Dissociative Identity Disorder (DID)

Here we will look at Dissociative Identity Disorder (DID) which is also known as multiple personality disorder.  Dissociative Identity Disorder (DID) is a dissociative disorder. It is described as the presence of two or more distinct identities that recurrently take control of behaviour.  This is accompanied by an associated memory loss that is more than normal forgetfulness.

When an alternate personality becomes dominant, memory loss will occur.  These symptoms can be associated with the temporary effects of drug use or a general medical condition but with DID the symptoms persistent. 

DID is the least common dissociative disorders and occurs in approximately 1% of dissociative patients. 

Symptoms

Diagnosis of DID can be difficult as many symptoms overlap and co-exist with other types of mental illness.  The symptoms of DID can fluctuate at different times and can include:

  • Disruptions of identity.  These are characterised by two or more distinct personalities.
  • Multiple mannerisms, beliefs and attitudes.
  • Distortion or loss of subjective time
  • Depersonalisation
  • Current memory loss of everyday events.
  • Flashbacks of abuse trauma
  • Depression
  • Sudden anger without due cause
  • Panic/anxiety attacks
  • Inexplicable phobias
  • Derealisation
  • Pseudoseizures (seizures which resemble an epileptic seizure)

Causes

The causes of DID are somewhat unclear although many DID patients report having been severely physically and/or sexually abused as a child.  This type of experience can lead to memory loss as high levels of stress can lead to memories and thoughts to be pushed from the consciousness, particularly when you are young.

DID is linked to overwhelming stress, traumatic past events and inadequate nurturing in childhood.  Patients have also reported early loss, serious medical illness and other traumatic experience.  It is thought that early childhood trauma can disrupt the normal development of the personality structure.

Treatment

The treatment of DID may include psychotherapy to help the root cause of the disorder and medications to treat any comorbid disorders or symptoms (there is no medication specifically for DID) . 

Generally treatment is given in different phases.  The first phase focuses on the relief of distressing symptoms.  This also includes ensuring the safety of the patient.  The second phase focuses on exposure to traumatic memories and the prevention of re-dissociation.  The third phase centres on reconnecting the identities of other alters into a single functioning identity.

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