Dissociative Identity Disorder

Alternative names: DID, Multiple Personality Disorder, Split Personality Disorder

Dissociative Identity Disorder is a condition in which a person's identity is fragmented into two or more distinct personality states ("alters"), which alternately take control of them and consistently exhibit different reactions, emotions, and body functioning.

The observed differences in personality states even go as far as having different physiological reactions to situations, including different emotions, pulse rate, blood pressure, and blood flow within different parts the brain.

Incidence; Causes and Development

The prevalence of Dissociative Identity Disorder can not be accurately determined due to the fact that even experts disagree about the symptoms and diagnosis – and even whether the condition exists at all.

DID is diagnosed in women 9 times more often than in men.

People with this condition often have a history of severe physical and/or sexual abuse: children respond to being severely traumatized by isolating altered states of consciousness in order to disassociate themselves from those memories.

Signs and Symptoms

Symptoms, from the perspective of the patient, include:

• unexplained losses of time
• memory lapses
• blackouts
• not remembering how they got to the place where they are now
• often being accused of being a liar
• finding strange items in their possession, not remembering how they were obtained
• being recognized as someone else by apparent strangers
• being called different names by others
• post-traumatic symptoms of nightmares, flashbacks, and startle responses
• unreal feelings
• hearing voices of others in their head
• feeling detached, as though they are observing their own life rather than living it
• feeling like being more than one person
• not recognizing themselves in the mirror
• self-harm
• self-destructive behaviors

Those with DID often suffer from other psychiatric conditions such as PTSD, Borderline Personality Disorder, other personality disorders, or conversion disorder.

Diagnosis and Tests

Because there are no specific tests for Dissociative Identity Disorder, a mental health professional will conduct an interview in order to rule out other mental disorders.

The diagnostic criteria for DID are:

1. The presence of at least two distinct identities (personality states)
2. At least two distinct identities repeatedly take control of the patient
3. Failure to recall personal information that goes beyond mere forgetfulness
4. Ruling out other causes, for example substance abuse.

The controversy about whether DID even exists, as well as the symptom overlap with a number of other mental illnesses, can result in misdiagnosis.

Care must be taken to determine whether the patient is simply pretending to have DID because they benefit (either legally or emotionally, for example) from having it.

Treatment and Prevention

Psychotherapy is the main form of treatment.

Complications

Those with a Dissociative Identity Disorder diagnosis often have trouble maintaining jobs or relationships, and are at increased risk of drug abuse, alcohol abuse, hurting themselves, suicide attempts, or violence against others.  The outlook becomes bleak if proper treatment is not received.  More than 70% of people with DID have attempted suicide.