What type of disorder is dissociative identity disorder

Overview

Dissociative identity disorder, previously known as multiple personality disorder, is a type of dissociative disorder. Along with dissociative amnesia and depersonalization-derealization disorder, it’s one of the three major dissociative disorders.

Dissociative disorders can be found in people of all ages, races, ethnicities, and backgrounds. The National Alliance on Mental Illness (NAMI) estimates that about 2 percent of people experience dissociative disorders.

The most recognizable symptom of dissociative identity disorder (DID) is a person’s identity being involuntarily split between at least two distinct identities (personality states). Other symptoms might include:

  • Dissociative amnesia. This is a type of memory loss — beyond forgetfulness — that’s not associated with a medical condition.
  • Dissociative fugue. A dissociative fugue is an episode of amnesia that involves not having memory of certain personal information. It may include wandering off or a detachment from emotion.
  • Blurred identity. This occurs when you feel like there are two or more people talking or living in your head. You might even feel like you’re possessed by one of several other identities.

It’s important to note that according to the Diagnostic and Statistical Manual of Mental Disorders, many cultures around the globe include possession as part of a normal spiritual ritual or practice. This isn’t considered a dissociative disorder.

Interacting with someone with dissociative identity disorder

If you believe someone you know has DID, you may get the impression that you’re communicating with not one, but several different people, as the person switches between personalities.

Often, each identity will have their own name and characteristics. They’ll each commonly have an unrelated detailed background with obvious differences in age, gender, voice, and mannerisms. Some might even have individual physical characteristics such as a limp or poor vision that requires glasses.

There are often differences in each identity’s awareness and relationship — or lack thereof — to the other identities.

Dissociative identity disorder — along with other dissociative disorders — usually develop as a way to deal with some type of trauma they’ve experienced.

According to the American Psychiatric Association, 90 percent of people with dissociative identity disorder in the United States, Canada, and Europe have experienced childhood neglect or abuse.

The primary treatment for DID is psychotherapy. Also known as talk therapy or psychosocial therapy, psychotherapy is focused on talking with a mental health professional about your mental health.

The goal of psychotherapy is to learn how to cope with your disorder and to understand the cause of it.

Hypnosis is also considered by some to be a useful tool for DID treatment.

Medication is sometimes used in the treatment of DID, as well. Although there are no medications specifically recommended for the treatment of dissociative disorders, your doctor might use them for associated mental health symptoms.

Some commonly used medications are:

  • anti-anxiety medications
  • antipsychotic drugs
  • antidepressants

If you can identify with any of the following, you should make an appointment to see your doctor:

  • You are aware — or others observe — that you involuntarily and unwillingly have two or more personalities or identities that have a distinctly different way of relating to you and the world around you.
  • You experience beyond ordinary forgetfulness, like extensive gaps in your memory for important personal information, skills, and events.
  • Your symptoms aren’t caused by a medical condition or from the use of alcohol or drugs.
  • Your symptoms are causing you problems or stress in important areas such as your personal life and at work.

If you identify with the symptoms of dissociative identity disorder, you should make an appointment to see your doctor.

If your friend or a loved one is displaying the common symptoms, you should encourage them to seek help. You can also contact the NAMI HelpLine at 1-800-950-6264 or email for support.

Dissociative disorders are characterized by an involuntary escape from reality characterized by a disconnection between thoughts, identity, consciousness and memory. People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder.

Up to 75% of people experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes. Women are more likely than men to be diagnosed with a dissociative disorder. 

The symptoms of a dissociative disorder usually first develop as a response to a traumatic event, such as abuse or military combat, to keep those memories under control. Stressful situations can worsen symptoms and cause problems with functioning in everyday activities. However, the symptoms a person experiences will depend on the type of dissociative disorder that a person has.

Treatment for dissociative disorders often involves psychotherapy and medication. Though finding an effective treatment plan can be difficult, many people are able to live healthy and productive lives.

Symptoms

Symptoms and signs of dissociative disorders include:

  • Significant memory loss of specific times, people and events
  • Out-of-body experiences, such as feeling as though you are watching a movie of yourself
  • Mental health problems such as depression, anxiety and thoughts of suicide
  • A sense of detachment from your emotions, or emotional numbness
  • A lack of a sense of self-identity

The symptoms of dissociative disorders depend on the type of disorder that has been diagnosed. There are three types of dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM):

  • Dissociative Amnesia. The main symptom is difficulty remembering important information about one’s self. Dissociative amnesia may surround a particular event, such as combat or abuse, or more rarely, information about identity and life history. The onset for an amnesic episode is usually sudden, and an episode can last minutes, hours, days, or, rarely, months or years. There is no average for age onset or percentage, and a person may experience multiple episodes throughout her life.
  • Depersonalization disorder. This disorder involves ongoing feelings of detachment from actions, feelings, thoughts and sensations as if they are watching a movie (depersonalization). Sometimes other people and things may feel like people and things in the world around them are unreal (derealization). A person may experience depersonalization, derealization or both. Symptoms can last just a matter of moments or return at times over the years. The average onset age is 16, although depersonalization episodes can start anywhere from early to mid childhood. Less than 20% of people with this disorder start experiencing episodes after the age of 20.
  • Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by alternating between multiple identities. A person may feel like one or more voices are trying to take control in their head. Often these identities may have unique names, characteristics, mannerisms and voices. People with DID will experience gaps in memory of every day events, personal information and trauma. Women are more likely to be diagnosed, as they more frequently present with acute dissociative symptoms. Men are more likely to deny symptoms and trauma histories, and commonly exhibit more violent behavior, rather than amnesia or fugue states. This can lead to elevated false negative diagnosis.

Causes

Dissociative disorders usually develop as a way of dealing with trauma. Dissociative disorders most often form in children exposed to long-term physical, sexual or emotional abuse. Natural disasters and combat can also cause dissociative disorders.

Diagnosis

Doctors diagnose dissociative disorders based on a review of symptoms and personal history. A doctor may perform tests to rule out physical conditions that can cause symptoms such as memory loss and a sense of unreality (for example, head injury, brain lesions or tumors, sleep deprivation or intoxication). If physical causes are ruled out, a mental health specialist is often consulted to make an evaluation.

Many features of dissociative disorders can be influenced by a person’s cultural background. In the case of dissociative identity disorder and dissociative amnesia, patients may present with unexplained, non-epileptic seizures, paralyses or sensory loss. In settings where possession is part of cultural beliefs, the fragmented identities of a person who has DID may take the form of spirits, deities, demons or animals. Intercultural contact may also influence the characteristics of other identities. For example, a person in India exposed to Western culture may present with an “alter” who only speaks English. In cultures with highly restrictive social conditions, amnesia is frequently triggered by severe psychological stress such as conflict caused by oppression. Finally, voluntarily induced states of depersonalization can be a part of meditative practices prevalent in many religions and cultures, and should not be diagnosed as a disorder.

Treatment

Dissociative disorders are managed through various therapies including:

  • Psychotherapiessuch as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT)
  • Eye movement desensitization and reprocessing (EMDR)
  • Medications such as antidepressants can treat symptoms of related conditions

Because dissociative disorders appear on the trauma spectrum, many patients may have conditions associated with trauma, as well as additional trauma-based conditions.

  • Posttraumatic stress disorder (PTSD)
  • Borderline personality disorder (BPD)
  • Substance use disorders / Dual Diagnosis
  • Depression
  • Anxiety

What type of disorder is a dissociative disorder?

Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.

Is dissociative identity a personality disorder?

Dissociative identity disorder is not a personality disorder. It is the result of a natural way of coping with sustained childhood trauma. Our page on the causes of dissociative disorders has more information.

What is dissociative identity disorder also known as?

(Multiple Personality Disorder) In dissociative identity disorder, formerly called multiple personality disorder, two or more identities alternate being in control within the same person.

Is dissociative identity disorder psychopathy?

In the movies, people with multiple personality disorder are nearly always psychopaths. But according to these contributing academics, most people who have dissociative identity disorder, as the condition is now known, aren't psychopaths – they're victims of society's most heinous crimes.