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.

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.

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.