Reviewed by Melinda (Santa) Gladden, LCSW
Dissociative Identity Disorder (DID), previously known as Multiple Personality mental illness, is not a condition that a person is born with. Rather, individuals with dissociative mental illnesses develop the condition over time, and therefore, the mental illness can be confusing, and sometimes frightening to address.
All About Dissociative Identity Disorder
“DID” was coined by the Diagnosis and Statistical Manual of Mental Disorders (DSM-IV) in 1994 because “multiple personality” gave the impression that a person with DID is capable of voluntarily conjuring multiple personalities whenever they want. That is not the case.
Depending on the severity or class of DID, a person’s alter(s) can be a fully realized personality, with a different name, different opinions, a different age, different gender orientation, or sexual orientation.
To understand DID, and its causes, it is first important to understand the different types of dissociative mental illnesses and their terminologies.
There are three primary types of dissociative mental illnesses:
- Dissociative Amnesia: Shown in the form of major memory loss, dissociative amnesia will cause a person to forget important facts about themselves. It’s even further categorized into the different ways it presents itself:
- Depersonalization-Derealization Disorder:
- Depersonalization is the sensation of having an “out of body” experience. For those with the mental illness, there is an added component of emotionlessness. Depersonalization is a dissociation from one’s body, mind, and emotions.
- Derealization is similar to depersonalization but in the context of a person’s environment. Derealization is the alarming detachment and distortion of that person’s surroundings.
- Dissociative Identity Disorder: Like the other two dissociative mental illnesses, dissociative identity disorder encompasses a detachment from memory, self, and surrounding. However, it is done in the form of adopting and embodying at least one other distinctly different personality.
What are the different types of dissociative identity disorder?
Dissociative Identity Disorder
A person with dissociative identity disorder instead experiences a splintering from his or her own identity under situations specific to that person’s trauma. The breakdown of dissociative identity disorder types is even further categorized by covert, or overt.
- Dissociative Identity Disorder Covert: Covert, meaning hidden, or “not openly acknowledged,” is used in dissociative identity disorder to describe a person that is relatively unaware of their condition. They might experience bouts of forgetfulness, or amnesia, and have strong feelings of “not being themselves,” but the extent to which their dissociative identity disorder is present is more concealed.
- Dissociative Identity Disorder Overt: Opposite to the previous categorization, dissociative identity disorder Overt is the acknowledgment and embracement of other personalities. There is a level of awareness of their alters’ traits, and ideally an oneness with the system.
Are you new to some of the terminology? Here is a helpful glossary.
When discussing dissociative disorders, it is important to recognize some of the common terminology, as we know them today:
- Core: The original personality.
- Host: The presenting personality.
- Alter: The alternative personalities sometimes referred to as “parts.”
- Switching: Because of their temporary nature, cases of dissociation are called “episodes,” or “switching.”
- System: A person with dissociative identity disorder might refer to the combination of their body, and alters as a system.
- Co-Conscious:Awareness of the presence of the alter during the switch.
Contrary to popular belief, dissociative identity disorder does not make a person dangerous. Having a realized alter is not indicative of aggressive, dangerous, or impulsive behavior. Realistically, a dissociative disorder can be more dangerous for the person with it, given the amnesic state the person might experience while going through an episode.
What can cause these conditions?
The causes of dissociative identity disorder vary, but they are always rooted in some sort of trauma, typically from childhood. For a person with dissociative identity disorder, in most cases, a form of abuse was present during that person’s development and frequently was a recurring trauma.
A person with dissociative identity disorder will not develop the mental illness after the age of six or seven years old. The trauma that occurs to cause dissociative identity disorder happens early enough in childhood for consciousness and memory to be significantly affected.
Some people can understand what it might feel like to block a memory out of consciousness, for the sake of moving forward. However, a person with a dissociation mental illness might have trouble remembering large portions of their childhood or struggle to recall significant events.
Under this circumstance, the brain intervenes in the form of dissociation.
Situations of sexual abuse, physical abuse, and/or emotional abuse are usually the cause for a dissociative disorder, thereby using a different facet of the personality to protect against that pain and suffering.
What triggers DID?
A dissociative identity disorder episode/switch can be triggered by situational stress similar to the root trauma. The mind is so keen to protect itself that it might switch just at the sight, sound, smell, or touch of someone, or something that reminds that person of their trauma, even if the memory is subconscious.
Though typically more temporary, an episode of dissociative identity disorder can last for hours, weeks, months, and on the rare occasion, years.
The concept of dissociation is complex, to begin with, and often difficult for an average person to understand. However, the disorder afflicts more people than the public knows.
Although dissociative identity disorder is caused by an event from childhood and manifests as such, the average person with dissociative identity disorder does not show dissociative identity disorder symptoms until later in life. The mental illness is more frequently diagnosed in women, specifically usually in the person’s 20s or 30s.
Dissociative identity disorder symptoms can include the following signs:
- Struggle to keep track of time
- Amnesia, or gaps in memory
- Uncharacteristic behavior
- Physical reactions to stress or potential trauma
- Unexplained changes in mood, food preferences, and routines
- General confusion
- Presence of 2 or more personalities (covert, or overt)
Dissociative Identity Disorder is not as rare as the public perceives it to be. Though the exact number of dissociative identity disorder diagnosis/DID prevalence is unknown, it is estimated that 1% of the general participating population is diagnosed with dissociative identity disorder. Though 1% looks small, in the grand scheme of things, 1% still makes up thousands of people.
To better understand what a person with dissociative identity disorder experiences; let us discuss what happens during a dissociative episode.
What happens when you dissociate?
A dissociative episode will look different for each individual, especially considering whether they are covert, or overt.
A person might not be co-conscious during an episode. In which case, a person with dissociative identity disorder might experience somewhat of an amnesia state during the switch, and not necessarily know what happened during the episode.
Have you ever woken up from a sound sleep and forgotten you had gone to bed in a different place? That is more or less, what it can be like to dissociate. However, the person with dissociative identity disorder does not know how they arrived at that place. Dissociating unconsciously can be scary, and likely happens more to those experiencing severe trauma in the present, or who experience covert dissociative identity disorder.
Disassociating co-consciously means the person is relatively aware of their condition. This can occur for people with overt DID, and essentially, it means they can “see” what is happening when an alter takes over.
A dissociative episode is when the core personality steps back from full personhood participation.
For some, dissociative episodes can be frequent. For others with more mild DID, episodes might be fewer, and further between.
Though it is under-researched, there seems to be a consensus that addressing other co-occurring mental illnessws can help curb the symptoms of dissociative identity disorder.
Though they are NOT interchangeable, it is possible to have both dissociative identity disorder AND:
- Bi-Polar Disorder
- Various other mental health disorders
Those with dissociative identity disorder can also be at risk for substance abuse, in an attempt to numb or avoid the condition.
DID vs. Schizophrenia
Dissociative Identity Disorder has for years been confused with schizophrenia. Though some of the symptoms or behaviors can look similar, there are a few important distinctions.
A person with schizophrenia has hallucinations of voices, and/or objects that are not present in reality. They also experience delusions and thought illnesses. Additionally, schizophrenia is commonly understood as being primarily genetic, whereas dissociative identity disorder is not.
Recognizing, and understanding the symptoms of dissociative identity disorder is important, and can lead to the treatment of co-occurring mental health struggles.
Dissociative Identity Disorder is not only under-researched, but there is also still a lot of worldwide skepticism about the validity of the mental illness.
With that said, methods to manage DID are becoming more widespread, as the mental illness becomes more normalized.
If you think you are struggling with DID, click the link below for a free, short, confidential assessment.