Have you ever felt like you had no control over what you said or did, or that you weren't yourself? Or, have you ever forgotten what you said or done, and been surprised when others talked about it? Today we're going to talk about a somewhat complicated, but very important, mental condition that not many people know about. This is what we call multiple personality disorder, or medically `(Dissociative Identity Disorder - DID)` . It used to be called `(Multiple Personality Disorder)`.
What is this multiple personality disorder (DID)?
Simply put, `(Dissociative Identity Disorder - DID)` is a mental condition in which you feel or act as if you have one or more other personalities in your mind and body besides yourself. Think of it as if you have several different people living inside your body. The word ``Dissociate`` means ``separation`` or ``disconnection`` .
A person with this condition may experience several different personalities (what doctors call ``alters''). Each of these ``alters'', or personalities, may have their own unique behaviors, memories, ways of thinking, ways of speaking, likes and dislikes, and sometimes even age and gender. Sometimes these personalities may behave like people of different races and interact with their environment differently.
These different personalities can control your behavior at different times. The most dangerous thing is that memories are not transferred from one personality to the other. This can cause memory loss or memory gaps (amnesia) . This memory loss is one of the most important symptoms that doctors pay attention to when diagnosing this disease.
DID can be a serious condition that can interfere with your ability to function in your daily life. It can affect your relationships with family and friends, your schoolwork, and your work. DID is a condition that belongs to a group of mental illnesses called dissociative disorders. These illnesses affect your ability to connect with reality.
Are there types of these DIDs?
Yes, there are two main types of `DID`:
1. Possession form: This is when an outsider or spirit takes over your body and it seems to others that you are possessed. You suddenly start talking and behaving differently, which is obvious to others. This is a personality change that you do not want, and the personality change occurs without your control. This is not to be confused with the 'disbelief' that some of our cultural beliefs refer to. DID is a mental illness.
2. Nonpossession form: In this form, the personality changes are not as obvious to others. You may suddenly feel a change in your identity. It may feel like you are being watched in a movie (an out-of-body experience), and you may feel like you are not in control of your speech, emotions, or behavior.
Importantly, the concept of 'possession' is a common belief in various cultures and religions around the world. However, such voluntary spiritual practices have nothing to do with `DID`.
How common is DID?
DID is not a very common condition . A small study in the United States found that it may affect about 1.5% of the population. However, this estimate may change with the new diagnostic criteria (`(Diagnostic and Statistical Manual of Mental Disorders, 5th Edition - DSM-5)`).
What are the symptoms of DID?
The main symptoms of `DID` are:
- Having at least two distinct personalities (personality states). These affect your behavior, memory, how you see yourself, and how you think.
- Loss of memory (amnesia) or gaps in memory for everyday events, personal details, and traumatic events. Sometimes, you may not remember things for hours or days.
- Disruptions in your social relationships, work, household chores, or schoolwork due to different personalities.
In addition, the following mental health problems can sometimes (but not always) be seen with DID:
- Anxiety
- Delusions - believing things that are not true.
- Depression
- Self-harm
- Substance use disorders
- Suicidal ideation
How does someone with DID feel?
If you have `DID`, you may feel or experience things like:
- Feeling disconnected from reality, your emotions, and your sense of "I".
- Being confused by what others say about your behavior. (For example, when someone says, "You said that yesterday," you may not remember it at all.)
- Feeling frustrated by the gaps in your memory .
- Feeling a lot of pressure about not being able to control anything.
- It's like you're being watched from behind, feeling like an outside observer .
Simply put, when you have `DID` you don't feel like you are "yourself". This can feel different for each person. If you feel like something is not right, if your experiences and memories don't match up, definitely see a doctor and talk about this.
Is it possible for someone to not know they have DID?
Yes, it is possible. While some people are aware of their multiple personalities, many are not aware of the times when a new personality emerges and takes control of them. When a new personality emerges, you may not remember certain events because you experienced them as a different personality. This is what causes memory lapses, or amnesia.
What are the causes of DID?
The main cause of DID is thought to be severe, traumatic experiences experienced during childhood. These may include:
- Stressful experiences
- Trauma
- Physical, sexual or psychological abuse (Abuse)
- Neglect
When faced with such unbearable experiences at a young age, the mind tries to protect itself. `DID` is a kind of defense mechanism that the mind uses to distance itself from such a terrible trauma. It's like putting that terrible experience in a separate "box" and hiding it somewhere in the mind.
DID symptoms can be triggered by:
- When you leave a stressful or traumatic environment (e.g., moving house).
- A close relative of yours or your own child, when you reach the age when that trauma happened to you.
- Having recently experienced a traumatic or severe stressor (e.g., a serious car accident).
- When your abuser dies or develops a life-threatening illness.
What are the risk factors for DID?
You may be at higher risk of developing DID if you have experienced any of the following:
- Being physically or sexually abused as a child.
- Neglect from parents or guardians.
- Having to undergo several medical surgeries or procedures as a child.
- Facing things like war or acts of terrorism.
What are the possible complications of DID?
People with DID are at increased risk of suicide . More than 70% of those diagnosed with DID attempt suicide or engage in self-harming behaviors.
If you are feeling suicidal, please seek help immediately. In the United States, you can call 988 or text the Suicide & Crisis Lifeline. Contact the emergency mental health service in your country. You are not alone, there is someone who can help.
How do doctors diagnose DID?
DID is usually diagnosed by a psychiatrist or psychologist. They will take your complete medical history and ask you about your symptoms. Sometimes they can also get information from people who know you well and spend the most time with you. Often, someone close to you will be the first to notice a change in your personality and express concern.
There is no single test to diagnose DID. Your doctor will do a physical exam and a neurological exam to rule out other medical conditions that could be causing your symptoms. They will then compare your symptoms to the criteria in the Diagnostic and Statistical Manual, 5th edition (DSM-5), a guide from the American Psychiatric Association.
In addition, your doctor may use various questionnaires or scales to assess your dissociative behavior. Some examples include:
- Dissociative Experiences Scale: This asks 28 questions about your daily experiences.
- Dissociation Questionnaire: There are 63 questions to measure the severity of identity dissociation.
- Difficulties in Emotion Regulation Scale: There are 36 questions about how you regulate your emotions.
Since the risk of suicide is high among people with DID, the doctor will ask you questions about that as well.
When is DID usually diagnosed?
Symptoms of DID often appear in childhood, between the ages of 5 and 10. However, parents, caregivers, teachers, and doctors may miss or misunderstand these early symptoms. They may confuse DID with other behavioral or learning disabilities, such as Attention-Deficit/Hyperactivity Disorder (ADHD). As a result, DID is often diagnosed in adulthood.
Because DID is a rare condition and has a wide variety of symptoms, it can take some time for even experienced doctors to make an accurate diagnosis.
What are the treatments for DID?
The following are used as treatments for DID:
- Medications to control symptoms such as depression and anxiety.
- Psychotherapy . For example, Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT).
The first step in treatment is always to ensure your safety. A doctor with special training in mental illness can refer you to the right treatment. Treatment is primarily focused on meeting your specific needs.
Psychotherapy (counseling) for DID
Psychotherapy for DID primarily focuses on:
- Identifying and working through traumatic events from the past.
- Managing sudden behavioral changes.
- Trying to merge separate personalities into a single, unified personality .
You may benefit from individual, group, or family therapy.
Remember, participating in psychotherapy can be challenging. You will have to talk about and relive very difficult and painful experiences in your mind. This may cause you to feel anxious, helpless, afraid, and lonely. But you are not alone. Your therapist and your loved ones are there to help and support you.
Can hypnosis help?
Some doctors recommend hypnotherapy along with psychotherapy. Hypnotherapy is a form of guided meditation. Some believe it can help bring back repressed memories.
Can DID be completely cured?
Unfortunately, there is no cure for DID. However, your symptoms can improve. You will have to manage this condition for the rest of your life. Although this may seem overwhelming, your doctor can help you find the right treatment or combination of treatments that will help your symptoms take control of your life.
Can DID be prevented?
There is no specific way to prevent DID. However, early recognition and treatment can help manage symptoms. Parents, caregivers, and teachers should be on the lookout for these signs in young children. Early treatment of abuse or trauma may prevent DID from becoming more severe.
Treatment can also help you identify the "triggers" that cause your personality or identity changes. Things like managing stress, avoiding illicit drugs, and avoiding excessive alcohol consumption can help reduce the frequency of your alters.
Are there ways to make living with DID easier?
Always follow your doctor’s treatment plan. This may include taking your medications as prescribed and continuing treatment even if you feel better. If things seem difficult or if you feel like they are getting worse instead of better, let your doctor know right away. They can then adjust your treatment plan as needed throughout your life.
Having a strong support system can go a long way in helping you manage living with DID. Make sure you have doctors, family members, and friends around you who understand your condition. Talk openly and honestly with those in your support system. Don't be afraid to ask for help when you need it.
If your loved one has DID, how can you help?
Finding out that someone you love has DID can be confusing and overwhelming for you. You may not know how to respond to their different personalities (alters) or behaviors. Here's how you can help:
- Learn about DID and its symptoms. Understanding is the first step.
- Express your willingness to participate in family counseling or support groups with your loved one.
- Stay calm and supportive when sudden behavior changes occur.
When should you see a doctor?
Sometimes you can underestimate the impact your symptoms have on your daily life. You may think, "This isn't that big of a deal." But if you suspect that something is wrong with your sense of self, your memory, or the way you function, please see a doctor.
If you or someone you know has DID and is exhibiting the following, seek medical attention immediately:
- Self-harm
- Suicidal thoughts
- Violent behavior
In the United States, you can contact the Suicide and Crisis Lifeline by calling or texting 988. This hotline connects you to a network of local crisis centers that provide free and confidential emotional support. These centers provide support 24 hours a day, seven days a week to people who are in a suicidal crisis or experiencing emotional distress. If you or a loved one is in an emergency, call 911 or your local emergency number. (In Sri Lanka, call 1990 for the Suwaseriya Ambulance Service or 119 for the police.)
Finally, what to remember (Take-Home Message)
Dissociative Identity Disorder (DID) is a mental health condition in which you have two or more distinct identities. It can occur as a way for your mind to escape from the overwhelming negative experiences you've had in your life. To protect yourself, to move on, you may have put that trauma in a box and hid it in the back of your mind.
While DID can provide an escape from reality, it can also distance you from your loved ones and your true self. A mental health counselor can help you carefully open that box when you're ready and work through these difficult experiences. Together, you can better understand the challenges you've faced and work through them in a positive way. While you're in therapy, it can be very helpful to build a strong support system of people you can trust when you feel like you're not yourself. Remember, you're not alone when dealing with DID.
Over time, with the right treatment, you can function better and live with more control over your true "you." Don't give up hope.
` Multiple Personality Disorder, Dissociative Identity Disorder, DID, Mental Health, Personalities, Memory Loss, Trauma, Multiple Personality Disorder
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