Reviewed by Melinda (Santa) Gladden, LCSW
To be clear: yes, Dissociative Identity Disorder is real, and it affects many people. However, it often goes undiagnosed and misunderstood, and there is still much left to be learned about the condition.
In this article, we will explain Dissociative Identity Disorder more in-depth so that you can better understand and identify it.
Dissociative identity disorder (DID) was formerly classified as a personality disorder due to those diagnosed with the condition seemingly switching from identity to identity.
Personality disorders often stir up fascination and intrigue due to the intricate nature of individuals and their personalities. Everyone has a unique identity due to the experiences and the environment to which they are exposed.
It is not unheard of for people to be unfamiliar with the disorder, and those that are may only be familiar with its portrayals in movies, literature, television, or media.
It is commonly believed and even fanaticized that individuals with this disorder can voluntarily choose which identity or personality they want to conjure, birthing its former name, multiple personality disorder, and other permutations, such as split personality disorder. Though this belief is highly intriguing and appealing to explain certain behaviors for the sake of fictional plots or stories, those who experience DID do not voluntarily have or switch into different personalities; rather, their identity is splintered into multiple facets.
Because of this finding, DID has since deviated from being classified as a personality disorder and now falls under dissociative disorders. Dissociative disorders differ from personality disorders in that an individual with this type of disorder is not characterized by a display of behaviors that contribute to their overall personality. Though they might be behaving aloof or acting strangely, they are disconnected from reality and their surroundings. They might not even be aware of the decisions they are making or be able to recall what they have done if they are in a dissociative episode.
What is The Difference between Personality Disorders and Dissociative Disorders?
Whereas personality disorders develop as a set of behaviors during adolescence that influence how an individual behaves and makes decisions throughout their life, dissociative disorders develop as a defense mechanism in early childhood due to wanting to escape severe trauma or abuse while it is occurring.
The longer the individual is exposed to trauma, the more likely dissociation becomes their primary coping mechanism, leading to a dissociative disorder such as DID. In circumstances or situations such as accidents, disasters, or abusive episodes where pain, fear, or overwhelming emotions may be too difficult to handle, dissociating can allow a person to shortly escape until the triggering situation subsides.
Because DID is a complex condition relative to an individual's childhood and experiences, it can be extremely difficult to recognize or even diagnose. Some professionals and experts argue that DID is not an individual or sole disorder but a symptom or by-product of other illnesses such as Borderline Personality Disorder due to overlapping features and believed causes. It might be considered one of the most controversial disorders found in the DSM-5, the manual used by healthcare professionals as a product of more than 10 years of studies and hundreds of mental health experts' efforts internationally.
What Is Dissociative Identity Disorder?
Dissociative Identity Disorder is a condition in which an individual experiences a severe form of dissociation. A dissociative disorder will find themselves disconnected from reality, often experiencing a lack of continuity between their memories, thoughts, actions, identity, and physical surroundings.
A person experiencing a dissociation may exhibit the following conditions:
detachment from oneself and their emotions
distorted perception of other people and physical surroundings, instances where things may seem and look hazy or blurry
trouble recalling everyday events, events in the past, or even personal information
feeling like they are not within their own body and unable to control their actions
feeling like they are watching a movie or even hypnotized
DID is a distinct and unique dissociative disorder in that dissociation occurs due to an individual switching between distinct identities or personality states known as "alters." Many can exist in an individual, depending on how and why their personality has splintered.
Switching between identities happens involuntarily and can often happen suddenly with the occurrence of a trigger. It can be difficult to prevent switching, with a switch lasting anywhere from seconds to days. Because the alters are entities with their own way of processing and remembering, individuals living with DID may feel like they are outside observers of their altar’s speech, actions, and perceptions of themselves. Because alters take over consciousness, the individual may then be unable to recall personal information or periods when an alter is dominant.
What Are "Alters"?
Alters are alternative identities or splinters of the individual's personality. Though DID varies from person to person, those with this disorder have at least two distinct personality states or alters present as required by the DSM-5.
When a person is experiencing strong emotions, pain, or trauma, they may dissociate or disconnect emotionally to shortly escape. Dissociation will occur for someone with dissociative identity disorder because their psyche switches to that of an altar, allowing them to repress experiences altogether by placing them onto the conscious of an alter instead.
Every alters represents a different aspect of the host or individual with Dissociative Identity Disorder. Unique names, personal memories, and characteristics, and distinguishing features like mannerisms, voice, gender are possessed by each alter. It is even possible for alters to have different physiological needs, such as having eyeglasses or dietary habits. The alters will have different relationships and familiarity with each other as well. Though they are unique and can be very different from each other, it is important to acknowledge that these identities are all entities and manifestations of a whole person, rather than several personalities or strangers inhabiting one body.
Often, the patient or others may not even be aware that alters are present, leading to amnesia or dissociative fugue reports. If this is the case, an individual struggles with what is known as covert dissociative identity disorder. These cases typically are ones in which the individual does not feel very much like themselves or has a lot of trouble with memory or recollection as their DID is somewhat concealed. Because of covert dissociative identity disorder's hidden nature, distress and confusion can occur within an individual who cannot recall periods of time or events and memories when their altars are dominant.
Overt dissociative identity disorder is classified by awareness, and observable existence of the different alters in an individual. The alters will be familiar with each other, and the host aware of the alters' identities even though they cannot control, which is dominant. In most cases of DID, the covert type is present rather than overt.
How Many Alters Can A Single Individual Have?
Because DID is an extremely complex and unique disorder, the number of identities that can inhabit one individual varies greatly. Typically most people with DID have been recorded with fewer than ten identities, with the majority having fewer than one hundred. It is not unheard of for rare cases to report higher numbers, as the average number of identities has increased over the past few decades, increasing studies of the disorder.
Alters are typically created to protect or shield the host from traumatic events, though it is known how, when, or exactly why each alters is created. Alters can be present from childhood into adulthood, playing specific roles and can create confusion or distress to the point of hopelessness in someone's life for years until DID is diagnosed and managed.
How Common Is DID Among Individuals?
Statistics show that only about 1 percent of the general population (in the United States) is diagnosed with DID. Though this may seem a small number, DID still affects thousands of people, given the population's size. Women are more likely than men to have DID due to the greater likelihood of experiencing physical or sexual abuse and trauma in their youth.
Though DID is difficult to diagnose, recognizing that you may be experiencing dissociative episodes or experiencing symptoms that sound similar is the first step towards treatment. If the symptoms and conditions described in this article are relevant to you, you can take a diagnostic test to identify whether your symptoms could be attributed to DID with Mind Diagnostics:
Can Dissociative Identity Disorder Be Cured?
It is crucial to get to the root of when or why an individual's personality may have started splintering to treat Dissociative Identity Disorder. Understanding the different identities being hosted by an individual and their relationships can help resolve and remediate the alters into fusing and integrating into one another. This typically is achieved with the help of licensed professionals like psychologists or psychiatrists.
Once an individual is diagnosed with DID, doctors may prescribe medications that help manage depression, anxiety, or PTSD (post-traumatic stress disorder) that could trigger switching. For all guidance regarding treatment, please make sure to consult a licensed medical professional. Psychotherapy is typically the primary treatment for DID cases, to stabilize the individual, confront trauma from the past, identify triggering memories or feelings, and integrate the separate alters back into the host's main identity.
Because DID's cause varies from individual to individual, treatment and length of treatment are entirely unique to each case. Individuals who have DID may experience extreme discomfort recalling memories or trauma from their past. Others may have other comorbid or mental disorders that need to be addressed, as dissociating could be their primary coping mechanism. Asking for help and receiving treatment can leave a person feeling extremely vulnerable or exhausted, requiring patience and plenty of emotional support.
Although it may take a long time and continued efforts to resolve DID, it does not mean it is not possible. There are many stories and recorded histories of patients who have received successful treatment for DID, allowing them to restructure their lives and develop healthy, stable relationships. Once a fusion of the separate identities has occurred, many patients continue to attend therapy to manage their mental health.
Having dissociative identity disorder can create confusion or exhaustion for an individual; receiving immediate treatment is necessary to resolve and manage the condition. With the right support and tools, any individual can begin to heal and build a fulfilled and happy life.