DISSOCIATIVE IDENTITY DISORDER (DID)

INTRODUCTION

Dissociative identity disorder, formerly referred to as multiple personality disorder, is characterized by a person’s identity fragmenting into two or more distinct personality states. People with this condition are often victims severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

DID

Dissociative identity disorder (DID) is a rare condition in which two or more distinct identities, or

personality states, are present in and alternately take control of an individual. DIDs involve problems with memory, identity, emotion, perception, behavior and sense of self. It is thought to arise due to several factors that may include trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self.

In many parts of the world, people may relate this with the possession.  Possession-like identities are claimed to be under the control of a spirit or other supernatural entity. Possession states become a disorder only when they are unwanted, which causes distress or impairment. They are not accepted as part of a cultural or religious practice.

OTHER TYPES OF DISSOCIATIVE  DISORDER

According to Diagnostic and Statistical Manual of Mental Disorders, various other types of dissociative disorders are :

1. Dissociative amnesia
2. Depersonalization / derealization disorder.

SYMPTOMS

• DID is identified by the presence of two or more distinct personality states that have control over the person’s behavior.
• Transitions from one identity to another are frequently due to psychological stress.                                                            In the possession-form of DID, alternate identities are visibly obvious to people around the individual.                In non-possession-form cases, most individuals do not potray their change in identity for long periods of time.

• The disruption in identity involves a change in sense of self, sense and changes in behavior, consciousness, memory, perception, cognition, and motor function.
• Significant distress and impairment in social, occupational, or other important areas of functioning
• Ongoing gaps in memory about everyday events, personal information and past traumatic events.

Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience a number of other psychiatric problems, including symptoms:

• Depression
• Mood swings
• Suicidal tendencies
• Sleep disorders
• Anxiety, panic attacks, and phobias
• Alcohol and drug abuse
• Eating disorders

CAUSES

• It has been frequently reported in the persons who experienced severe physical and sexual abuse during childhood. The study says almost 90% of the people with this disorder are the victims of childhood abuse.
•  Individuals with dissociative identity disorder may have post-traumatic symptoms or post-traumatic stress disorder.
• Several studies suggest that DID is more common among close blood relations of persons who also have theisdisorder than the others with no similar illness in the family.

DIAGNOSIS

The Diagnostic and Statistical Manual of Mental Disorders -5 provides the following criteria to diagnose dissociative identity disorder:

1. Two or more distinct personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.
2. Amnesia must occur, defined as inability to recall the everyday events, important personal information, or traumatic events.
3. Due to this disorder, the person must be distressed or have trouble functioning in one or more major life areas.
4. The symptoms can not be due to the direct physiological effects of a substance or a general medical condition.

Often dissociative identity disorder is diagnosed with borderline or other personality disorders, anxiety and depression. It requires time to diagnose the disorder. A study says it takes approximately seven years to reach the accurate diagnosis.

RISK FACTORS

Suicide attempts and other self-injurious behavior are common among people with dissociative identity disorder. More than 70 percent of patients with this disorder have attempted suicide. In order to prevent such actions, the person needs to monitored closely and call out for help to the professionals when required.

TREATMENT

• The primary treatment for DID is long-term psychotherapy with the goal of deconstructing the different personalities and integrating them into one.
•  Other treatments include cognitive and creative therapies.
• Medications are not available to specifically treat this disorder. So antidepressants, anti-anxiety drugs, or tranquilizers are prescribed to help control the psychological symptoms associated with the disorder.
• With regular and proper guidance by the medical professionals (psychiatrist), the person can lead a more normal life by eliminating the symptoms of the disorder.