Dissociative Identity Disorder (DID), previously known as multiple personality disorder, is one of the three types of Dissociative Disorders. The American Psychiatric Association describes DID as a condition in which a person experiences two or more distinct identities. These identities are also associated with changes in memory, behavior, and thinking patterns.
While it is often mistakenly referred to as having ‘split personalities,’ the different identities people experience are known as ‘alters.’ These alters can vary in gender, ethnicity, age, and interests; therefore, a person may have very different interactions and perceptions of the environment. According to the Cleveland Clinic, some people living with DID can even have up to 100 distinct alters that a person can switch from at different times of the day.
Many factors can influence a switch in alters for someone with DID, including positive and negative triggers. Healthy Place describes a positive trigger as a non-trauma-related stimulation that prompts the person to experience pleasant emotions to cause an alter to switch in place. Experiences such as being exposed to an object with sentimental value, tasting a favourite food, or being in a special place can be positive triggers that may cause a switch in alters. However, being exposed to something that can be associated with a negative experience or emotion can also cause a switch in alters. While people living with DID have different stances regarding the matter, there are many situations in which it is not appropriate to force someone with DID to switch.
What causes DID?
Using a Magnetic Resonance Imaging (MRI) Scan, computers are able to differentiate the brain of a healthy brain from the brain of someone with DID (Kings College London).
According to the National Alliance on Mental Illness, DID usually develops as a coping mechanism when dealing with trauma, especially within children exposed to long-term physical, mental, emotional, or sexual abuse. NCBI studies show that symptoms of DID can only develop during the early childhood stage from ages 5-10, but individuals are often diagnosed at a much later age. Other traumatic experiences such as natural disasters, war, or losing a loved one may also increase the risk of developing the disorder.
How is DID treated?
Unfortunately, if DID is left untreated, the disorder may last a lifetime in many individuals. The American Association for Marriage and Family Therapy states that treatments such as psychotherapy, family therapy, group therapy, medications, and clinical hypnosis are often used to treat the disorder. While the treatment process may take several years and there is yet to be a known cure for the disorder, a combination of treatments can reduce the symptoms and make the disorder more manageable.
While DID is perceived as an extremely rare mental disorder, a study from the Harvard Review of Psychiatry shows that DID may affect about 1.1-1.5% of the population and even higher in different areas. This indicates that DID is found in more individuals and is more common than many other mental disorders such as schizophrenia, which is also agreed upon by the Psychiatry Organization.
Additionally, people often perceive individuals living with DID as more prone to violence; however, there is no evidence that suggests that DID patients are more violent than the general population. In fact, The Recovery Village states that there is no link between increased criminal activity and the disorder. This stigma creates a cautious and fearful attitude towards people living with DID, which may further isolate them from their communities, leading to a larger decline in mental health.
How is DID perceived in pop culture?
Although film producers often confront experts to gain a deeper understanding of a certain topic, it is often dramatized to accurately represent reality. Unfortunately, the case is no different with DID. Split is a psychological horror film that depicts a dangerous kidnapper who is suffering from DID. The main character depicted as a villain has 23 alter egos, ranging from friendly to manipulative and violent. The movie gained recognition and popularity from the global community, receiving many nominations and film awards. However, the movie does not accurately represent the life and experiences of someone with DID.
Image is courtesy of James McAvoy in the movie Split.
The impact of the movie creates a villainized perception of someone living with DID and does not take into account the hardships and reality that a patient endures. In an interview with Healthline, Dr. Peter Barach, a clinical psychologist, described that the media is fascinated with mental illness as a cause for violent actions, adding that “unfortunately, nearly all of the media depictions of DID are sensationalized. They sometimes depict treatment that would be considered unethical”. Not only are DID patients misunderstood, but also negatively stigmatized, which fails to spread proper awareness of the disease.
DID and Other Psychological Disorders
DID is often confused for other psychological disorders such as Bipolar disorder and schizophrenia. According to MyMed, the root of this common misconception stems from the media using these terms interchangeably. However, it is important to note that each disorder is completely unique from one another with different experiences, causes, and treatments.
The Mayo Clinic explains that bipolar disorder is when an individual suffers from extreme mood swings, alternating between states and episodes of mania and depression. The main difference between bipolar disorder and DID is that bipolar disorder involves extreme mood changes, whereas DID involves different personalities or alters.
Schizophrenia is a complex mental disorder that alters one’s perception of reality. The Mayo Clinic states that the disorder is often characterized by delusions and hallucinations, with other varying symptoms such as disorganized speech and lack of motivation. While DID involves different alters, schizophrenia only experiences a split mind from reality during a psychotic episode. Additionally, while trauma is associated with both disorders, the main cause of schizophrenia is still unknown, as there are many other factors such as genetics that also influence the risk for developing the disorder.
Article Author: Rachel Weng
Article Editors: Valerie Shirobokov, Victoria Huang