Many people have a poor understanding of what dissociative identity disorder (DID) is. That’s because it might be one of the worst-portrayed mental health disorders of all time. The most common portrayal of DID can be found in movies like Split, a horror movie that villainizes someone with DID by portraying him, literally, as a monster.

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These hurtful portrayals and misunderstandings are possibly developed because not many people will come in contact with DID. 1.5% of people in the US have been diagnosed with DID. It’s a rare and misunderstood disorder, but it’s important that these individuals get the treatment they deserve.

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In this guide we’ll cover everything you need to know about dissociative identity disorder:

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• Definitions and terminology 
• What DID is
• Symptoms of DID
• Signs of DID
• Treatments for DID

Definitions and Terminology

Dissociative identity disorder hasn’t always been called that. You may know it by the name of multiple personality disorder. This original name doesn’t fully define what’s actually going on.

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As you’ll learn in this guide, people with DID don’t just have multiple personalities living within them, they also experience symptoms of dissociation like memory loss and disconnection of self-identity. Dissociative identity disorder is also not a personality disorder further making the old name irrelevant to the true nature of DID.

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Because of this, this disorder is now called dissociative identity disorder (DID) to better define what it is.

Important Terminology

Before we can talk about DID, we need to define some terms that are used within the DID community to better define their experience.

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• Host: The main personality that is often considered the original and the one who is most often in control. 
• Alternates / Alters: The different personalities that exist within a single host.
• Headmate: An endearing term used to talk about alternate identities.
• System: This term is used to refer to all alts within someone with DID; including the host. 
• Switching: The act of changing alters. Switches are not a controlled action and often happen at random. Switches can happen quickly or over time and are often subtle.
• Fronting: When an alternate is in control, that alternate is considered to be fronting.

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Throughout this guide, we’ll be using these terms freely. Refer back to this section if you need it.

What Is Dissociative Identity Disorder?

DID is a dissociative disorder that affects someone’s ability to perceive and connect with reality. Those with DID have at least two alternate identities that live within themself. The alternates within someone switch to control the host. While an alter is in control, the host is dissociated and is not in control.

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Alternates each of their own personalities, goals, thoughts, feelings, biases, genders, and ethnicities. Every alter tends to relate to reality in a different way, and there doesn’t seem to be a limit to how many alternates can exist within a system.

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A defining characteristic of DID is switching. Switching occurs when a headmate takes control of the host's body. While this happens the host is dissociated and is unlikely to remember the events that occurred while an alter is fronting.

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Related Articles: Moon Knight: What Disney’s Latest Series Gets Right and Wrong About Dissociative Identity Disorder

Types of Dissociative Identity Disorder

There are two kinds of switches someone with DID may experience. These are not defined by what outside observers can witness during a switch, but rather are focused on the feelings and experiences of the person with DID. 

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• Possessive—These kinds of switches are most associated with black outs, and the host will have no control of their body while an alter is fronting.
• NonPossessive—To someone with DID, these kinds of switches feel like becoming someone else. The person will have agency over their actions but their personality or identity will change.

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These kinds of switches can occur in anyone with DID, and it’s not uncommon to experience both throughout life..

What Causes Dissociative Identity Disorder?

DID can develop in people who have experienced overwhelming traumatic events, childhood abuse, and complex PTSD. 

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At its inception, DID is a coping mechanism developed to live through trauma. Children experiencing complex trauma might express different behaviors or identities. While children take on different identities, they’re actually dissociating to protect themself. 

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As trauma continues and dissociation continues to occur, these coping mechanisms will become more automatic and the behaviors will become a fully formed identity.

Symptoms of Dissociative Identity Disorder

DID is a hard disorder to identify. Those who experience this disorder may notice some of these symptoms, but it’s rare for them to notice what’s going on.

Memory Loss

Memory loss is one of the most distressing symptoms of DID.

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DID protects the host from trauma through dissociation. If someone is dissociated during traumatic events, they won’t be able to remember the events. Alternates act as a protective barrier so the host doesn’t have to live through awful events.

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Over time, switching will begin to occur even when there is no trauma happening. Someone with DID may experience blocks of time where they don’t know what is happening because of an alter switch. This could happen at any time and will cause distress.

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People with undiagnosed DID won’t be able to identify the true issue of what they’re experiencing. They’ll just notice gaps in their memory.

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Related Resources: Dissociation 

Anxiety and Depression

People with DID are at risk of experiencing anxiety and depression as a result of their unknown disorder. Dissociation is a disconnection from reality and can leave people feeling lost, confused, and numb. Experiencing frequent dissociations will increase these feelings of distress.

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These symptoms of DID are probably the reason most people with DID will seek treatment.

Suicidal Ideation and Self-Harm

Most people with DID report engaging in self-injury. Those with DID are at risk for self-harm and suicidal ideation. Trauma-related cues are a big reason for this behavior, but a vast majority (92.31%) of people reported being unaware of the reason for self-injury.

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If you or a loved one is experiencing suicidal ideation, please call the Suicide and Crisis Lifeline by dialing 988. The Suicide Crisis Lifeline will connect you to local crisis centers while offering confidential and free emotional support. If you or a loved one are in an immediate emergency, call 911.

Signs of Dissociative Identity Disorder

DID is not easy to identify yourself. Most people with DID will receive a diagnosis while seeking treatment or help for other issues. That being said, there are signs that someone could be experiencing symptoms of DID.

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These are the signs that someone has DID:

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• Disconnected memories
• Feeling detached from self-identity
• Flashbacks and altered consciousness
• Amnesia
• Blackouts and forgetfulness 

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This list is not exhaustive, and it shouldn’t be used for self-diagnosis or to diagnose a friend. To receive a diagnosis of DID, someone will need to see a medical professional.

How is Dissociative Identity Disorder Diagnosed?

To receive a diagnosis of DID, someone will need to meet with a medical professional and work with them to explore their mental health history and symptoms.

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The DSM-V’s diagnosis criteria are simple. There needs to be at least two distinct and separate personalities within an individual. How they search for that is up to them. However, they should take time before proposing a formal diagnosis.

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It will take a while before a medical professional will be able to identify whether or not symptoms are pointing toward DID. 

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Related Resources: Self-Diagnosing Mental Illness

Dissociative Identity Disorder Treatments

DID is difficult to identify and difficult to treat. It is possible, however. Once treatment begins it may never stop. DID isn’t typically curable, but with consistent treatment, symptoms can be better managed.

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The following treatment options should be considered alongside a professional and be a part of a whole treatment program.

Medical Treatments for DID

There is no medical treatment for DID specifically, but some medications can help regulate some of the distressing symptoms associated with DID.

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Prescriptions like antipsychotics, anti-anxiety, and antidepressants can help regulate patients' moods, but whether they’re used should be decided between patients and doctors.

Talk Therapies

Talk therapy is the most used treatment for DID. While in talk therapy, patients will work with their therapist to better understand their experience through psychoeducation. They’ll also work through thoughts, behaviors, and past traumas.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) is a talk therapy focused on acceptance. During this therapy, patients work with their therapists to accept their emotions rather than fight them. 

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The scary experiences and feelings associated with DID can be distressing and DBT challenges that. By accepting these thoughts and feelings, a patient will be better able to work through them rather than running from them.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT), is the most popular form of therapy. It connects thoughts, emotions, and behaviors together so patients can better understand the root of their behaviors better. From there, they’ll be able to change their behaviors by changing their thoughts.

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CBT also challenges distorted thoughts and helps create a more accurate depiction of reality for the patient. Patients who go through CBT are better equipped to have a healthy and correct understanding of reality.

Trauma Therapies

Because the cause of DID is trauma, trauma therapies are a great option for those experiencing DID. Trauma therapies address trauma directly.

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Talking through traumatic memories isn’t easy and those with DID aren’t capable of recalling those memories. Therapies like eye movement desensitization and reprocessing (EMDR) use bodily functions to find subconscious memories and feelings. Other forms of trauma therapies help patients feel more comfortable while talking about traumatic memories. 

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The processing of these therapies will require a lot of time. There’s no quick or easy fix, but with consistent care, patients can properly process traumatic distressing memories.

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Related Resources: Eye Movement Desensitization & Reprocessing (EMDR), Trauma Therapy

Integration

Integration is a newer concept within the realm of DID that hasn’t been thoroughly studied. In short, integration is the combining of a system into one identity. After this process, alters can no longer front and they cannot communicate with the host.

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For some, integration is the final step of DID treatment. However, very little is understood about the process. What we do know is that it takes a very long time, and some choose not to pursue it. Some people with DID may choose to seek harmony between alters instead of integrating them into one self.

Start Your Counseling Journey At Inner Balance

Inner Balance Counseling offers mental health counseling for any battle you may be fighting. We offer specialized treatment options that are designed to meet you where you’re at. Online therapy options are available to bring therapy wherever you’re at, but we also offer in-person options.

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One phone call can change your life. Reach out for an initial consultation and we’ll work to find the best therapist and treatment options for you. 

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