Dissociative Identity Disorder: What It Is and How It Manifests

Sometimes a person describes a strange sensation: as if they are watching themselves from the outside or cannot remember a chunk of their own life. Such experiences may be caused by a dissociative disorder — a group of conditions in which the mind seems to disconnect from reality. Let us calmly examine what is known about this diagnosis.

What dissociative identity disorder is

Dissociative disorders are a group of conditions that can cause both physical and psychological problems. Some of them are very brief, for example after a severe event, and resolve on their own within weeks or months. Others last considerably longer. There are three main types: depersonalization-derealization disorder, dissociative amnesia, and dissociative identity disorder.

How dissociative identity disorder manifests

This diagnosis was formerly called "multiple personality disorder." A person may feel uncertainty about who they are, sense the presence of other identities — each with its own name, voice, history, and mannerisms. The main symptoms are gaps in memory about everyday events and personal information and the presence of several distinct identities. In dissociative amnesia there are periods when a person does not remember information about themselves or their past, and sometimes forgets a learned skill. Such gaps are more serious than ordinary forgetfulness. Some people with dissociative disorders experience attacks ranging from fainting to a state resembling an epileptic seizure. In addition, dissociative disorders may co-occur with other conditions: PTSD, depression, anxiety and panic attacks, suicidal tendencies or self-harm, eating disorders, OCD, and sleep problems.

Possible causes and risk factors

Dissociation is a way the mind copes with overwhelming stress. Many people with this disorder have experienced a traumatic event in childhood: physical, sexual, or emotional abuse. Sometimes dissociation occurs after war, kidnapping, or even an invasive medical procedure. Disconnecting from reality is a normal defense mechanism, a form of denial, as if "this is not happening to me." It becomes a problem when the situation is no longer traumatic but the person continues to live as if it still were, and the event has not been processed.

How it differs from schizophrenia and the "split personality" of movies

Dissociative disorders also include a sense of unreality of oneself or the world. Depersonalization is the feeling of being outside oneself and observing one's actions from the outside; derealization is the feeling that the world around is unreal, that people and things seem "lifeless" or "foggy." Schizophrenia in the MedlinePlus classification belongs to psychotic disorders, while dissociative disorders are described separately.

How the diagnosis is made

A doctor may examine the person and conduct tests to rule out other illnesses with similar symptoms. Then the person is usually referred to a mental health specialist for a full assessment. The assessment includes questions about thoughts, feelings, behavior, and symptoms. Being honest about one's experiences is the path to the right support.

When to see a psychiatrist or psychotherapist

Reasons to seek help include memory gaps that interfere with life, a feeling that you do not recognize yourself, or that reality is slipping away. Many people with a dissociative disorder fully recover with treatment and support. A doctor assesses the condition and, if necessary, selects appropriate care.

• gaps in memory about events and about oneself
• a sense of unreality of oneself or the world
• a feeling of the presence of other identities
• attacks resembling fainting or epileptic seizures

A dissociative disorder by itself is not a reason to call an ambulance. Call 103 or 112 if there are thoughts of suicide, a risk of self-harm, or the person is a danger to themselves or others.

This material is for reference and does not replace a doctor's consultation: only a specialist can assess the condition and suggest the next step.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer