Dissociative identity disorder (DID)

Learn about DID, treatment options and supporting a loved one.
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Found in: Mental Health Conditions
Date: September 2022

About dissociative identity disorder (DID)

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 structure 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. It is thought to be a coping mechanism, where the person literally shuts off or dissociates themselves from a situation or experience that is too violent, traumatic, or painful to assimilate with their conscious self. DID is a survival mechanism for the person.

The causes of DID are as complex as the condition, but mental health professionals agree that chronic ongoing trauma throughout 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 or neglect, usually beginning before a child is five years of age and with no adult around who provides comfort or safety. The trauma can also be caused by an accident, disaster or medical event. As many as 99% of people who develop DID have a history of traumatic childhood abuse or other trauma.

The person’s identities remain dissociated as their body matures through the teen years into adulthood. This ongoing disconnection between identities can lead to other problems as they struggle to make sense of their experience of the world.

People who live with DID may experience depression, mood swings, anxiety and panic attacks, suicidal thoughts and feelings, self-harm, headaches, time loss, trances, hearing voices, sleep disorders, phobias, alcohol and drug abuse, obsessive-compulsive behaviour and various physical health problems. It can be distressing to find items that you don’t recognise or to find out you have done things you do not remember. Sometimes people find themselves in places they do not know.

It is important to stress that people who live with DID are in no way violent or dangerous. This is a misconception that comes from pop culture. 

If you feel suicidal or don’t feel you are able to keep yourself safe, you 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 (indicators and experiences)

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 or watching from within yourself, with someone else in control
  • feeling as though the world is distorted or you are experiencing something that is not your life
  • having problems remembering things, and having gaps in your memory (losing time)
  • experiencing flashbacks
  • desire to self-harm
  • difficulty remembering periods of time
  • sudden and unexpected shifts in mood, e.g. feeling very sad for no reason
  • hearing voices, smelling things or seeing things that others cannot
  • feeling like your memories are not your own – you remember them, but don’t remember being “in” them
  • 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, or forgetting skills you previously had
  • not recognising places or people that others think you should.

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

The current identity may have a completely different view and perspectives from the person who is normally present. 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. Remember not all shifts will be this dramatic – for some people, the signs of DID can be much more subtle.

' There are many different ways of describing people’s multiplicity outside of the language of ‘disorder’. Pluralism, multiplicity, fragmented selves and internal collectives are some. People who live with DID may refer to their identities in many different creative ways: parts, aspects, flatmates, personalities, internals – those are just some. People form beautiful ways of describing what they may call ‘systems’, ‘committees’, internal worlds. Finding out the language and way that works for your internal collective is important, and special to you. '

– Individual with lived experience of DID

How the clinician determines if you have DID (diagnosis)

DID can be difficult to diagnose, as any signs and symptoms identified during routine mental health assessments (e.g. for depression, anxiety, insomnia, self-harming, hearing voices) are common to other mental health problems. A standard assessment will therefore often not identify a dissociative disorder. 

It is therefore useful to work with a clinician who specialises in this experience. It’s 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 experience 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 needs. It’s important you choose a mental health professional with experience in treating dissociative conditions.  

The goals in therapy may include integrating different personalities into one cohesive personality. It may also be that your different personalities remain in your life but you find better ways to relate to them, so they don’t cause you distress. Certainly, therapy will help you to process any trauma you are carrying. Treatment options include:

Talking Therapies

Therapeutic alliance

Due to the trauma that people with DID have often experienced, building a trusting relationship with a therapist is essential. A strong therapeutic relationship includes a safe environment and appropriate boundaries. The therapist should have a good understanding of personality and know how to teach stress management and work through traumatic and dissociated material. 

Useful types of therapy may include sensorimotor and somatic psychotherapy, to address the physical disconnect from the body in trauma, and the body’s flashbacks to trauma. Trauma-focused cognitive behavioural therapy (TF-CBT) may help process trauma and challenge unhelpful core beliefs. Dialectical behavioural therapy (DBT) may provide useful skills for managing intense emotions and tolerating distress as trauma is being processed.

It may take a long time, often years, for you or your loved one and a trusted therapist to cover all the agreed goals for treatment. That is expected and beneficial. As you work through therapy, you can expect your life to improve bit by bit along the way.

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

' It can be difficult to find a therapist where you feel understood and that you can work with successfully. This is a process. Many people go through a period of time with several different diagnoses before they find one that makes sense and helps you move forward. Don’t give up, ask around and keep trying! '

– Individual with lived experience of DID


There are no specific medications to help DID, but your doctor may prescribe medication to help with other issues you may be experiencing, such as not being able to sleep, 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 
  • what the process of stopping medication might look like.

Withdrawing from the medicine (i.e. stopping taking them) can have complex effects. Make sure you talk this through thoroughly with your doctor and are aware of supports that are available.

Even if you are breastfeeding, medication might be an option. It is best to discuss with your health provider what might be on offer for you.

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, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.

' I moved from trying to conform, to sitting with the discomfort of not being like other people, to actually celebrating and being proud of our difference. This has been a core part of moving towards wellbeing. As long as we tried to conform, we always felt lacking… I think it is most important that people know that life gets better, that identities can work together and craft beautiful lives. It is hard work, but it is possible. Don’t believe the myths; write your own story '

– Individual with lived experience of DID

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 is a child’s personality, maybe use colouring-in pencils and paper to communicate.
  • Try to learn what each identity or part enjoys and likes. This will help you spend time with them and understand their boundaries. The process can be frustrating and confusing – it is important to find support and link with others who may have experience with the process.
  • 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 okay.
  • 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.

' What has helped me? Accepting that our way of being was understandable in the context of our life, even if it was not understandable to people generally. That our way of being didn’t equal disorder, rather strength and a desire for life. And that actually being able to see the world through multiple lenses meant we were able to see different worldviews and have different skills. '

– Individual with lived experience of DID

Thanks to Jenni Beckett, clinical psychologist, and members of the Thriving Madly peer support network in Christchurch for reviewing this content. Date last reviewed: September, 2022.

Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.