What is Dissociative Identity Disorder?
Dissociative Identity Disorder, DID for short, is a mental disorder in which a person has two or more personalities.
Dissociative identity disorden can develop when a person is subjected to childhood trauma such as neglect, physical abuse, sexual abuse or mental abuse.
There are a few different ways to understand DID, different teachings and believes. Although DID has been mentioned for years and years there is little research on the subject.
These are some symptoms of dissociation;
1. Dissociative amnesia
Amnesia means memoryloss. With dissociative amnesia one cannot remember things from ones life, often stressfull and traumatic situations. Amnesia is not like normal forgetfulness and can occur recently or in the past. There are manny reasons why someone gets amnesia, with DID it often occurs when different alters are in charge of the body and no co-conscious is happening, like if a situation is so stressfull that one person cannot handle it.
When a person experiences derealization it meens that the person experiences the environment as unreal and strange. It can also meen that one does not recognize people one knowes or that everything is like in a haze, surreal.
When a person experiences a depersonalization it is the opposit of derealization. Now it is one self that feels unreal, it can feel like one is outside ones body and that what one is experiencing is not happening for real or that memories are about someone else.
Derealization and depersonalization often happen at the same time but it is also possible to only have one at a time. As a symptom derealiztions and depersonalizations are the most common form of dissociation.
4. Identity confusion and identity variation.
These symptoms can be combined in different variations and it is what combination a person have that determins what diagnosis within the dissociative spectrum that person gets.
To dissociate is normal in everyday life, such as daydreaming or driving a known road and suddenly you are home without really knowing how you ended up there so quickly. A person can also have a dissociative reaktion or episode to a stressfull and overwelming situation, it is the bodys way to cope. This is all normal reaktions.
But when you get the diagnosis DID the symptoms are more extreme. A person with DID have got two or more personalities, also called alters. These alters have there own sence of self-esteem and can act independently of each other, feel, think and be attendent in the past and present.
Another way of processing dissociative disorders is that of structional dissociation, which is when a person can split and become more than one personality because of trauma, regardless of the severity of the trauma. In this theory conditions such as Emotionally unstable personality disorder (EIPS) earlier called borderline personality disorder (BPD) and post traumatic stress disorder (PTSD) are included.
Structional dissociation can be explained by the Emotional part of the personality and the apperent Normal part of the personality. The shattering of the personality can happen when a persons defencive system is activated, such as strong stress or threat. An emotional part is created when the defencive system can no longer cope. This emotional part stays in the threatening and overwhelming situation, while the apperently normal part continues life as if the overwhelming event or situation has not occured. The normal part does not integrate with the emotional part. So the emotional part has no access to the day to day system. Although the apperantly normal part does everything to keep the emotional part or parts out of the loop, the emotional part will try to get attention and remind the apperant normal part of its existance by giving it flashbacks and nightmares. This corresponds with the diagnosis of PTSD (Post traumatic stress disorder), DESNOS (Disorder of extreme stress, not otherwise specified) and DDNOS (Dissociative disorder, not otherwise specified). Which are that the body has one apparently normal part and several emotional parts. However with DID the body/mind has created two or more apparently normal parts/ alters and even more emotional parts.
It is not nessecary for people outside to spot the different alters.
To get the diagnosis DID you also have to have amnesia and reacuring memoryloss, loss of important personal information and of everyday events. The amnesia can be explained by different alters taking comand over the body.
Some alters will be co-concious and some will be oblivious to others. Sometimes one alter can take charge and no other alter will be concious, this is usualy the reason for amnesia of everyday events. Sometimes there is a co-concious which will result in one or several alters knowing whats going on. Most times the co-concious alters can´t act or react to what is happening, to what the leading alter is doing.
There are a few alter roles that are usual with DID, for example; children, protectors or internal perpetrator, but the variations is as wildly spread as there are people with DID alters.
How difficult it is to live with DID does not nessecary depend on how many alters there are in a body. It is not always that a better integration increases the function for the person living with DID. There can sometimes be a higher functionality because the alters are separated. But there can also be utter chaos, with a everyday life that is unmanageble and incomprehensible because of amnesia.
Dissociation is not equal with psycosis. Although there are some overlapping symptoms, like auditory hallucinations. The hallucinations in DID are often a dialogue between or a reaction from different alters inside, with for example schizofrenia the hallucinations are experienced as if they came from outside the body.
With dissociative disorders there are not just emotional symptoms but also physical. For example, one can partly or completely become unable to move, loose feeling and the sencibility to experience pain. One can get blurred visual impressions or become unable to speak or react less to light, sound and touch. This is called psycosymatic symptoms.
A person can go through war and severe trauma without developing DID or other dissociative disorders. It seemes that unprocessed traumas are the foundation for developing DID or other dissociative disorders.
To dissociate can be frightning and creates the feeling of loosing control. Even if one understands the symptoms and were they come from, it is hard to accept them. This is mainly because dissociations arent controlled by willpower and this leeds to a feeling of fright and uncontrollessness. Even though one knowes this is strategies created once because one needed it, they can be utterly hard to cope with in present time.
It is common that ones inside and otside self does not concurre with each others. On the outside it can look like one is functioning ok but on the inside there is chaos. The dissociative symptoms are not dangerous in themselves but for example suicide and self harm is a greater risk when someone has DID.
The most important thing to say is that dissociation can be experienced in so many different way and regardless of how, it often creates great suffering. The stigma in the society does not help either or that many movies portraits people with DID as violent perpertrators when it in fact, most of the time is the complete opposit.
If the dissociation is caused by an acute stressreaction one can become "normal" again by oneselfe after the stressfull event. But for one with DID who has several parts/ alters it is often not possible to integrate and it is not allways the prefered way either. Dissociation is hard and sometimes impossible to get rid of. One can just accept that life is like it is with DID and try to live life as managable as possible, often this meens to finds a way to co-operate between alters and emotions.
Of what we now know DID is mainly caused by childhood trauma, but other types of dissociative conditions are caused by other mental disorders, such as panic attacs, depression or drug use. Dissociative disorders are common when someone experiences overwhelming stress regardless of this being caused by trauma or not.