How to Recognize Dissociative Identity Disorder (DID)

Once called Multiple Personality Disorder (MPD), Dissociative Identity Disorder (DID) is an illness where the individual's reality is so unbearable, that their personality becomes fragmented into two or more distinct personalities. Up to 97 percent of DID patients suffered childhood abuse but some have had other traumas. One sign of DID is that often these patients refer to themselves as "we" or "he or she" rather than "I" without realizing they're doing that. Many patients have early amnesia--huge gaps in their backgrounds beginning in mid-childhood or the early teen years.

Instructions

1. Understand that dissociation occurs in the face of unbearable childhood anxiety, pain or trauma that causes a disintegration of the ego or a splitting off of certain mental processes from the conscious mind. DID also causes memory loss. It is usually a response to childhood trauma and the lack of protection against it. Some say as many as 97 percent of those with DID suffered childhood abuse, but there have been cases where trauma other than abuse, such as loss due to a death or long illness, were found.

2. Know the diagnosis. DID is now considered a secondary diagnosis that is associated with borderline personality disorder (longstanding pattern of instability in relationships, behavior, mood and self image) and emotional dysregulation (the inability to show normal emotional responses). It is not thought that DID can occur alone.

3. Know the symptoms of DID. Myriad symptoms can come into play in DID, although all patients do not exhibit them all. Symptoms include phobias and panic attacks, time distortion and lapses in memory, depression, anxiety, evidence of self mutilation, sexual dysfunction, eating disorders, suicidal tendencies, Post Traumatic Stress Disorder (PTSD) and myriad physical complaints.

4. Understand the feelings of DID patients. Many experience feelings of depersonalization (feeling detached from one's self) and watching rather than living one's own life. Many report feeling that everything and everyone looks and feels strange to them (derealization). They are further disoriented when they are told that they've done things or gone places they don't remember or they find personal items (journals, clothing, photos) that is with their belongings that they can't remember buying or using.

5. Know what to do if you suspect DID. Physical causes for symptoms should always be ruled out first with a physical exam, which may include blood work, X-rays and a careful consideration of all drugs and supplements being taken. Certain brain and head injuries can mimic DID symptoms, as can some drugs, intoxication and sleep deprivation. If these causes are ruled out, a psychiatrist should be consulted.

6. Understand the prognosis. Some patients have a complete recovery while others, because they are complicated by other disorders, have a slower recovery. Some, however, while still within the influence of those who abused them, don't recover but instead are helped by only the relief of their symptoms.

7. Know the treatment options. Treatment is likely to include some combination of the following methods: Behavior therapy, psychotherapy, hypnosis, cognitive therapy, family therapy and Expressive therapy (can include dance, poetry, art or music). Much depends on what other disorders or conditions have to be dealt with.

8. DID is a rare occurrence. Often the person with it has no knowledge of it, other than memory lapses and reports of behaviors they don't remember or strange clothing or belongings around. Usually a secondary diagnosis, DID must have medical attention to be treated. It doesn't play itself out or spontaneously disappear. If you or someone you love is showing signs of DID, get help as soon as possible. Look for a psychiatrist who has treated DID patients before since it is so rare that not all doctors have dealt with it.