There was a time during which the field of psychiatry was still developing that disorders like dissociative identity disorder (DID) were known by names such as “multiple personality disorder.” Today, the disorder is looked at with much more compassion than in previous generations. Dissociative identity disorder is a complex psychological condition more than likely caused by several different factors like early childhood trauma or sexual abuse.
Dissociative identity disorder gets its name from a severe form of dissociation that occurs with the disorder. Dissociation is a mental process resulting in a lack of connection in a person’s memories, feelings, thoughts, or sense of identity. The dissociation observed in people with the disorder is thought to be a coping mechanism where the person quite literally shuts off or dissociates themselves in a situation that is too extreme, violent, or traumatic. The circumstances and environment, at that time, are too traumatic to assimilate into the conscious self.
The symptoms from a dissociative disorder can potentially disrupt every area of mental functioning. They can include, among others, loss of memory, amnesia, and the experience of detachment (feeling as if one is outside one’s body.)
Signs and symptoms of dissociative identity disorder
- Amnesia (memory loss) can include events, people, time periods, and even personal information
- A feeling of being detached from yourself and your emotions
- A feeling that the people and things around you are distorted and unreal.
- Lacking a coherent and clear sense of identity
- Significant stress levels or stressors in the form of relationships, work, or other vital areas.
- An Inability or to cope well with emotional or professional stress
- Mental health problems such as depression, anxiety, and other mental health disorders often individual one or more underlining Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors
Comorbid disorders
Comorbidities are noted among patients with a dissociative identity disorder. In a study by Tezcan et al., all patients with dissociative disorder also had other psychiatric disorders. A high prevalence of dissociative disorder is noted among patients admitted from emergency psychiatric departments. Comorbid major depression, somatization disorder, and borderline personality disorder is seen in most of these patients. Auditory hallucinations, psychogenic amnesia, flashback experiences, and childhood abuse and neglect are other features seen in patients with a dissociative disorder.
Borderline personality disorder
Borderline personality disorder, also known as BPD, is a specific mental health disorder that impacts and alters how individuals feel and think about themselves, other people, their place in the world, and their role. Problems resulting from this disorder are severe enough to significantly affect functioning in daily living.
Although these three symptoms are not seen exclusively with BPD, difficulty managing emotions and behavior, a pattern of unstable relationships and a severe fear of being abandoned almost always typifies borderline personality disorder.
What Causes dissociative identity disorder
An exact cause is unknown. However, research indicates that DID’s cause is most likely a psychological reaction to environmental and interpersonal stresses. Especially during the early childhood years. This assessment is based on 99% of individuals who develop DID have histories of recurring, overpowering, and often life-threatening trauma. More specifically, these traumas occurred in early childhood at a sensitive developmental childhood stage (usually before age 6).
However, acute traumas are not the only times dissociation can happen; it can also happen in response to persistent neglect or emotional abuse. Overt physical or sexual abuse need not always take place for a dissociative identity disorder to occur.
Developmental trauma
Severe early childhood trauma can sometimes be known as developmental trauma or Complex PTSD. With developmental trauma, childhood experiences of being repeatably mistreated or abused build up over time, resulting in trauma. In this regard, abuse could be verbal, neglect, or manipulation.
Who Is At Risk
Research tells us that the most at risk-group include people who experience trauma, abuse, or neglect during early childhood.
Treatments and Therapies
There is no cure for DID, so its treatment revolves around relieving the symptoms caused by it while ensuring the patient’s safety and those around them. A core aspect of a successful treatment is integrating and “reconnecting” the different personalities into one integrated, well-functioning identity. Another vital part of treatment is helping the patient safely express and process painful memories, develop new coping skills, restore optimal functioning, and improve relationships.
The best treatment approach is individualized and should depend on the individual, their triggers, and the severity of their symptoms. Most often, treatment will combine some form of:
- Psychotherapy: This is sometimes called “talk therapy” and is the primary treatment for dissociative identity disorder.
- Cognitive-behavioral therapy (CBT): CBT is a form of psychotherapy that focuses on the link between thoughts, feelings, and behaviors and attempts to restructure that process cognitively.
- Eye Movement Desensitization and Reprocessing (EMDR): This technique was designed to treat people with persistent nightmares, flashbacks, and other symptoms of post-traumatic stress disorder (PTSD).
- Dialectic behavior therapy (DBT): DBT is similar to CBT except for several distinct features relating to its emphasis on mindfulness meditation and present moment awareness.
- Family therapy: Including the patient’s family into therapy is has been shown to improve results; in family therapy, the family of the patient can learn about the disorder and process their feelings regarding the same.
- Medication: Technically, there is no medication to treat DID. However, medication is often used to treat co-occurring or underlining disorders like depression and anxiety.
Understanding dissociative identity disorder
Understanding DID has come a long way since it was known as “multiple personality disorder.” For example, it is now known that dissociation can occur from anything, not just personalty. However, with the right treatment, normal life is possible despite living with the disorder.
