BY: SAJIDA EJAZ &  SEHRISH RIYAZ 

Dissociative identity disorder is formally called multiple personality disorder. It is the mental illness in which two or more distinct identities exist in one person that causes disruption or break down of memory, awareness, identity, emotions, sense of self or perception.

 People with DID experiencing a disconnection and lack of continuity between thoughts, memories, actions and identity. People with multiple personality develop one or more alternate personalities that function with or without the awareness of person’s usual personality. They often feel as multiple voices or people reside in their head. They behave as they possess 2 or more selves, each with its own characteristics, moods, and memories.

Dissociation is often thoughts as a coping mechanism that a person uses to disconnect from a stressful situation or experience that’s too violent, painful to assimilate with their conscious self. 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.

Those who experience DID feel detached from themselves as if they are outside observers of their experience when they have a dissociative episode. The 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.

Multiple personality disorder has been difficult to understand, difficult to diagnose and difficult to treat

Causes of DID:

  1. Trauma is main cause of dissociative identity disorder.

A history of trauma is a key feature of multiple personality disorder. The trauma often involves severe emotional, physical or sexual abuse. It might be also linked to accidents, natural disasters and war.

  • The syndrome of DID is associated with a high incidence of physical or sexual abuse in childhood. About 90% of the cases involve history of abuse. MPD may be cause due to reminder of childhood abuse for a parent may be when their child reaches the same age at which the parent was abused.
  • Research indicates that the cause of DID is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood.

Symptoms of DID:

Although not everyone experiencing DID the same way, for some alters or different identities have their own age, sex or race. Each has their own postures, gestures and distinct way of talking.

But there are some symptoms which are common to all DID patients.

  1. A person with multiple personality disorder has two or more different and distinct personalities, there is generally one identity that associates with person real name and anything connected to that, which is called the host.
  2. Feeling disconnected from one’s own thoughts, feelings and body.
  3. Feeling that surrounding environment is foreign, odd or unreal.
  4. Depression
  5. Anxiety
  6. Eating and sleeping disturbance
  7. Problems with functioning sexuality
  8. Amnesia: loss of memory
  9. Hallucinations( false perceptions or sensory experiences, such s hearing voices
  10. Self injurious behavior such as cutting or burning their skin
  11. Suicide risk: 70% of people with MPD have attempted suicide.
  12. Drug or alcohol abuse
  13. Cry or seem anxious
  14. Become violent
  15. Notable changes in a person sense of self.
  16. In ability to cope well with emotional or professional stress
  17. Out of body experience, or depersonalization

 The symptoms of DID can be mild, but they can also be severe to the point where they interfere with the persons general functioning both in personal life and at work.

When the alternate personality take over they often talk with different vocabulary, and gesture differently. In some cases one personality may also pick up certain habits that the other does not such as smoking.

In some cases the person with DID may benefit from a particular alter for example, a shy person may use a more assertive alter to negotiate a contract

Diagnosis:

DID is difficult and complicated to diagnose both because of the nature of syndrome and because of professional reluctance. Although multiple personality is difficult to diagnose during childhood but much higher morbidity found in adult cases. It is estimated that individuals with DID have spent seven years in the mental health prior  to accurate diagnosis. DID is diagnosed in a multitude of ways, it take times to diagnose DID. Misdiagnosis is common, a doctor needs to observe a person’s symptoms, and dismiss other conditions.

Additionally as often occur alongside other disorders, doctor need to rule out the symptoms of other conditions before they make a diagnosis

  1. A health professional conducting a physical exam to rule out injuries or physical conditions that could be contributing to symptoms.
  2. A psycatrist exam may also be conducted. A doctor uses particular questions and asks about patients past and childhood to help identify dissociative identity disorder.

Treatments of DID:

The goal of treatment of MPD is to relive symptoms, ensure the safety of 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 his painful memories, develop new coping skill, restore optimal functioning, and improve relationships.

No specific medication exist for DID but there are some methods which can be used for treatment.

  1. Psychotherapy:

Also called talk therapy, it is main treatment for personality disorder.

  • Cognitive behavior therapy:

Cognitive behavioral therapy may help a person work through and learn to accept the triggers that causes personality shift.

It functions on changing dysfunction thinking patterns, feelings, and behavior

  • Eye movement desensitization and processing:

This technique was designed to treat people with persistent night mares, flashbacks

  • Family therapy:

This helps teach family about the disorder as well as helping family members recognize symptoms of a recurrence.

Art therapy, movement therapy, music therapy and relaxation techniques are other methods for treatment of DID which help the patient to explore and express their thoughts, feelings and experience in a safe and creative environment. They all have a place in the treatment of DID.

Survey about DID: We collected a series of 23 cases of multiple personality disorder. Reported to them by 4 psychiatrists, clinical psychologists and other health care professionals. MPD patients experienced extensive sexual (79%) and physical (21%) abuse as children. The most common alter personalities were a child personality (80%), a personality of different age (20%). Patients of DID are highly suicidical with 72% attempting suicide and 28% being successful