Dissociative identity disorder (DID)

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Also known as multiple personality disorder (mpd)

If you experience a dissociative disorder you will be coping with many challenges. It can be frightening for you and your loved ones.

Dissociative identity disorder was previously known as multiple personality disorder (MPD). The media and popular culture still talk about MPD.

DID is a complex and quite rare condition where more than one personality exists within you. You may in fact be unaware of this and usually other people will tell you of your other identities. Each identity within you has their own pattern of thinking and behaving, and this may be quite different from your own established patterns. In fact, each separate personality controls your behaviours and thoughts at the times they are present.

Dissociation is a mental process of disconnecting from your thoughts, feelings, memories or sense of identity.

The causes of DID are as complex as the condition, but mental health professionals agree that ongoing trauma in childhood is the leading contributor. The trauma causes the child to “disconnect” from what is happening to them during the times of extreme stress. Trauma can include repeated emotional, physical or sexual abuse that usually begins before a child is five years of age, and during that time there is no adult around who provides comfort or safety.

Children remain dissociated into their teens and adulthood. This can lead to other problems as they struggle to make sense of the world around them.

If you have DID, you may experience depression, mood swings, anxiety and panic attacks, suicidal thoughts and feelings, self-harm, headaches, hearing voices, sleep disorders, phobias, alcohol and drug abuse, obsessive-compulsive behaviour and various physical health problems.

If you feel suicidal or don’t feel you are able to keep yourself safe, you may need urgent help. It is important that if you are having any suicidal thoughts you seek help immediately.

Treatment for DID is based on your personal needs and aspirations. It can take time working with a specialist in DID care to make progress and help you achieve your goals, but you can achieve significant progress in taking control of your life.

Signs to look for (symptoms)

Things you may feel include:

  • Feeling disconnected from your emotions (emotionally numb).
  • Feeling detached from what is happening around you, like you are watching a movie of yourself.
  • Feeling as though the world is distorted or not real. 
  • Having problems remembering things, and having gaps in your memory (losing time).
  • Sudden and unexpected shifts in mood, eg, feeling very sad for no reason.
  • Hearing voices, or smelling or seeing things that only you can see or smell.
  • Feeling as though there are different people inside you.
  • Referring to yourself as “we”.
  • Being unable to recognise yourself in a mirror.
  • Significant memory lapses such as forgetting important personal information.
  • Knowing about things you don’t remember learning, like driving.
  • Not recognising places or people that others think you should.

It’s often those nearest people experiencing DID who will see signs that the person they are currently talking to does not have the same personality and mannerisms that the person they were speaking to yesterday, or that morning, or even a few moments ago had.

The current identity may have a completely different view and perspectives from what the person who is normally present thinks. They may project mannerisms and speech from a different age or gender. They may also lose skills between personalities, such as not knowing how to drive one day, yet knowing how to drive the next day.

How the doctor determines if you have DID (diagnosis)

DID can be difficult to diagnose as any signs and symptoms identified during routine mental health assessments (eg, for depression, anxiety, insomnia, self-harming, hearing voices) are common to other mental health problems. And so a standard assessment will often not identify a dissociative disorder. Thus working with a doctor who specialises in this condition is useful.

It's also important you take the time to talk with your doctor and help them understand what you or your loved one is experiencing.

Your doctor will help you find the right mental health professional to diagnose the condition you have, then they will work alongside you to help you feel more in control and live the life you choose.

Treatment options

Treatment of DID can involve a number of aspects, each of which can be tailored to your individual need. It’s important you choose a mental health professional with experience in treating dissociative conditions. Treatment options include:

Medication

There is no specific medications to help DID, but your doctor may prescribe medication to help with other symptoms, such as not being able to sleep, or anxiety or depression. If you are prescribed medication you are entitled to know:

  • the names of the medicines
  • what symptoms they are supposed to treat
  • how long it will be before they take effect
  • how long you will have to take them for and what their side effects (short and long-term) are.

If you are breast feeding no medication is entirely safe. Before making any decisions about taking medication at this time you should talk with your doctor about the potential benefits and problems.

Talking therapies

These are the therapies most recommended for DID. A strong therapeutic relationship, a safe therapeutic environment, appropriate boundaries, development of no self-harm contracts, an understanding of personality, stress management, working through traumatic and dissociated material, are some of the processes a therapist might use.

It may take a long time, often years for you or your loved one, and their trusted therapist to cover all the agreed goals for treatment. That is expected and beneficial.

All types of therapy/counselling should be provided in a manner that is respectful to you and with which you feel comfortable and free to ask questions. It should be consistent with and incorporate your cultural beliefs and practices.

Complementary therapies

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it. Certain complementary therapies may enhance your life and help you to maintain wellbeing. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.

Important strategies to support a loved one with DID

Family, whānau and close friends of someone with DID may find the following strategies important and useful:

  • Learn what you can about DID, its treatment and what you can do to assist recovery. Sometimes the person with DID finds it difficult to explain to others how hard it is for them, or they may have trouble understanding what is happening to them and their behaviour.
  • Listen with acceptance and understanding to whatever your loved one chooses to share. Also remember to talk to them in a way that makes sense to the person in front of you. If it a child’s personality, maybe use colouring in pencils and paper to communicate.
  • Help the person to recognise stress and find ways of coping with it. This may include helping to solve problems that are worrying them. 
  • Find ways of getting time out for yourself and feeling okay about this. It is critical to do what is needed to maintain your own wellbeing. 
  • Be cautious about touching and intimacy – ask the person what is OK.
  • Don’t overlook any situation or suggestion from the person experiencing DID that they are suicidal and wanting to end their life. Get support for this immediately.
Thanks to Janet Peters, registered psychologist for reviewing this content. Date last reviewed: May 2015.