One of the stigmas that frustrate me the most is that of “multiple personality disorder.”
The most important thing to know about this topic is that there is no such thing as multiple personality disorder.
That cluster of symptoms is called “dissociative identity disorder” or DID. Most of us have experienced mild dissociation, such as daydreaming or getting lost in thought. However, DID is a much more severe form of those feelings and creates a lack of connection in a person’s thoughts, memories, feelings, actions and/or sense of identity.
This disorder typically arises from severe early childhood extreme, repetitive physical, sexual and/or emotional abuse. Dissociation serves as a coping mechanism for victims of that kind of abuse – the person literally dissociates him or herself from a situation that is too traumatic, painful or violent to assimilate with his or her conscious self, often creating one or more alternate identities.
While these symptoms can arise from other disorders, such as borderline personality disorder, DID can also stand on its own and is a very real, very terrifying disorder.
The Diagnostic and Statistical Manual of Mental Disorders (DSM), the sort of encyclopedia of all mental health illnesses, also presents depersonalization and derealization disorders, which are more mild forms of DID.
DID is characterized by the presence of two or more distinct or split identities or personality states that continually have power over a person’s behavior. When one “alter” (or identity) is in control, the person cannot recall key personal information about him or herself that is too far-reaching to be explained away as mere forgetfulness.
Each alter has its own age, sex or race; each has his or her own postures, gestures and distinct ways of talking, sometimes even speaking in languages that the person has no fluency in. Alters can be imaginary people or even animals.
As each personality reveals itself and takes a turn in controlling the person’s behavior and thoughts, a process called “switching” occurs; this process can take minutes to days. Symptoms of switching include headache, amnesia, time loss and trances.
DID not only manifests as split identities but also in other ways: moments of depersonalization, feeling like you aren’t really yourself and you aren’t in your own body and sometimes looking in the mirror and not recognizing the person there; derealization, a feeling like the world is not real or it looks foggy and far away; amnesia, the inability to recall important personal details that can’t be blamed on ordinary forgetfulness; and identity alterations, feeling like you don’t know who you are and you can’t define things about yourself, such as your political or religious views or even sexual orientation.
These dissociated states do not represent alternate personalities but rather a disjointed sense of reality and identity.
With the type of amnesia that is typically associated with DID, different alters remember different types of autobiographical information. There is usually a “host” personality within the individual; that is the personality that identifies with the person’s real name.
However, the host personality is usually unaware of the presence of other personalities. When another personality takes control, the person later only remembers blackout periods of time loss.
Each personality serves a diverse role in helping the individual cope with his or her life.
There are an average of two to four personalities present when a patient is initially diagnosed; 13 to 15 personalities are generally uncovered during the course of treatment; and while unusual, there have been cases of DID that presented with more than 100 personalities.
Each alter arises due to different environmental triggers. Remember, these personalities were created to help deal with trauma.
DID patients also experience a myriad of other symptoms, such as depression, mood swings, suicidal tendencies, sleep disorders, anxiety disorders, alcohol and drug abuse, psychotic-like symptoms and eating disorders.
Treatment for DID requires a high level of commitment because it can be quite long-term. Antipsychotic medications can be used to manage symptoms, but the most effective forms of treatment are psychotherapy, hypnotherapy and/or adjunct therapies such as art or music therapy.