Dissociative identity disorder, often known as DID, is a mental health problem that manifests itself when an individual has many identities that operate independently of one another. It is possible to refer to these identities as “alters” or “personality states.” These identities possess their own awareness, memories, and even personalities. According to estimates provided by researchers, around 1.5% of the total population of the world is affected by this illness.

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Dissociative Identity Disorder

According to studies, the most common cause of dissociative identity disorder (DID) is severe and repeated childhood trauma. Alternate identities, also known as alters, often include a variety of traumatic experiences and may exhibit behaviours that are either self-destructive or problematic.

The gaps in memory that persons with dissociative identity disorder experience as a result of switching between their alters may have an impact on their day-to-day functioning.

Patients with dissociative identity disorder (DID) may benefit from treatment and assistance in order to more securely navigate their fluctuating alters and process a variety of traumatic events. Doctors often make incorrect diagnoses of dissociative identity disorder (DID), and many persons may not acquire a correct diagnosis until much later in life.

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People who have dissociative identity disorder (DID) are not more likely to engage in violent behaviour than the average population, and they are able to lead lives that are satisfying.

Symptoms

People who suffer from dissociative identity disorder (DID) have a “primary” personality state, but they also have a variety of alters that take control of their awareness. It is common for the main personality state to be unaware of the presence of many alters, which may result in painful gaps in memory, deficits in functioning, and a variety of other symptoms.

The Presence of Two or More Alters

Alters have their own characteristics, including their identities, memories, behaviours, and even preferences (such as their preferred meals and articles of clothing). Alternates often have their own names and might be of varying ages and genders. Alternates are also available.A person who lives with dissociative identity disorder (DID) typically has thirteen alters, although they might have less or much more than that.

Examples of alters include:

An infant or young kid who often sheds tears, expresses a need to be comforted, and recalls particular painful occurrences
An angry adolescent who acts uncontrollably and participates in behaviour that is damaging to himself
An individual who is considered to be a “leader” and who is cognizant of the other influences

Switching Between Altered States

Involuntary switching between alters is a symptom of dissociative identity disorder (DID). The occurrence of this flip might take place unexpectedly and is often brought on by factors such as stress. There is a possibility that other individuals will be unable to see when a changeover is occurring or has occurred.

Signs of switching between alters include:

Eye blinking or rolling
Changes in posture
Appearing to be in a trance

Amnesia

In most cases, a person who suffers from dissociative identity disorder does not recall ever being in a state of altered consciousness. These lapses in memory may be distressing and have an effect on functioning, which can ultimately result in an inability to retain vital information that is encountered on a daily basis.

In addition, a person who suffers from dissociative identity disorder may have significant gaps in their recollections of their upbringing or may have a limited remembrance of the traumatic experiences they went through.

Additional Symptoms

Some of the symptoms that persons with dissociative identity disorder (DID) may encounter include, but are not limited to, various alterations, difficulties functioning, and memory problems.

Anxiety
Depression
Symptoms associated with trauma (e.g., hypervigilance, flashbacks)
Somatic symptoms (e.g., headaches, seizures, or gastrointestinal issues)
Self-harm
Suicidal ideation or attempts

Causes

DID is often the outcome of severe and repeated traumatic experiences that occurred during early infancy, including repeated instances of sexual and physical abuse.Researchers think that excessive and frequent dissociation produces a collapse of memory and sense of self in persons who acquire dissociative identity disorder (DID).

Dissociation, also known as the detachment between one’s body, mind, and sense of self, is a typical experience for people who have survived traumatic experiences.

In the case that a person experiences a horrific incident, for instance, they may feel separated from their body in order to make the experience more bearable. However, a kid who develops dissociative identity disorder (DID) takes this survival strategy one step further by dissociating into distinct identities (alters) in order to make their maltreatment more bearable.

Note that not everyone who goes through a traumatic event as a youngster will go on to acquire dissociative identity disorder (DID). According to one idea, in order for a person to acquire dissociative identity disorder (DID), they must have all four of the following elements present:

An ability to dissociate
Overwhelming traumatic experiences that distort reality
Creation of alters with specific names and identities
Lack of external stability, leading the child to rely on self-soothing

Other factors that may increase one’s risk of developing DID include:

Early onset of trauma (before the age of 5)
Abuse at the hands of attachment figures (e.g., parents or guardians)
Disorganized attachment style
Social isolation
Chronic stress

Diagnosis

People wait anywhere from five to twelve years, on average, before they are given an accurate diagnosis. This is due, in part, to the fact that diagnosing dissociative identity disorder (DID) sometimes requires numerous evaluations carried out over an extended period of time, a comprehensive personal history gathered from a variety of sources (including friends and family), and medical examinations that exclude other potential causes for the symptoms.

People who suffer from dissociative identity disorder (DID) may have difficulty correctly self-reporting their symptoms or remembering their whole trauma histories due to gaps in their memory.

Individuals who suffer from dissociative identity disorder (DID) often make the mistake of being misdiagnosed with other mental diseases, such as borderline personality disorder, and may come across medical professionals who are either dubious or uninformed of their condition.

The following are some of the evaluation methods that a healthcare professional may employ in order to diagnose dissociative identity disorder (DID):

Dissociative Experiences Scale (DES)
The Dissociation Questionnaire (DIS-Q)
The Multidimensional Inventory of Dissociation Dissociative Disorders Interview Schedule (DDIS)
Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D)

Treatment

The aim of therapy for dissociative identity disorder (DID) might differ from person to person. Some people seek therapy with the intention of integrating their identities and reducing or eliminating the amount of changes they are experiencing as a result of their condition.

When it comes to other individuals, the key objectives of therapy are to enhance the level of collaboration between the alters and to enhance the individual’s general quality of life.

The majority of mental health practitioners who treat dissociative identity disorder (DID) use a therapy method that consists of three phases:

Establishing safety and stabilization: During this phase, the focal point is on the management of behaviours that pose a danger to one’s life, such as drug abuse, self-harm, or suicidal tendencies. In order to assist a person with dissociative identity disorder (DID) in generating a more immediate sense of safety, mental health professionals teach them skills for emotional control and anchoring.

Confronting and working through traumatic memories: During this stage, a person may engage with a clinician to process previously experienced traumatic events. It is possible that this may be seen as the safe accessing of painful memories via the use of several alters.

Identity integration/cooperation: Providers concentrate their attention on a person’s interaction with their “whole” self throughout this part of the process. The objectives of this phase are customized and are determined by the requirements and considerations of the individual in terms of healing and rehabilitation.

Providers of mental health services may also employ psychotherapy, commonly known as talk therapy, to assist individuals living with dissociative identity disorder (DID) in managing their symptoms and processing traumatic experiences.These therapies include:

Trauma-focused cognitive behavioral therapy (TF-CBT)
Dialectical behavioral therapy (DBT)
Eye movement desensitization and reprocessing (EMDR)

Living With DID

There is a dismal prognosis (or outlook) for those who have dissociative identity disorder (DID) if they do not get the appropriate therapy. To put this into perspective, if an individual is provided with a proper diagnosis and appropriate treatment, they are able to lead lives that are satisfying.

It is possible for persons who have dissociative identity disorder (DID) to work toward the creation of mechanisms that assist them in securely navigating their fluctuating alters or to seek to merge their alters into a single, main identity with the assistance of a mental health specialist.

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One example of this would be the use of techniques for dealing with forgetfulness, such as making use of support networks and writing things down in order to recall them in the event that their identity is changed.

The treatment process may be extensive and challenging, and it often requires processing fresh memories of trauma as well as continuing safety planning in the event that suicide or self-harming behaviours are involved.

Assisting persons with dissociative identity disorder (DID) in putting the pieces of their lives together, as well as improving their general functioning and quality of life, may be accomplished by becoming more acquainted with their alters and learning new knowledge about their history.