Dissociative identity disorder (DID):

Dissociative identity disorder (DID) was formerly called multiple personality disorder. People

with DID develop one or more alternate personalities that function with or without the awareness

of the person’s usual personality.

DID is one of a group of conditions called dissociative disorders. Dissociative disorders are

mental illnesses that involve disruptions or breakdowns of memory, consciousness or awareness,

identity and/or perception , mental functions that normally work smoothly.

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 the point where they interfere with a

person’s general functioning, both in personal life and work.

Prevalence:

Instances of true DID are very rare. When they occur, they can occur at any age. Females are

more likely than males to get DID.

Etiological Factors:

A history of trauma is a key feature of dissociative identity disorder. About 90% of the cases of

DID involve some history of abuse. The trauma often involves severe emotional, physical, and/or

sexual abuse. It might also be linked to accidents, natural disasters, and war. An important early

loss, such as the loss of a parent or prolonged periods of isolation due to illness, may be a factor

in developing DID.
Dissociation is often thought of as a coping mechanism that a person uses to disconnect from a

stressful or traumatic situation, or to separate traumatic memories from normal awareness. It is a

way for a person to break the connection with the outside world, and create distance from an

awareness of what is occurring.

Dissociation can serve as a defense mechanism against the physical and emotional pain of a

traumatic or stressful experience. By dissociating painful memories from everyday thought

processes, a person can use dissociation to maintain a relatively healthy level of functioning, as

though the trauma had not occurred.

Episodes of DID can be triggered by a variety of real and symbolic traumas, including mild

events such as being involved in a minor traffic accident, adult illness, or stress. Or a reminder of

childhood abuse for a parent may be when their child reaches the same age at which the parent

was abused.

Symptoms:

 Changing levels of functioning, from highly effective to disturbed/disabled

 Severe headaches or pain in other parts of the body

 Depersonalization (feeling disconnected from one’s own thoughts, feelings, and body)

 De-realization (feeling that the surrounding environment is foreign, odd, or unreal)

 Depression and/or mood swings

 Anxiety

 Eating and sleeping disturbances

 Problems with functioning sexuality

  Substance abuse

 Amnesia (memory loss or feeling a time distortion)

 Hallucinations (false perceptions or sensory experiences, such as hearing voices)

 Self-injurious behaviors such as “cutting”

 Suicide risk — 70% of people with DID have attempted suicide.

Diagnosis of Dissociative identity Disorder:

If symptoms are present, an evaluation will be done with a complete medical history and

physical examination. Although no laboratory tests can diagnose dissociative disorders

medically, various diagnostic tests such as blood tests or imaging (X-rays, CT scans, or MRIs)

may be used to rule out physical illness or medication side effects.

If no physical illness is found, the person might be referred to a mental health professional such

as a psychiatrist, psychologist, or psychiatric social worker who is specially trained to diagnose

and treat mental illnesses. They will perform a clinical interview to get a full picture of the

person’s past experiences and current functioning. Some psychiatrists and psychologists may

employ specialized tests (for example, the Dissociative Experiences Scale-DES) or a standard

interview such as the Structured Clinical Interview for Dissociation (SCID-D).

Diagnostic criteria in DSM – V:

A: Disruption of identity characterized by two or more distinct

personality states, which may be described by some culture as an experience of possessions.

B: Recurrent gaps in the recall of every day events, traumatic events that are inconsistent with

ordinary forgetting.

C: The symptoms cause clinically significant distress in social occupational or any other

important area of functioning.

Diagnostic features are following:

Major Depressive disorder:

Depressive disorder in individuals with dissociative identity disorder often has an important

feature: the depressed mood and cognitions fluctuate because they are experienced in some

identity states but not others.

Bipolar Disorder:

Individuals with dissociative identity disorder are often the misdiagnosed with a bipolar disorder,

most often bipolar two disorders. The relatively rapid shifts in mood in individuals with this

disorder typically within minutes or hours.

Conversion disorder (functional neurological symptom disorder):

This disorder may be distinguished from dissociative identity disorder by the absence of an

identity disruption characterized by two or more distinct personality states or experience of

possession.
Treatment of dissociative identity disorder (DID):

The goals of treatment for DID are to relieve symptoms, ensure the safety of the individual and

those around him or her, and “reconnect” the different personalities into one integrated, well-

functioning identity.

Treatment also aims to help the person safely express and process painful memories, develop

new coping skills and life skills, restore optimal functioning, and improve relationships. The best

treatment approach depends on the individual, the nature of any identifiable triggers, and the

severity of the symptoms. Most likely treatment will include some combination of the following

methods:

 Psychotherapy: Sometimes called “talk therapy,” psychotherapy is the main treatment

for dissociative disorders. This is a broad term that includes several forms of therapy.

 Cognitive-behavioral therapy: This form of psychotherapy focuses on changing

dysfunctional thinking patterns, feelings, and behaviors.

 Eye Movement Desensitization and Reprocessing (EMDR): This technique was

designed to treat people with persistent nightmares, flashbacks, and other symptoms of

post-traumatic stress disorder (PTSD).

 Dialectic-behavior therapy (DBT): A form of psychotherapy for people with severe

personality disturbances, which can include dissociative symptoms that often occur after

an experience of abuse or trauma.

 Family therapy: This helps teach the family about the disorder as well as helping family

members recognize symptoms of a recurrence.

 Creative therapies (for example art therapy, music therapy): These therapies allow

patients to explore and express their thoughts, feelings, and experiences in a safe and

creative environment.

 Meditation and relaxation techniques: These help people to better tolerate their

dissociative symptoms and become more aware of their internal states.

 Clinical hypnosis: A treatment method that uses intense relaxation, concentration, and

focused attention to achieve an altered state of consciousness, allowing people to explore

thoughts, feelings, and memories they may have hidden from their conscious minds.

 Medication: There is no medication to treat dissociative disorders themselves. However,

people with dissociative disorders, especially those with associated depression and/or

anxiety, may benefit from treatment with antidepressant or anti-anxiety medications.

Dissociative Identity Disorder

Submitted to:
Dr. Umara Rauf
Assistant Professor in Clinical Psychology

Submitted by:
Jannat Zahid (20)

Student of Bachelor of Science

6th semester Department of psychology

Government College Women

University Sialkot