DID (Dissociative Identity Disorder)

Jenny Ewen, BA, NREMT
Editor-In-Chief
The signs of being intoxicated are typically pretty obvious – flushed cheeks, dizziness, disorientation, slurred speech, memory problems. While it usually requires actually drinking alcohol to reach this state, a rare disease actually creates these symptoms, making someone very drunk without consuming any alcohol at all. This is Auto-Brewery Syndrome (ABS).

For those who suffer from this syndrome, their gut fungi (which is yeast) ferments ingested carbohydrates (similar to the way beer is made through fermentation), resulting in production of ethanol. The ethanol production causes the person to become inebriated with all the same symptoms of actual alcohol intoxication, including the possibility of drunk driving.

What is DID?

DID stands for Dissociative Identity Disorder (or formerly known as Multiple Personality Disorder). Dissociating is when you detach from reality, such as getting lost in a moment or daydreaming. DID is a severe form of dissociation – when someone completely changes their personality while dissociating.

A person with this rare condition has their identity split into multiple and distinct personalities. These personality states (also known as “alters”) may take control of the individual one at a time, changing the original personality and identity completely. Typically it also presents with extensive memory loss after an alter has taken over.

Why Do People Develop DID?

This identity fragmentation is not brought on by drugs, medication, or medical conditions, which is why it is considered a psychological disorder. People with DID are often victims of severe abuse or trauma, typically during childhood. Ninety percent of people with diagnosed DID in the US, Canada, and Europe report having experienced childhood abuse. DID can start at any age – often in conjunction with Post Traumatic Stress Disorder (PTSD).

Due to these factors, DID is considered by some to be a result of a coping mechanism – when a person dissociates themselves from a situation that they find far too emotionally difficult to cope with. The new identity can cope better with that particular situation.

Some people believe that DID patients can be easily hypnotized, and therefore symptoms could appear as a result of therapists’ suggestions. However, brain imaging studies have shown proof of identity transitions in certain individuals.

Symptoms of DID

In 1994, the name for the disorder was officially changed from Multiple Personality Disorder to DID. The new name gives a better understanding of the condition – while it is portrayed as a person becoming other people through personality changes, the condition is actually a splintering of the same identity.

DID is essentially an inability to integrate everything that shapes one’s personality (memory, consciousness, sense of identity) into one personality – instead, different pieces of this identity split among personalities. Each personality alter presents with a distinct history, identity, and self-image – all of which contrasts with the original personality and identity of the individual. Specific stressors, situations, or emotions can make an alter appear.

The alters themselves are aware of each other, but may deny this knowledge, or appear to be in conflict with each other. Individuals with DID report feeling that they have suddenly become observers of themselves, and are inundated with streams of thought that they have no control over. They have also reported that they suddenly feel different in their bodies (such as feeling like a young child or huge and muscular).

Alters can present with different ages, sex, or race, and distinct speech, postures, and gestures. “Switching” is the process from the individual to an alter, or an alter to another alter – it can take seconds to days to complete this switch. To be diagnosed, an individual has at least two alters, but there has been documentation of having as many as one hundred alters in one individual.

A person with DID may not have a strong sense of self or identity – they may not be sure what their values are, what they like to do, what their sexual orientation is, or what their ambitions are.

Diagnosis

Diagnosis of DID is debated among mental health professionals, since some believe it is simply a version of other psychological disorders, such as borderline personality disorder. It can take years to diagnose DID since it can be misdiagnosed as many other psychiatric disorders. Typically DID is diagnosed in conjunction with depression or anxiety.

Certain symptoms are required to diagnose DID, including:

  • Two or more distinct identities or personality states
  • The alters present with a change in identity factors: sense of self, sense of agency, behavior, consciousness, memory, perception, cognition and motor function
  • Frequent gaps in memories that are not ordinary forgetfulness
  • Significant problems in normal social functioning due to the disorder
  • Symptoms of depression, anxiety, and suicidal thoughts
  • Sleep disorders (including insomnia, sleep walking, and night terrors)
  • Hallucinations

Treatment

There’s no cure for DID, similar to many other psychiatric disorders. Certain medications may help with the depression, anxiety, and PTSD that can go along with DID, but DID treatment is rooted in psychological help. The most effective treatment is therapy – talk therapy, psychotherapy, hypnotherapy, or art/movement therapy.

The individual must be committed to their treatment and partake fully in therapy for it to be successful long-term treatment. The goal of therapy is to merge the identities back into one so the individual can be successful in their personal and professional lives.

Sources & More Information

National Alliance on Mental Illness, “Dissociative Disorders” https://www.nami.org/Learn-More/Mental-Health-Conditions/Dissociative-Disorders

Psychology Today, “Dissociative Identity Disorder (Multiple Personality Disorder)” https://www.psychologytoday.com/conditions/dissociative-identity-disorder-multiple-personality-disorder

WebMD, “Dissociative Identity Disorder (Multiple Personality Disorder)” https://www.webmd.com/mental-health/dissociative-identity-disorder-multiple-personality-disorder#1

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