Dissociative identity disorder

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Dissociative identity disorder (DID) is a mental health condition. People with DID have two or more separate identities. These personalities control their behavior at different times. Each identity has its own personal history, traits, likes and dislikes. DID can lead to gaps in memory and hallucinations (believing something is real when it isn't).

Dissociative identity disorder used to be called multiple personality disorder or split personality disorder.

DID is one of several dissociative disorders. These disorders affect a person's ability to connect with reality. Other dissociative disorders include:

Depersonalized or derealization disorder, which causes a feeling of detachment from your actions.
Dissociative amnesia, or problems remembering information about yourself.
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How common is DID?
DID is very rare. The disorder affects between 0.01 and 1% of the population. It can occur at any age. Women are more likely than men to have DID.

SYMPTOMS AND CAUSES
What causes dissociative identity disorder (DID)?
DID is usually the result of sexual or physical abuse during childhood. Sometimes it develops in response to a natural disaster or other traumatic events like combat. The disorder is a way for someone to distance or detach themselves from trauma.

What are the signs and symptoms of DID?
A person with DID has two or more distinct identities. The "core" identity is the person's usual personality. "Alters" are the person's alternate personalities. Some people with DID have up to 100 alters.

Alters tend to be very different from one another. The identities might have different genders, ethnicities, interests and ways of interacting with their environments.

Other common signs and symptoms of DID can include:

Anxiety.
Delusions.
Depression.
Disorientation.
Drug or alcohol abuse.
Memory loss.
Suicidal thoughts or self-harm.
DIAGNOSIS AND TESTS
Is there a test for DID?
There isn't a single test that can diagnose DID. A healthcare provider will review your symptoms and your personal health history. They may perform tests to rule out underlying physical causes for your symptoms, such as head injuries or brain tumors.

Symptoms of DID often show up in childhood, between the ages of 5 and 10. But parents, teachers or healthcare providers may miss the signs. DID might be confused with other behavioral or learning problems common in children, such as attention deficit hyperactivity disorder (ADHD). For this reason, DID usually isn't diagnosed until adulthood.

MANAGEMENT AND TREATMENT
What is the treatment for dissociative identity disorder (DID)?
Some medications may help with certain symptoms of DID, such as depression or anxiety. But the most effective treatment is psychotherapy. A healthcare provider with specialized training in mental health disorders, such as a psychologist or psychiatrist, can guide you toward the right treatment. You may benefit from individual, group or family therapy.

Therapy focuses on:

Identifying and working through past trauma or abuse.
Managing sudden behavioral changes.
Merging separate identities into a single identity.
Can hypnosis help with DID?
Some healthcare providers may recommend hypnotherapy in combination with psychotherapy. Hypnotherapy is a form of guided meditation. It may help people recover suppressed memories.

PREVENTION
Can dissociative identity disorder (DID) be prevented?
There's no way to prevent DID. But identifying the signs as early in life as possible and seeking treatment can help you manage symptoms. Parents, caregivers and teachers should watch for signs in young children. Treatment soon after episodes of abuse or trauma may prevent DID from progressing.

Treatment can also help identify triggers that cause personality or identity changes. Common triggers include stress or substance abuse. Managing stress and avoiding drugs and alcohol may help reduce the frequency of different alters controlling your behavior.

OUTLOOK / PROGNOSIS
Will dissociative identity disorder (DID) go away?
There is no cure for DID. Most people will manage the disorder for the rest of their lives. But a combination of treatments can help reduce symptoms. You can learn to have more control over your behavior. Over time, you can function better at work, at home or in your community.

LIVING WITH
Are there ways to make living with DID easier?
A strong support system can make living with DID more manageable. Make sure you have healthcare providers, family members and friends who know about and understand your condition. Communicate openly and honestly with the people in your support system, and don't be afraid to ask for help.

If a friend or family member has DID, how can I help?
Having a loved one with DID can be confusing and overwhelming. You may not know how to respond to their different alters or behaviors. You can help by:

Learning about DID and its symptoms.
Offering to attend family counseling or support groups with your loved one.
Staying calm and supportive when sudden behavior changes occur.
When should I call my doctor about DID?
If you or someone you know has DID and exhibits any of the following symptoms, seek medical attention right away:

Self-harm.
Suicidal thoughts.
Violent behavior.
You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a network of local crisis centers that provides free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.

A note from Cleveland Clinic

Dissociative identity disorder (DID) is a mental health condition. Someone with DID has multiple, distinct personalities. The various identities control a person's behavior at different times. The condition can cause memory loss, delusions or depression. DID is usually caused by past trauma. Therapy can help people manage their behaviors and reduce the frequency of identity "switches." It's important for anyone with DID to have a strong support system. Healthcare providers, family members and friends can help people manage DID.

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