Dissociative Identity Disorder

What is Dissociative Identity Disorder

Dissociative identity disorder is a long-term (chronic) mental illness. This disorder used to be called multiple personality disorder. This disorder may start in childhood as an involuntary escape from reality.

It can be a defensive coping response to a very stressful or abusive situation. It may become a pattern that lasts into the adult years. It can cause problems with:

  • Memory.
  • Behavior.
  • A person’s sense of self.

People with this disorder seem to have many distinct personalities. These personalities repeatedly take control of the person’s behavior and awareness.

What are the causes?

This disorder may be caused by:

  • Childhood trauma. This includes emotional, sexual, or physical abuse.
  • Natural disasters.
  • Combat.

What are the signs or symptoms?

Symptoms of this disorder include:

  • Memory gaps.
  • Flashbacks.
  • The sudden return of traumatic memories.
  • Feeling disconnected from one’s body or thoughts, or having “out of body” experiences.
  • Seeing or hearing things that are not real (hallucinations).
  • Writing with different handwriting and different times.
  • Depression.
  • Anxiety or panic attacks.
  • Mood swings.
  • Trouble sleeping (insomnia).
  • Sleepwalking.
  • Severe headaches or pain in other parts of the body.
  • Abnormal sexual behavior. This includes sexual addiction and avoiding sex.
  • Suicidal thoughts or behaviors.

People with this disorder may also:

  • Find themselves in strange places and not know how they got there.
  • Be greeted by people who are not familiar to them and who claim to know them.
  • Have clothing and jewelry that they do not remember buying and are not consistent with their tastes.

How is this diagnosed?

This condition is diagnosed based on symptoms and personal history. A health care provider may first do tests to rule out a physical health problem, such as:

  • A brain injury.
  • A brain tumor.
  • A seizure disorder.

After physical causes are ruled out, a health care provider who specializes in physical and psychological causes of mental conditions (psychiatrist) will do a psychiatric evaluation. This may include interviews and written journals. This condition is diagnosed if:

  • There are at least two distinct identities that cause changes in behavior, memory, and thinking. Symptoms may be self-reported or witnessed by others. They must not be part of the person’s normal cultural or religious practices or behavior.
  • There are repeated gaps in memory about daily events, personal information, or traumatic events from the past.
  • Symptoms cause a lot of distress and interfere with the person’s job, relationships, or daily activities.

How is this treated?

This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. More than one type of treatment may be needed. Treatment may include:

  • Psychotherapy. This therapy may involve:
    • Addressing traumatic life events.
    • Identifying personalities.
    • Combining personalities into one.
  • Cognitive behavioral therapy. This helps the person to recognize and change unhealthy feelings, thoughts, and behaviors. It involves finding new, more positive thoughts and actions to replace unhealthy ones.
  • Dialectical behavioral therapy. Through this type of treatment, a person learns to understand his or her feelings and control them. This may be one-on-one treatment or part of group therapy.
  • Family therapy. This treatment includes family members.
  • Support groups.
  • Medicines.
  • Eye movement desensitization and reprocessing (EMDR). This is a form of psychotherapy. It is often helpful for those who have been abused.
  • Hypnosis. This can help people:
    • Remember memories they have repressed.
    • Control harmful behaviors.
    • Combine their personalities.

Follow these instructions at home:

People with this condition should:

  • Take over-the-counter and prescription medicines only as told by their health care provider.
  • Talk to their health care provider about the possible side effects of their medicines. The medicines used to treat this condition can affect different people in different ways.
  • Keep all follow-up visits as told by their health care provider. This is important.

Where to find more information

Contact a health care provider if:

  • Symptoms get worse.
  • New symptoms develop, such as:
    • Unexplained memory loss.
    • Significant changes in behavior that are related to stress.
    • A sense that one’s identity or world is fuzzy or unreal.

Get help right away if:

  • Serious thoughts occur about self-harm or about hurting others.
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