Sensationalized in films and TV, such as
Sybil, Split, and
The Three Faces of Eve, dissociative identity disorder—once called multiple personality disorder—remains one of the most misunderstood mental health issues. The condition is characterized by a disconnect between memories and a person’s sense of self and involves the presence of at least two distinct identities within a single individual. These identities—known as splits or alters—have a profoundly negative impact on a person’s quality of life. Yet, many people refuse to believe the condition is real.
WHAT IS DISSOCIATIVE IDENTITY DISORDER?
Dissociative identity disorder (DID) is one of 3 types of dissociative disorders—the other 2 types are dissociative amnesia and depersonalization/derealization disorder. Approximately 2% of the general population are affected by dissociative disorders. DID is more commonly diagnosed in women and is estimated to affect up to 1% of people. In DID, which involves multiple distinct identities, these splits or alters can have different names, mannerisms, genders, ethnicities, memories, interests, tones of voice, and speaking patterns. Many people with DID are unaware of their alternate personalities.
DISSOCIATIVE IDENTITY DISORDER SYMPTOMS
In general, the criteria for a diagnosis of dissociative identity disorder include:
- The existence of two or more distinct identities with accompanying changes in memories, behaviors, interests, and thinking
- Gaps in memory, including everyday activities, past traumatic events, and people
- Significant distress and problems in everyday life as a result of these alters
For a DID diagnosis, these out-of-character behaviors, thinking patterns, and interests cannot be the direct result of mind-altering substances, a religious practice, or a medical condition.
Other signs and symptoms of dissociative identity disorder include headaches, out-of-body experiences, self-harm, and suicide attempts. One
study in the journal
Psychiatry that analyzed 236 people with DID found that 72% of them had attempted suicide. Violent behavior may also be present and is more commonly seen in men. These symptoms can make it extremely challenging to navigate everyday life, careers, academics, and relationships.
People with DID may also have co-occurring mental health problems, such as:
- Anxiety, panic attacks, phobias
- Insomnia and other sleep disorders
- Depression
- PTSD
- Borderline personality disorder
- Substance use disorders
- Mood instability
- Compulsive behaviors
- Hallucinations
- Eating disorders
WHAT CAUSES DISSOCIATIVE IDENTITY DISORDER?
What makes someone vulnerable to such a complex disorder? Experts say experiencing physical, sexual, or emotional abuse during childhood is the biggest risk factor for developing DID. Dissociation is believed to be a way for children to cope with, or compartmentalize, the ordeal of ongoing
adverse childhood experiences.
In a
study in the
Canadian Journal of Psychiatry, researchers interviewed over 100 people with DID and found that during childhood 90% of them had suffered sexual abuse and 84% had suffered physical abuse. More than half of these individuals reports that the sexual or physical trauma commenced before they reached their fifth birthday. On average, the abuse lasted a decade.
Other risk factors for DID include childhood exposure to war, violence, or natural disasters.
WHAT BRAIN IMAGING SHOWS ABOUT DISSOCIATIVE IDENTITY DISORDER
Brain imaging offers clues about the development of dissociative identity disorder. A
study in
The American Journal of Psychiatry found that key structures in the brain involved in memory and fear have decreased volume in people with DID. The volume of the hippocampus was over 19% smaller and the amygdala was 31% smaller in those with DID compared with healthy individuals.
A 2020
systematic review of the neuroimaging findings related to DID also showed smaller volume in parts of the frontal lobes involved in fear learning and the parietal lobes involved in personal awareness. People with DID had heightened levels of white matter, which plays a role in communication in areas involved in feelings, memory retrieval, and perception. The study authors concluded, “The neuroanatomical evidence for the existence of DID as a genuine disorder is growing and the structural differences seen in DID patients’ brains, as reviewed in this report, contribute to that growth.”
TREATING DISSOCIATIVE IDENTITY DISORDER
Treatment for DID often includes
psychotherapy to work through any past childhood trauma, learn to manage symptoms related to the condition, and blend alternate personalities into a single one. One technique that has shown benefits for trauma survivors is
EMDR (eye movement desensitization and reprocessing). Some people with DID have shown improvement with
hypnosis. In fact,
research shows that hypnosis played a pivotal part in successfully treating the first-known case of the disorder in the 1830s. In treating DID it is also critical to address any co-occurring disorders, which may involve medication and natural therapies.
Dissociative identity disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.
