Dissociative Identity Disorder

A complex disturbance of identity and memory, dissociative identity disorder is characterized by the existence of two or more distinct, fully integrated personalities in the same person. The personalities alternate in dominance. Each has unique memories, behavior patterns, and social relationships; rigid and flamboyant personalities often are combined. Usually, one personality is unaware of the existence of the others.
Dissociative identity disorder usually begins in childhood, but patients seldom seek treatment until much later in life. The disorder is three to nine times more common in women than in men.

Causes

The cause of dissociative identity disorder isn't known. The patient typically has experienced abuse, often sexual, or another form of severe emotional trauma in childhood. Psychiatrists believe that a child exposed to such overwhelming stimuli may evolve multiple personalities to dissociate himself from the traumatic situation. The dissociated contents become linked with one of many possible shaping influences for personality organization.

Symptoms

• Memory lapses, frequent bouts of amnesia or 'lost time'.
• Unexplained events, such as new clothes the patient has no recollection of buying.
• Sense that one's body is being transformed or changed
• Two or more distinct personalities, usually with their own names, personalities and interests.
• Depression
• Physical disorders including headaches, abdominal pain, a sensation of choking, and pain in the vagina or anus.
• Transitions from one identity to another are often triggered by psychosocial stress.
• Severe anxiety attacks and/or numerous phobias
• Flashbacks to traumatic events.

Diagnosis

To make the diagnosis of dissociative identity disorder, a doctor conducts a thorough psychologic interview. A medical examination may be needed to determine if a physical disorder is present that would explain certain symptoms. Special questionnaires have been developed to help doctors identify dissociative identity disorder.

However, some doctors feel that hypnosis and drug-facilitated interviews should not be performed because they believe the techniques can themselves generate symptoms of dissociative identity disorder.

Treatment

Psychotherapy is essential to unite the personalities and prevent the personality from splitting again. The treatment's success is linked to the strength of the therapist's relationship with each of the personalities. All of the personalities, whether disagreeable or congenial. require equal respect and empathetic concern. Other treatments include cognitive and creative therapies. Although there are no medications that specifically treat this disorder, antidepressants, anti-anxiety drugs or tranquilizers may be prescribed to help control the mental health symptoms such as anxiety or depression, but does not affect the disorder itself.