashbacks. .
- Personality change.
- Selective loss of memory.
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.
Diagnosing dissociative identity disorder (DID) is done with two things in mind:
- ruling out other possible diagnoses
- ruling in dissociative identity disorder (DID)
In fact, ruling out other diagnoses is so critical to a dissociative identity disorder diagnosis, that one might even say that diagnosis of dissociative identity disorder is an exclusionary process. It is because so many other mental health disorders must be considered first that most people do not receive a DID diagnosis promptly. It’s estimated that people with DID spend seven years in the mental health system prior to receiving the correct diagnosis (What’s It Like Living with Dissociative Identity Disorder).
When Diagnosing DID, What Else Could It Be?
Many of the signs and symptoms of dissociative identity disorder overlap with other psychiatric disorders. For example, auditory hallucinations are common in DID as well as in schizophrenia. In clinicians not well educated in dissociative identity disorder, an incorrect diagnosis of schizophrenia is common.
Additionally, in a study by Tezcan et al of patients with dissociative disorders, all patients suffered from an additional disorder. Comorbid disorders, as they are known, make the diagnosis of underlying dissociative identity disorder more difficult.
When diagnosing dissociative identity disorder, the following need to be ruled out:
- Temporal lobe epilepsy – dissociation is more common in temporal lobe epilepsy than in any other neurological disorder.
- Schizophrenic disorders – as mentioned, some symptoms do overlap but there are several ways to tell the difference between schizophrenia and DID. One of which is that people with schizophrenia hear voices from outside their heads whereas in DID, the voices heard are from within.
- Borderline personality disorder – according to two studies, people with DID commonly have a comorbid borderline personality disorder; however, not all do. In the case where both disorders are present, DID is likely to be treated first as working with alternate personalities provides an avenue of therapy that is not available when treating the individual only as a whole.
- Malingering – malingerers make up or inflate symptoms to seem sick when they are not due to secondary gain (because there’s some advantage for the patient). This is ruled out based on an individual’s circumstances.
- Dissociative amnesic disorder – it can be difficult to differentiate between these two disorders but, according to Medscape, “With other dissociative amnesic disorders, behavior may be complex, but recovery is often complete, recurrences are less common, and the onset of amnesic spells may be intimately related to stressful events or to ingestion or intoxication.”
How Is Dissociative Identity Disorder Diagnosed?
Diagnosing dissociative identity disorder must always be done by a mental health professional such as a psychiatrist or psychologist, preferably one with experience with dissociative disorders. An initial assessment may be done by a general practitioner (family doctor) with referral to a psychiatrist or psychologist once other conditions have been ruled out (Read about famous dissociative identity disorder cases).
A dissociative identity disorder assessment will start with a complete psychological and physical health history. While there is no specific test for dissociative identity disorder, medical tests may be ordered to help rule out other causes of dissociative symptoms such as a neurological disorder, medication side effects or intoxication.
Once other causes of dissociative symptoms have been ruled out, a specially designed interview and personality assessment tools are used to evaluate a person for a dissociative identity disorder diagnosis.
For some people, being diagnosed with dissociative identity disorder (DID) is a huge shock.
It’s frightening to find out you have ‘personalities’ in your head and they’ve been there for years, or there are alters present and you haven’t known about them.
Diagnosis, in a way, was having a name for what I perceived to be something ‘different’ about me. It provided a reason for my behaviour and gave me something to work on. When you know what the problem is then you can work on a solution.
DID, for me, contains varying levels of awareness of alters. Or as I call them ‘Voices’. I have mild awareness of some Voices, like shadows I notice from time to time. Others I have complete awareness of both their sound and what I believe they look like. I am aware of their preferences, moods, attitudes, behaviours and what they are capable of.
DID used to be known as multiple personality disorder. There are five criteria for DID used by health professionals. Hopefully my personal experience can give you some context around the symptoms relevant to me.
Two or more distinct personality states
What are these personalities or alters? And what does it feel like? For someone who doesn’t live with DID, I imagine it’s highly confusing and even disbelieving.
For starters, my Voices are inside my head. They are not external sounds. They’re more like the conscious thoughts you have in your mind.
However, my Voices don’t sound like a conscious thought pattern. They have their own ‘sound’. It’s similar if you listen to people around you in a restaurant. They are distinctive. When your partner or boss talks to you, you know the sound of their voice and can tell them apart from other people. This is the same with my Voices, I can tell most of them apart when they talk.
One of the more nerve-racking aspects of DID, is the sound of a new Voice. That first time they make you aware of their existence.
I had this one day as I was driving. No warning. I was driving my car through a shopping centre car park, thinking how late I was, when wham, a male Voice with an accent started talking to me. His focus was time.
Another distinct awareness of my Voices can be how they make me feel. For example, I may be walking through a shopping centre and feel extremely anxious. I feel sweaty and nervous. This sensation of feeling overwhelmed can trigger one of my Voices we’ll call ‘Jim’. Suddenly, I feel Jim’s presence, it’s like he’s walking beside me. He’ll say to me ‘you’re fine, keep going, I’m with you’. And just like that my anxiety reduces. Nothing has changed in the shopping centre, the environment is the same. It’s just Jim has calmed me. All this happened in a few seconds, no-one around me would know what happened.
Recurrent gaps in the recall of events
This is best demonstrated by the personal information I’m missing from my early life, including childhood. I can recognise a childhood pet in a photo and know their name, but have no memory of playing with the pet. This is not a medical memory loss issue.
For me, DID brings varying levels of awareness of alters. Some Voices I don’t feel for weeks or months, some are fleeting moments. Others are around quite often, nearly every day. Some are moved into action by necessity, they feel the need to function. One older Voice may have me in the kitchen baking. I feel like I’m a puppet on a string, or there’s a compulsion to cook. Once I’ve finished baking the compulsion is dealt with and I can go back to what I was doing before.
A major thing at home is doing things I don’t remember. Moving things in the house. Getting blamed for things! Receiving groceries I don’t remember ordering.
I regularly change what I’m doing. I have to tape most TV shows, because I would miss too much if I didn’t. For example, 15 minutes into a show I may find myself up, walking to the laundry because a Voice remembered the washing. No sooner is the washing hung out, then I’m in the kitchen turning the jug on. Next, I’m back to the lounge to rewind and watch what I missed on the show. But then 10 minutes later I’m up because the other Voice wants the cup of coffee. That’s a typical dysfunctional day. It’s very exhausting!
Symptoms cause distress or impairment
Generally I’ve been able to cope with most situations throughout my life. But, in times of significant distress or personal loss – a miscarriage, trauma and death in the family – I’ve found myself incapable of working. It’s been a number of years since these events and unfortunately I’ve been unable to return to my career. DID can be, and for me is, disabling.
At times I feel like other people around me are ‘ageing’, which is very odd. I look at someone and think they look older. I have to remind myself that I’ve aged as well. I often see wrinkles on my skin that I don’t think should be there. This is a connection with one of my younger Voices who has popped in to mingle with me. It’s as if they look through my eyes and see a body quite different from ‘their’ body. A Voice who is 10 would understandably be confused looking at hands of a 40 year old. Sometimes I have intrusions, moments where I’m thinking odd things or feeling unnaturally upset. For example, crying but not feeling distressed.
My DID diagnosis means that so many things from my life now make sense. I have an explanation for things that were extraordinary. They can be explained, in many cases, because a particular action or behaviour turned out to be a Voice being triggered by something. It’s very liberating.
But the reality is it’s very tough. It’s a struggle – not just for me, but for my family, close friends and my Voices.
I’d like to stress that, despite what the movies may suggest, we are not dangerous. This illness has affected my ability to work, socialise and exist. It’s impact is like an ever-expanding drop in an ocean, becoming larger and larger. Treatment is long term, uncertain at times and expensive. For me suicide is an ever-present fear, but something I’m successfully fighting.
Amnesia happens either when we cannot access the memory, or when the memory was not encoded in the brain in the first place.
Many things can explain not encoding the memory: substance abuse, tiredness, stress, lack of mindfulness, depression. All of this can happen together with dissociative disorders, or separate from dissociative disorders.
If you have issues that are difficult for you in an everyday basis, do not hesitate to check with a therapist who is skilled in differential diagnosis between dissociation and other, similar phenomenons.
Key: ♂ he/him | ♀ she/her | ɸ they/them
Social: Zamiel ɸ (complex fusion) or Daniel ♂ɸ (Zamiel + David)
Self-care: David ♂
Managers: The Mirror ♂ (inner self-helper) – Isaïa ♂ ("trauma-sitter") – Theia ♀ (gatekeeper)
Trauma holders: Pride|Wrath ♂ – Lust ♀ – Reyna ♀ – Ulysses ɸ
Re: Is this normal?
by TheGangsAllHere » Sun Oct 24, 2021 3:41 pm
As David said, the amnesia alone could be due to different causes. However, separate consciousnesses sharing a body only occurs in DID/OSDD. And when there’s amnesia for switches between those separate consciousnesses, then it’s considered DID rather than OSDD. So if you have another person sharing your body who can take over and you have amnesia for what they did, it would be important for you to find a therapist who understands how to help you with this.
I’m curious how you know what she experienced. Did she talk to you about that? Did she tell you what she did yesterday evening and that she doesn’t remember anything you did for the past couple of days?
One of the initial goals with DID is to improve communication so that memories can be shared and there’s a more continuous experience of what you do in your shared life each day.
I just figured out recently that I have been suffering from DID all my life, or at least, finally listened to people who have diagnosed me after so long. I'm broke from having been rendered frozen by the fibromyalgia, depression, and anxiety that came along with it. Parental support just got pulled out for what I feel is probably the final time. Before what little I've saved runs out, and it will really fast, I want to figure out how to get out of my predicament.
I only found out today that I pushed away everyone close to me, refused job opportunities, ruined my interpersonal affairs, and let people down,
All as an act of self-sabotage. My left and right brain, or at least I like to think of it that way, have been at odds with each other without me even noticing. Their war is so much more important to them than my own safety and wellbeing that they'd go so far as to let me get beaten up without so much as attempting to fight back, that they'd starve me for days on end,
That they'd make me refuse my dream job, or my dream girl, just because they want to punish each other. Their hatred for other people is so great too, that even when the lives of others have been at stake, and there was no real danger to myself, I would stop myself from taking action, even if I've wanted to help so bad. I can't forgive myself anymore for what this hatred has resulted to. I do want to tell how much damaged this has caused to the world around me, but I fear it will make people dismiss me instead.
I acknowledged today that the split in my personalities is all because I wouldn't own up to my emotions and actions, so I've decided to, but I can't stop. All that's needed is for me to suck up my pride, forgive my own father for causing my traumas in the first place, and everything will be OK, but despite this, I can't. I know now that I had deliberately done things to hurt him as revenge, like miss his birthdays on purpose just to get back at him for missing special events in my own life. I knew the morning of his last birthday but I couldn't stop it. Even when I can tell that it's not helping him or anyone learn their lessons, I cannot help but use negativity to try and control people.
I have a girl and her dog that my family had helped support. They will have nowhere to turn. All it takes is for me to forgive, and they will have free lodging and meals for the rest of their lives, instead of starving to death like what's about to happen. My war with myself matters more than my love for them. It's that bad. This war needs to end now.
Dissociative identity disorder (DID) is a mental health condition. People with DID have two or more separate identities. These personalities control their behavior at different times. Each identity has its own personal history, traits, likes and dislikes. DID can lead to gaps in memory and hallucinations (believing something is real when it isn’t).
Dissociative identity disorder used to be called multiple personality disorder or split personality disorder.
DID is one of several dissociative disorders. These disorders affect a person’s ability to connect with reality. Other dissociative disorders include:
, which causes a feeling of detachment from your actions. , or problems remembering information about yourself.
How common is DID?
DID is very rare. The disorder affects between 0.01 and 1% of the population. It can occur at any age. Women are more likely than men to have DID.
Symptoms and Causes
What causes dissociative identity disorder (DID)?
DID is usually the result of sexual or physical abuse during childhood. Sometimes it develops in response to a natural disaster or other traumatic events like combat. The disorder is a way for someone to distance or detach themselves from trauma.
What are the signs and symptoms of DID?
A person with DID has two or more distinct identities. The “core” identity is the person’s usual personality. “Alters” are the person’s alternate personalities. Some people with DID have up to 100 alters.
Alters tend to be very different from one another. The identities might have different genders, ethnicities, interests and ways of interacting with their environments.
Other common signs and symptoms of DID can include:
. . .
- Disorientation. .
- Memory loss.
- Suicidal thoughts or self-harm.
Diagnosis and Tests
Is there a test for DID?
There isn’t a single test that can diagnose DID. A healthcare provider will review your symptoms and your personal health history. They may perform tests to rule out underlying physical causes for your symptoms, such as head injuries or brain tumors.
Symptoms of DID often show up in childhood, between the ages of 5 and 10. But parents, teachers or healthcare providers may miss the signs. DID might be confused with other behavioral or learning problems common in children, such as attention deficit hyperactivity disorder (ADHD). For this reason, DID usually isn’t diagnosed until adulthood.
Management and Treatment
What is the treatment for dissociative identity disorder (DID)?
Some medications may help with certain symptoms of DID, such as depression or anxiety. But the most effective treatment is psychotherapy. A healthcare provider with specialized training in mental health disorders, such as a psychologist or psychiatrist, can guide you toward the right treatment. You may benefit from individual, group or family therapy.
Therapy focuses on:
- Identifying and working through past trauma or abuse.
- Managing sudden behavioral changes.
- Merging separate identities into a single identity.
Can hypnosis help with DID?
Some healthcare providers may recommend hypnotherapy in combination with psychotherapy. Hypnotherapy is a form of guided meditation. It may help people recover suppressed memories.
Can dissociative identity disorder (DID) be prevented?
There’s no way to prevent DID. But identifying the signs as early in life as possible and seeking treatment can help you manage symptoms. Parents, caregivers and teachers should watch for signs in young children. Treatment soon after episodes of abuse or trauma may prevent DID from progressing.
Treatment can also help identify triggers that cause personality or identity changes. Common triggers include stress or substance abuse. Managing stress and avoiding drugs and alcohol may help reduce the frequency of different alters controlling your behavior.
Outlook / Prognosis
Will dissociative identity disorder (DID) go away?
There is no cure for DID. Most people will manage the disorder for the rest of their lives. But a combination of treatments can help reduce symptoms. You can learn to have more control over your behavior. Over time, you can function better at work, at home or in your community.
Are there ways to make living with DID easier?
A strong support system can make living with DID more manageable. Make sure you have healthcare providers, family members and friends who know about and understand your condition. Communicate openly and honestly with the people in your support system, and don’t be afraid to ask for help.
If a friend or family member has DID, how can I help?
Having a loved one with DID can be confusing and overwhelming. You may not know how to respond to their different alters or behaviors. You can help by:
- Learning about DID and its symptoms.
- Offering to attend family counseling or support groups with your loved one.
- Staying calm and supportive when sudden behavior changes occur.
When should I call my doctor about DID?
If you or someone you know has DID and exhibits any of the following symptoms, seek medical attention right away:
- Self-harm. .
- Violent behavior.
You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a network of local crisis centers that provides free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.
A note from Cleveland Clinic
Dissociative identity disorder (DID) is a mental health condition. Someone with DID has multiple, distinct personalities. The various identities control a person’s behavior at different times. The condition can cause memory loss, delusions or depression. DID is usually caused by past trauma. Therapy can help people manage their behaviors and reduce the frequency of identity “switches.” It’s important for anyone with DID to have a strong support system. Healthcare providers, family members and friends can help people manage DID.
Last reviewed by a Cleveland Clinic medical professional on 05/25/2021.
- American Association for Marriage and Family Therapy. Dissociative Identity Disorder. (https://www.aamft.org/Consumer_Updates/Dissociative_Identity_Disorder.aspx) Accessed 6/3/2021.
- Child Mind Institute. The Most Common Misdiagnoses in Children. (https://childmind.org/article/the-most-common-misdiagnoses-in-children/) Accessed 6/3/2021.
- Gillig PM. Dissociative Identity Disorder. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719457/) Psychiatry. March 2009;6:24-29. Accessed 6/3/2021.
- National Alliance on Mental Illness. Dissociative Disorders. (https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders) Accessed 6/3/2021.
- National Alliance on Mental Illness. DID Factsheet. (http://namimi.org/mental-illness/dissociative-disorder/didfactsheet) Accessed 6/3/2021.
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