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Refer to conditions of use

Dissociative Identity Disorder

Defined as the occurence of two or more personalities within the same individual, each of which during sometime in the person's life is able to take control. This is not often a mentally healthy thing when the personalities vy for control.

Symptoms are of course somewhat self-explanatory, but it is important to note that often the personalities are very different in nature, often representing extremes of what is contained in a normal person. Sometimes, the disease is assymetrical, which means that what one personality knows, the others inherently know.

The patient has at least two distinct identities or personality states. Each of these has its
      own, relatively lasting pattern of sensing, thinking about and relating to self and environment.

At least two of these personalities repeatedly assume control of the patient's behavior.

Common forgetfulness cannot explain the patient's extensive inability to remember
      important personal information.

This behavior is not directly caused by substance use (such as alcoholic blackouts) or by
      a general medical condition.

Associated Features 

Trauma
Depression
Mood swings
Suicidal tendencies
Sleep disorders (insomnia, night terrors, and sleep walking)
Panic attacks
Phobias
Alcohol and drug abuse,

 

Differential Diagnosis 

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Effects of a substance - Alcohol Intoxication
General medical condition - (e.g., complex partial seizures
Post-Traumatic Stress Disorder (PTSD)

Cause:

When faced with overwhelmingly traumatic situations from which there is no physical escape, a patient may resort to "going away" in his or her head. This ability may be used and is extremely effective defense against acute physical and emotional pain, or anxious anticipation of that pain. By this dissociative process, thoughts, feelings, memories, and perceptions of the traumatic experiences can be separated off psychologically, allowing the patient to function as if the trauma had not occurred.

Often, even after the traumatic circumstances are long past, the left-over pattern of defensive dissociation remains. Chronic defensive dissociation may lead to serious dysfunction in work, social, and daily activities. Repeated dissociation may result in a series of separate entities, or mental states, which may eventually take on identities of their own. These entities may become the internal "personality states,"  Changing between these states of consciousness is described as "switching."

 

Treatment:

Treatment methods include psychotherapy and the use of specific medications either on their own or , which is more effective in conjunction with each other.

Counseling and Psychotherapy [ See Therapy Section ]:

Psychotherapy is the treatment of choice for individuals suffering from any type of dissociative disorder. Approaches vary widely, but generally take an individual modality (as opposed to family, group or couples therapy) and emphasize the integration of the various personality states into one, cohesive whole personality. The role of hypnosis remains controversial partly because of concerns that hypnosis may increase the risk of creating false memories.

Pharmacotherapy [ See Psychopharmacology Section ] :

The use of medication, except for the treatment of acute, specific concurrent Axis I disorders, is not recommended. Maintenance and effective use of prescriptions given the multiple personality states is difficult to attain. If medication is prescribed, it should be carefully monitored



Coding Note

In children, the symptoms cannot be attributed to fantasy play, including imaginary playmates.

Also see our Dissociative Disorders Links Page