What is split personality disorder?

Dissociative identity disorder (DID), sometimes called split, multiple, or dual personality, is when a person has two or more sets of thoughts, actions, and behaviors. Examples may include marked differences in personality or a sense of self, or gaps in memory.
Trauma often causes this condition, particularly during childhood. While there is no defined cure for DID, long-term treatment may help people combine their personalities into one.
A split personality is a popular term for DID. In the past, DID was known as multiple personality disorder. People with DID have two or more distinct personalities. They do not present as simple changes in traits or moods. A person with DID expresses significant differences between these alternate identities, which can also be referred to as alters.
Often, these personalities are completely different from each other. These fragmented personalities take control of the person’s identity for some time. A person also maintains their primary or host identity, which is their original personality, and will answer to their given name. Their primary identity is generally more passive, and they may be unaware of the other personalities.
When a personality change happens, the new personality will have a distinct history, a new identity, and different behaviors. These split personalities, or alters, often have their own distinct: name, age, gender, moods, memories and vocabulary.
A new personality will see themselves differently. For instance, someone assigned male at birth may have an alternate identity as a woman. They may experience themselves with female biological sex characteristics.
The shift between these personalities tends to occur when a person faces a certain stressor or trigger.
The exact cause of DID is not fully understood. However, there is a strong link between the condition and trauma. This may be particularly true for trauma or abuse during childhood. In Europe, the United States, and Canada, 90% of people who experience DID are victims of severe trauma in childhood.
The condition represents someone who struggles to integrate and assimilate certain aspects of their own identity, which become disjointed over time.
The signs of DID may vary, but they include a change between two or more separate personalities.
Symptoms include experiencing two or more separate personalities, each with their own self-identity and perceptions, a notable change in a person’s sense of self, frequent gaps in memory and personal history, which are not due to normal forgetfulness, including loss of memories, and forgetting everyday events.
When these other personalities take over, they often talk with a different vocabulary, and gesture differently. In some cases, one personality may also pick up certain habits that the other does not, such as smoking, or becoming violent.
In the shift from one personality to another, a person may experience other symptoms. Some people can have anxiety, as they may be afraid of the personality change. Some may become very angry or violent. Others may not notice or remember these transitions at all, although another person may notice them.
Specific personalities may appear in response to certain situations. These symptoms can cause a person significant distress, and disrupt their ability to live their life normally.
Other symptoms may include:
• amnesia
• losing sense of time
• going into a trance-like state
• out-of-body experiences, or depersonalization
• engaging in behaviors that are unusual for the person
• sleep disturbances
A person with DID may also experience symptoms of other conditions, such as self-harm. One study notes that more than 70% of people with DID have attempted suicide.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
Ask the tough question: “Are you considering suicide?”
Listen to the person without judgment.
Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
Stay with the person until professional help arrives.
Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Risk factors
Trauma often triggers DID as a psychological response, so it is a strong risk factor, especially in childhood. This trauma can stem from physical or sexual abuse, emotional neglect or psychological abuse.
In some cases, a child may not experience a clear form of abuse, but may not grow up in a safe home environment. For example, they may live with highly unpredictable parents, and start to dissociate in response to the stress that comes with this.
Dissociative identity disorder may appear alongside other disorders. This means that several mental health disorders could arise from the same cause.
Other common disorders that can occur alongside DID include:
• borderline personality disorder
• depression
• substance use disorder
• post-traumatic stress disorder
• eating disorders
• anxiety
• obsessive-compulsive disorder
Diagnosis
It takes time to diagnose DID. Misdiagnosis is common, and doctors need to observe a person’s symptoms, and dismiss other conditions. To properly make a diagnosis, doctors need to see the different personalities and how they affect the person.
Time is also an important factor in seeing the full scale of the symptoms. This is because people who seek help for DID commonly present with symptoms linked to other mental health conditions.
Additionally, as DID often occurs alongside other disorders, doctors need to rule out the symptoms of other conditions before they make a diagnosis. As such, they may prescribe therapies or medications to treat these conditions first.
Treatment
There are no guidelines on how to treat DID. Doctors often prescribe treatments on a case-by-case basis. No specific medication exists for DID. Treatment plans manage any conditions that occur alongside DID, and they can combine psychotherapy, with any necessary drugs to help with symptoms.
Psychotherapy, or talk therapy, is the main treatment for people with DID. Techniques, such as cognitive behavioral therapy, may help a person work through and learn to accept the triggers that cause personality shifts.
In DID, psychotherapy aims to help integrate a person’s identity and learn to cope with post-traumatic experiences.
Art therapy, movement therapy, and relaxation techniques may all have a place in the treatment of DID. These methods may help people connect aspects of their mind in a low-stress environment.
There is no specific cure for DID. However, many people can help manage their symptoms and work to integrate their identities through regular psychotherapy. They can also ease any other symptoms with medication.
By Jon Johnson