Multiple Personality Disorder
Dissociative identity disorder (previously known as multiple personality disorder) is an effect of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse. Dissociative identity disorder is a severe form of dissociation, a mental process, which produces a lack of connection in a person´s thoughts, memories, feelings, actions, or sense of identity. The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that´s too violent, traumatic, or painful to assimilate with his conscious self.
Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality that continually have power over the person´s behavior. With dissociative identity disorder, there´s also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which fluctuate with the person´s split personality.
The different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the identities are imaginary people; sometimes they are animals. As each personality reveals itself and controls the individuals´ behavior and thoughts, it´s called “switching.” Switching can take seconds to minutes to days.
The distinct personalities may serve diverse roles in helping the individual cope with life´s dilemmas. For instance, there´s an average of two to four personalities present when the patient is initially diagnosed. Then there´s an average of 13 to 15 personalities that can become known over the course of treatment. While unusual, there have been instances of dissociative identity disorder with more than 100 personalities. Environmental triggers or life events cause a sudden shift from one alter or personality to another.
Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience any of the following symptoms: Depression,
Mood swings, Suicidal tendencies, Sleep disorders, Anxiety disorders, Alcohol and drug abuse, Compulsions and rituals, Psychoses, Eating disorders, and Other symptoms of dissociative identity disorder including headache, amnesia, time loss, trances, and “out of body experiences.”
While the causes of dissociative identity disorder are still vague, research indicates that a combination of environmental and biological factors work together to cause it. As many as 98% to 99% of individuals who develop dissociative disorders have recognized personal histories of recurring, overpowering, and often life-threatening disturbances usually before age 9. Dissociation may also happen when there has been insistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Making the diagnosis of dissociative identity disorder takes time. It´s estimated that individuals with dissociative disorders have spent seven years in the mental health system prior to accurate diagnosis. This is common, because the list of symptoms that cause a person with a dissociative disorder to seek treatment is very similar to those of many other psychiatric diagnoses.
While there´s no “cure” for dissociative identity disorder, long-term treatment is very successful, if the patient stays committed. Effective treatment includes psychotherapy with the goal of deconstructing the different personalities and uniting them into one, hypnotherapy, and adjunctive therapies such as art or movement therapy. Because symptoms of dissociative disorders occur with other disorders, such as anxiety and depression, dissociative disorder may be treated using the same drugs prescribed for those disorders. A person in treatment for a dissociative disorder might benefit from antidepressants or anti-anxiety medication.
Little is known about prognosis of untreated dissociative identity disorder It rarely if ever goes away without treatment but symptoms may resolve from time to time or wax and wane spontaneously. Patients with mainly dissociative and posttraumatic symptoms face a better prognosis than those with co-morbid disorders or those still in contact with abusers, and the latter groups often face lengthier and more difficult treatment. Duration of treatment can vary depending on patient goals, which can extend from elimination of all identities to merely reducing inter-alter amnesia, but generally takes years.
