Dissociative identity disorder is when an individual develops alternate personalities
that function with or without the awareness of the person's usual self.
The diagnostic and statistical manual of mental disorders also known as DSM5 identifies it as an
identity disruption indicated by the presence of two or more distinct personality states.
DID is one of a group of conditions called dissociative disorders. Dissociative disorders
are mental illnesses that involve disruptions or breakdowns of behavior consciousness memory
and perception cognition or sensory motor functioning which would otherwise function
normally. When one or more of these functions is disrupted, dissociative symptoms can result
these symptoms can be mild but they can also be severe to a point where they interfere with a
person's general functioning both in personal life and at work. Dissociative disorders are
actually among the oldest reported psychiatric disorders with case reports appearing at the end
of the 18th century and extensive descriptions in the medical literature of the 19th century.
Some common symptoms of DID include, but not limited to, the inability to remember large
parts of childhood, unexplained events, like finding yourself somewhere you don't remember walking to,
hallucinations, out-of-body experiences, difference in handwriting and some symptoms of DID can be
attributed to a person's cultural background where possessions may be a part of cultural
beliefs. DID may often then form as spirits, demons or animals and this is also how DID
may go undiagnosed and untreated. People of all ages and all racial ethical socioeconomic
backgrounds can experience DID. However women are much more likely to be diagnosed.
Beginning in the 1980s, researchers on dissociation and dissociative disorders developed a number of
reliable self-report inventories and diagnostic interviews to assess dissociation in children,
adolescents and adults. In these studies higher dissociation scores and a dissociative disorder
diagnosis were strongly linked to those with acute or chronic traumatic experiences.
Studies have included victims of childhood maltreatment and neglect,
adult rape, prisoner of war experiences,
torture, trafficking, repeated painful medical procedures, accidents and natural disasters.
However, people who have experienced physical and sexual abuse and childhood are at increased risk
of dissociative identity disorder. The vast majority of people who developed
dissociative disorders have experienced repetitive overwhelming trauma in childhood. Genetic studies
of dissociation also suggests that there is a complex interplay between genetic factors and type,
timing and chronicity of trauma. Up to now the precise neurobiological underpinnings of
dissociation remain elusive, but a growing number of neuroimaging studies have found altered brain
structure and function for those with DD. Studies that investigated functional alterations found
that DID patients showed elevated cardiovascular responses like heart rate and blood pressure
and stronger amygdala and insulin activity that are responsible for emotional processing, memory,
attention and introspective awareness. In another study DID patients exhibited decreased blood flow
in the thalamus during alter state which is responsible for the filtering of sensory input.
In terms of structural alterations one study found that individuals with DID have reduced volumes in
the amygdala and hippocampus. The hippocampus is responsible for learning and memory. Smaller
volumes may be related to early life trauma as the hippocampus is sensitive to heightened
stress and therefore leading to potential cell damage in the area. Usually the goals of
treatment for DID are to release symptoms ensure the safety of the individual and those around him
or her and more importantly to reconnect the different personalities into one integrated
well-functioning identity. However, the best treatment approach will depend on the individual.
Although there are multiple treatment methods the most common treatments
include a combination of psychotherapy, cognitive brain therapy, medication, family or group therapy,
meditation and relaxation techniques and creative therapies. People with DID generally
respond well to treatment but realistically treatment can be a long and painstaking process.
To improve a person's outlook it is important to treat any other problems or complications
such as depression, anxiety or substance abuse before. Some simple things friends and family
can help are to be patient and understanding, think about methods and ways to handle identity
structures when they arise and learn how to recognize and avoid triggers,
and lastly help them find the right support and take care of yourself