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Dissociative Identity Disorder (DID)

TW: Mention of Abuse

Introduction


Dissociative Identity Disorder (DID), previously known as Multiple Personality Disorder, is a mental health condition where a person has two or more separate identities. These personalities control their behaviour at different times and each identity has its own personal history, traits, likes and dislikes. DID can lead to gaps in memory and hallucinations. This is also called multiple personality disorder or split personality disorder. The shift between these personalities tends to occur when someone faces a certain trigger or stressor.


Causes


Many studies show that DID is very much influenced by environmental factors. There is a strong link between the condition and trauma, especially during childhood. In Europe, the USA and Canada, 90% of people who experience DID are victims of severe trauma in childhood. This condition represents someone who struggles to integrate and assimilate certain aspects of their own identity, which become disjointed over time.


Signs and Symptoms


These may vary, but they include changes between two or more separate personalities, including:

  • Encountering two or more separate personalities, each with their own self-identities and insights

  • Significant change in one’s sense of self

  • Frequent gaps in memory and individual history, which are not because of typical carelessness and failing to remember ordinary events


When other personalities take over, they often talk using different vocabulary and gesture differently. In the shift from one personality to another, someone may experience other symptoms. Some people can have anxiety, some may become very angry or aggressive; some may not notice or remember the transitions at all, although someone else may notice this.


Specific personalities may appear in response to specific situations. These symptoms can cause a person significant distress and disrupt their ability to live life normally. These may include:

  • Dissociative Amnesia (elaborated later)

  • Losing sense of time

  • Going into a trance

  • Depersonalisation

  • Disturbances


Someone with DID may also experience symptoms of other conditions, such as self-harm. Research shows that more than 70% of people with DID have attempted suicide at least once.


Dissociative Amnesia


Dissociative Amnesia is a form of amnesia that many people with DID experience. Prior to getting a diagnosis, people with DID will often be aware of dissociation, but not aware of other alters.


Dissociative Amnesia means both the amnesia of the traumatic event that occurred, as well as the memories and events that the alters created.


Most people only find out through evidence, like a supposed stranger acting like they know them while calling them a different name, or seeing something in their handwriting that they did not write.


Risk Factors


Those who have suffered from long-term sexual, emotional or physical abuse during childhood often have the greatest risk of developing dissociative identity disorder and other dissociative disorders.


Adults and children who have experienced other stressful and traumatic events, for example: abuse, kidnapping, war, torture, natural disasters or stressful medical procedures, are also susceptible to developing this condition.


Diagnosis

Due to DID being such a complex condition and each case having its own unique traits (with exception to the obvious similarities between alters and behaviour), there is currently no specific test that guarantees a definitive diagnosis. Therefore, a mental health professional such as a psychiatrist, psychologist or psychoanalyst will need to conduct an in-depth interview of the patient in order to examine their personality and disorder further through attempting to detect any of the previously mentioned symptoms.


Criteria needed for diagnosis


  • Existence of at least two personality states of distinct identities with each alter having its own relatively determined and persistent pattern of thinking, relating to and perceiving her or himself and the outside world (ideologies)


  • Two or more of the alters or personality states take control of the individual’s behaviour and mind at different times on a repeated basis


  • Individual cannot remember vital information about themselves or others, with this forgetfulness being too severe or chronic to be explained by another underlying medical condition or ordinary memory issues associated with forgetfulness


  • Not caused by any psychological effects of any substances such as drug abuse or alcohol intoxication that may have an effect on one’s personality


  • Not a result of any other medical condition in general, such as seizures. In children, mental healthcare professionals need to be sure that the child’s symptoms are not the result of any imaginary friends or fantasy play


Common Misconceptions


“People with DID are dangerous.”

  • A misconception that has been emphasised due to the film “Split”.

    • In the film, the main character has DID, and is often portrayed as violent and dangerous, even kidnapping a teenage girl.

  • In reality, it is the complete opposite.

    • People with DID are completely normal, like the rest of the public

    • Their lives are filled with mundane chores, family to take care of, and jobs to do, just with slight additional difficulties.


“Alters are just the same person with different names”

  • Alters are not the same person

  • Dissociated states with unique experiences, names, gender identities and more.


Real-life case study

Former NFL running back Herschel Walker wrote about his struggle managing multiple personalities in his book, Breaking Free. As a child, Walker was overweight and had a speech impediment. He believes he first developed DID as a coping mechanism. The highly motivated "warrior" was one of Walker's alters who drove his physical fitness and football ability. Another alter, "the hero", was his public face. For years, he managed the disorder without really understanding what it was. He doesn't even remember receiving the Heisman Trophy.

After Walker retired from football, his different personalities started to become jumbled. He fell into depression, at one point playing Russian Roulette with himself. Walker's wife, Cindy Grossman, left him after an episode where he pointed a gun at her head. It was at this point that Walker sought psychiatric help and was diagnosed with DID.




Sources





"Dissociative identity disorder (DID) - SANE ...." 23 Mar. 2021, https://www.sane.org/information-stories/facts-and-guides/dissociative-identity-disorder.


"Dissociative identity disorder | healthdirect." https://www.healthdirect.gov.au/dissociative-identity-disorder.


"Causes of Dissociative Identity Disorder (DID) | HealthyPlace." https://www.healthyplace.com/abuse/dissociative-identity-disorder/did-causes.


"Dissociative Identity Disorder Symptoms - DID Research." https://did-research.org/did/basics/symptoms.


"4 Common Misconceptions About Dissociative Identity Disorder ...." 27 Dec. 2010, https://www.healthyplace.com/blogs/dissociativeliving/2010/12/4-common-misconceptions-about-dissociative-identity-disorder.


"What causes dissociative identity disorder? | Carolyn Spring." 1 Jul. 2012, https://www.carolynspring.com/blog/what-causes-dissociative-identity-disorder/.


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