Dissociative Identity Disorder

To qualify as dissociative identity disorder, also known as D.I.D., at least two personalities must routinely take alternate control of the individual's behavior, and there must be a loss of memory that goes beyond normal forgetfulness. This memory loss is often referred to as "losing time". These symptoms must occur independently of substance abuse or a general medical condition. (Stickley & R.,2006) “Dissociative identity disorder is a rare diagnosis, although people currently with a diagnosis of psychosis may in fact be experiencing what is associated with the disorder. Because of the rarity of the diagnosis, there is much misunderstanding and ignorance among people and mental health professionals. Special attention is given to the reality of coping with the difficulties that dissociative identity disorder creates.”

D.I.D. has been mistaken quite frequently for schizophrenia (also called dementia praecox). Other misdiagnoses include borderline personality disorder, somatization disorder, and panic disorder, and can take 6-7 years, on average, from the first sign to the diagnosis. D.I.D. patients are often frightened by their dissociative experiences and may go to emergency rooms or clinics because they fear they are going insane.

D.I.D. is very rare; it may be because the correct number of people have yet to be diagnosed. Even though it starts from an early age, it generally affects more women than men; with it being diagnosed three to nine times more. A probable cause for this is there are more sexually abused females than there are males.

As specified by (DSM-IV-TR), “Individuals with Dissociative Identity Disorder frequently report having experienced severe physical and sexual abuse, especially during childhood. The disorder may become less manifest as individuals age beyond their late 40’s, but may reemerge during episodes of stress or trauma or with substance abuse.” Some people never realize their children have it because they assume that the child has an imaginary playmate and are unaware of any physical or sexual abuse in the child’s life.

The symptoms of D.I.D., according to (Haines, MD,, 2005), “Changing levels of functioning, from highly effective to nearly disabled, severe headaches or pain in other parts of the body, depersonalization (episodes of feeling disconnected or detached from one's body and thoughts), derealization (perceiving the external environment as unreal), depression or mood swings, unexplained changes in eating and sleeping patterns, anxiety, nervousness or panic attacks, problems functioning sexually, suicide attempts or self-injury, substance abuse, amnesia (memory loss) or a sense of lost time hallucinations (sensory experiences that are not real, such as hearing voices) and violence.”

Symptoms can, and do, vary. Some people also experience times where they were told of things that they have done, and yet, they have no recolection of the event. Some symptoms can be “triggered” by certain memories that may come to light. This can be frightening, making the person even more terrified to seek any medical help. (Haines, MD, 2005) “Dissociative identity disorder (DID) is one of a group of conditions called dissociative disorders. Dissociative disorders are mental illnesses that involve disruptions or breakdowns of memory, awareness, identity and/or perception. When one or more of these functions is disrupted, symptoms can result. These symptoms can interfere with a person's general functioning, including social activities, work functions and relationships”.

In 1994, with the publication of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-IV, Multiple Personality Disorder (MPD) was changed to Dissociative Identity Disorder (DID), reflecting changes in professional understanding of the disorder, which resulted largely from increased empirical research of trauma-based dissociative disorders.

Post-Traumatic Stress Disorder (PTSD), widely accepted as a major mental illness affecting 9-10% of the general population, is closely related to Dissociative Identity Disorder (MPD) and other Dissociative Disorders (DD). In fact, as many as 80-100% of people diagnosed with D.I.D. (MPD) also have a secondary diagnosis of PTSD. The personal and societal cost of trauma disorders [including DID (MPD), DD, and PTSD] is extremely high. For example, recent research suggests the risk of suicide attempts among people with trauma disorders may be even higher than among people who have major depression.

There are three screenings tools that are used to identify patients at risk for a dissociative disorder. The first tool is the Dissociative Experiences Scale (DES). The DES is a twenty-eight question self-report that rates a patient’s dissociative symptoms and experiences. The patient indicates his/her agreement with a question by circling a percentage from 0% to 100%. The sum of the twenty-eight scores is taken and averaged to determine whether or not the patient suffers from a dissociative disorder. The DES is reported to have 80% sensitivity, and D.I.D. patients usually score above forty points. The two other screenings tools are the Dissociative Questionnaire and the Questionnaire of Experiences of Dissociation, and are both very similar to the DES.

According to (Haines, MD, 2005), “The goals of treatment for D.I.D. are to relieve symptoms, to ensure the safety of the individual, and to "reconnect" the different identities into one well-functioning identity. Treatment also aims to help the person safely express and process painful memories, develop new coping and life skills, restore functioning, and improve relationships. The best treatment approach depends on the individual and the severity of his or her symptoms.” Treatment of D.I.D. is long-term, intense, and painful. However, if the patient receives and completes the correct treatment, the person’s condition may be completely cured, and he or she will be able to lead healthy and normal life.

The treatments currently used, as described by (Haines, MD, 2005), are “Psychotherapy: This kind of therapy for mental and emotional disorders uses psychological techniques designed to encourage communication of conflicts and insight into problems. Cognitive therapy: This kind of therapy focuses on changing dysfunctional thinking patterns. Medication: There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety might benefit from treatment with a medication such as an antidepressant or anti-anxiety medication. Family therapy: This kind of therapy helps to educate the family about the disorder and its cause, as well as to help family members recognize symptoms of a recurrence. Creative therapies (art therapy, music therapy): These therapies allow the patient to explore and express his or her thoughts and feelings in a safe and creative way. Clinical hypnosis: This is a treatment technique that uses intense relaxation, concentration and focused attention to achieve an altered state of consciousness or awareness, allowing people to explore thoughts, feelings and memories they might have hidden from their conscious minds.”

Alternative treatments that help to relax the body are often recommended for D.I.D. patients as an adjunct to psychotherapy and/or medication. These include hydrotherapy, herbal medicine, therapeutic massage, and yoga. Meditation is usually discouraged until the patient's personality has been reintegrated. Treatment of D.I.D. is complex. Patients are often treated under a variety of other psychiatric diagnoses for a long time before being re-diagnosed with D.I.D. Many patients are misdiagnosed as depressed because their primary personality is subdued and withdrawn.

The outlook for people with D.I.D. is usually very good, if they stick with the therapy that works for them. Some therapists believe that the prognosis for recovery is excellent for children and good for most adults. Although treatment takes years, it is often ultimately effective. As a general rule, the earlier the patient is diagnosed and properly treated, the better the chances for improvement.

by nobodyhere17 at hotmail dot com