by Alan R

Dissociative Identity Disorder

IMAGE 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 time and learn some facts of this sometimes controversial condition.

Causes and Risk Factors

The common thread of people with DID is repetitive, prolonged trauma (physical and/or sexual abuse) which usually comes from a trusted caregiver. The risk of DID increases with abuse that is more severe and begins earlier in life. This history may make DID more likely than other psychiatric disorders with similar symptoms.
Each situation is unique, but several factors other increase the chance of developing DID. Having a family history of DID or of seizure both increase the risk of developing this condition. DID is also more common in women, older adolescents, and young adults. Family dynamics and culture also contribute to DID risk. Despite these risk factors most children will not develop DID. At risk child must still have the ability to take their conflicting feelings and place them into different parts of their unconscious brain in order to cope with the ongoing trauma.
Because there are many things that contribute to the cause of DID, the diagnosis can be a bit tricky.

Diagnosis

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.
Observations by friends, family, or doctors of the person may reveal:
  • 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 other psychiatric conditions.
DID is a complicated condition, but treatment is available through intensive psychotherapy and medication.

Scope of Treatment

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

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 person 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.isst-d.org

CANADIAN RESOURCES

Canadian Mental Health Association http://www.cmha.ca

Mental Health Canada http://www.mentalhealthcanada.com

References

Cherry A. Multiple personality disorder: Fact or fiction? Great Ideas in Personality website. Available at: http://www.personalityresearch.org/papers/cherry2.html. Accessed December 11, 2014.

Dissociative identity disorder. American Association for Marriage and Family Therapy website. Available at: http://www.aamft.org/imis15/content/Consumer%5FUpdates/Dissociative%5FIdentity%5FDisorder.aspx. Accessed December 11, 2014.

Dissociative identity disorder. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/psychiatric%5Fdisorders/dissociative%5Fdisorders/dissociative%5Fidentity%5Fdisorder.html. Updated November 2013. Accessed December 11, 2014.

Dorahy MJ, Brand BL. Dissociative identity disorder: An empirical overview. Aust NZ J Psychiatry. 2014;48(5):402-417.

Foote B, Park J. Dissociative identity disorder and schizophrenia: Differential diagnosis and theoretical issues. Current Psychiatry Reports. 2008;10:217-222.

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