There’s no question that McCord is doing a lot to break the stigma around mental illness by opening up about her diagnosis. But now the question on all of our minds is: What is DID, exactly? What causes it, and how do you treat it? Here’s what to know
What is dissociative identity disorder?
Dissociative Identity Disorder (DID), formerly called multiple personality disorder, is a mental condition in which two or more distinct identities exist in one person that causes problems with memory, perception, identity, emotions, sense of self and behaviors, Dr. Catherine Jackson, licensed clinical psychologist and certified neuro therapist explains. “Individuals with DID alternate between different personalities or identities. It is as if multiple voices or people reside in their head,” says Dr. Jackson. “Often those who experience DID feel detached from themselves as if they are outside observers of their experiences when they have a dissociative episode.” There are three types of dissociative disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5): Dissociative Identity Disorder, Dissociative Amnesia and Depersonalization/Derealization Disorder.
How common is DID?
Research regarding how common DID is varied. However, it occurs in .5% to 2% of the population, Dr. Jackson says. As with many mental health disorders, the occurrence of DID may be higher (10-15%) when considering those who experience the symptoms but have not been diagnosed. Furthermore, DID does not discriminate. People of all ages, races, SES, ethnicities and genders can experience it. However, women are more likely than men to be diagnosed with DID.
What causes DID?
Trauma is the main cause of dissociative identity disorder. “It occurs predominantly in people who have had extreme trauma in their childhood, especially abuse,” Dr. Gail Saltz, MD, a clinical associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine, explains. “It is much more common in women than men. The actual mechanism of cause is unclear but it is believed to be a neurobiological reaction to trauma.” Also, cases of DID exist in places where there is a lot of traumatic experiences like war zones and natural disasters. DID is also more likely to occur in those who sustain long-term abuse, physical, emotional, or sexual, says Dr. Jackson. The dissociative disorder usually develops as a way to cope with and protect one’s self from traumatic experiences. Dissociation is a coping mechanism that is triggered in some individuals when they become overwhelmed with stress as a way to avoid or detach from the stressful event.
What are the symptoms of DID?
Dr. Sanam Hafeez, NYC Neuropsychologist and faculty member at Columbia University says DID symptoms include, but are not limited to:
AnxietyHallucinationsBlurred identityDepersonalizationDissociative amnesia (memory loss)DepressionDissociative fugue (forgetting personal information)Mood swingsSignificant stress in relationshipsDistorted perception of realityInability to cope well with emotions
“The biggest symptom of DID is a drastic shift in how an individual is acting,” says Alyssa Mairanz, LMHC, DBTC, “You may see different mannerisms or ways of talking. For example, I encountered someone with DID professionally who would drastically shift into talking and acting like a child during sessions. As sessions were virtual, they would also stop engaging in therapy and start bringing toys as a sort of show and tell. This goes beyond a mood shift; it feels like you are talking to someone completely different.” There is generally one identity that associates with the person’s real name and anything connected to that, which is called the “host” identity, Mairanz adds. Most of the time the host is not aware of the other identities and that is what leads to the above-listed symptoms.
How is DID diagnosed?
Having multiple identities along with the host is the distinguishing factor of DID, which can sometimes get overlooked, especially if the provider is not seeing these symptoms. “With my client above, they did not show the multiple personalities for the first year of treatment. Then, they went through a really stressful situation where they regressed, and the different identities emerged in the session,” Mairanz states. “It’s estimated that individuals with DID have spent several years working with a mental health professional prior to an accurate diagnosis.” This is quite common because the list of symptoms is similar for schizophrenia and other psychiatric diagnoses. Those with DID may also have other diagnoses such as borderline or other personality disorders, anxiety, or depression, Mairanz adds. DID is diagnosed in a multitude of ways, including a health professional conducting a physical exam.“A professional performs a physical exam to rule out other injuries or physical conditions that could be contributing to symptoms,” says Dr. Hafeez. “A psychiatric exam may also be conducted. A doctor uses particular questions and asks about the patient’s past and childhood to help identity dissociative identity disorder.” After reviewing symptoms, physical exam results, psychiatric exam findings, and the patient’s personal history, the doctor can usually diagnose, Dr. Hafeez explains.
How is DID treated?
While treatment for DID varies, Dr. Jackson explains the two most common treatment methods:
Psychotherapy
Also called talk therapy or counseling, traditional mental health therapy is the most common and best treatment as it allows the individual and his or her therapist to identify the cause and triggers as well as collaborate on ways to cope with stress to reduce DID symptoms. Specific psychotherapies aimed at reducing DID symptoms include Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT). Also, trauma-based therapies such as Brainspotting and Eye Movement Desensitization and Reprocessing (EMDR) work well in treating dissociative disorders.
Medication
While there are no medications specific for dissociative disorders, a medical doctor, usually a psychiatrist may prescribe an anti-depressant, an anti-anxiety or an antipsychotic medication to reduce symptoms related to DID. Next, read 30 of the best mental health apps, because we all deserve to feel a little better right now.
Sources
Catherine Jackson, licensed clinical psychologist and certified neuro therapist Sanam Hafeez, NYC Neuropsychologist and Faculty Member Columbia UniversityAlyssa Mairanz, LMHC, DBTCGail Saltz, MD, a clinical associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine
