Dissociative Identity Disorder

Although it is rare, you may be aware of a condition called dissociative identity disorder (DID). Maybe you read it in the news, or saw it in a movie or on a TV show. DID, once known as multiple personality disorder, is a disorder that involves a shift into two or more distinct identities that controls a person's behavior at different times.

It is a serious psychiatric condition that requires long-term treatment. Take some time and learn some facts of this sometimes controversial condition.

Causes and Risk Factors    TOP

In the majority of cases, DID is caused by extreme and prolonged trauma during childhood such as physical and/or sexual abuse. The theory is that in order to deal with such extreme and prolonged trauma, a child will create alternative personalities to compartmentalize and thus deal with the ongoing trauma.

Each situation is unique but certain factors may increase the chance of developing DID. Having a family history of DID and experiencing severe childhood abuse both increase the risk of developing this condition. A family history of epilepsy can also be a factor. DID is also more common in women, older adolescents, and young adults.

Because there are many things that contribute to the cause of DID, the diagnosis can be a bit tricky.

Diagnosis    TOP

Often, the original personality of a person with DID is unaware of the other distinct, alternative personalities. Control of the individual is switched to an alternative personality by triggers that are often related to the underlying trauma that caused the disorder. When control switches back to the original personality, some do not recall any of the time when they were under the control of one of the alternative personalities.

At the doctor, patients or their loved ones may report:

  • At least two or more distinct personalities existing within one person, with each personality being dominant (in control) at different times
  • Behavior that varies depending on the personality that is dominant at any given time
  • Forgetting large amounts of personal information, which is beyond typical forgetfulness
  • Lapses in time with no memory

In addition to the above criteria, therapists and psychiatrists also confirm that situations where the personality disorder suggesting DID cannot be explained by substance abuse or another psychiatric condition.

DID is a complicated condition, but treatment is available through intensive psychotherapy and medication.

Scope of Treatment    TOP

Treating DID is not a quick fix. It may encompass medications that treat anxiety and depression, but the crux of treatment lies with psychotherapy, which can take years. Psychotherapy can involve individual, group or family therapy. Here are some common elements that make treatment successful:

  • Communication between personalities
  • Hypnosis
  • Finding the personality that remembers the trauma
  • Finding the triggers for splitting of personalities and working through the traumatic events

Ultimately, the goal of treatment is putting all the personalities together as one.

The Controversy of DID    TOP

According to the American Psychiatric Association, DID is controversial for a few reasons. It may be overdiagnosed because of the popularity of the condition from TV and other media. There are even some therapists that feel a patient may be suggestible to the theory, which may lead to a diagnosis and/or treatment that may be incorrect.

Despite those concerns, the truth is that DID is very rare. If you suspect that you or a family member may be having problems that sound like DID, contact a doctor. Together you and your doctor can get to the cause of your problems and start treatment as soon as possible.

RESOURCES:

American Psychological Association
http://www.apa.org
International Society for the Study of Trauma and Dissociation
http://www.issd.org

CANADIAN RESOURCES:

Canadian Mental Health Association
http://www.ontario.cmha.ca/index.asp
Canadian Psychiatric Association
http://www.cpa-apc.org

References:

Cherry A. Multiple Personality Disorder: Fact or Fiction? Great Ideas in Personality website. Available at: http://www.personalityresearch.org/papers/cherry2.html. Updated March 2005. Accessed November 8, 2010.
Dissociative Identity Disorder. AAMFT Therapy Topics at the American Association for Marriage and Family Therapy website. Available at: http://www.aamft.o.... Accessed December 3, 2012.
Dissociative Identity Disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 30, 2009. Accessed December 3, 2012.
Foote B, Park J. Dissociative Identity Disorder and Schizophrenia: Differential Diagnosis and Theoretical Issues. Current Psychiatry Reports. 2008;10:217-222.
Multiple Personality (DID): A Controversial Diagnosis. False Memory Syndrome Foundation website. Available at: http://fmsfonline.com/mpddid.html. Accessed December 3, 2012.
Last reviewed December 2012 by Brian Randall, MD
Last Updated: 12/3/2012
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