Dissociative identity disorder


Dissociative identity disorder

Description, Causes and Risk Factors:

Abbreviation: DID.

Dissociative identity disorder

Dissociative identity disorder is defined in the DSM-IV-TR as the presence of two or more personality states or distinct identities that repeatedly take control of one's behavior. The patient has an inability to recall personal information.

The extent of this lack of recall is too great to be explained by normal forgetfulness. The disorder cannot be due to the direct physical effects of a general medical condition or substance. DID entails a failure to integrate certain aspects of memory, consciousness and identity. Patients experience frequent gaps in their memory for their personal history, past and present. Patients with DID report having severe physical and sexual abuse, especially during childhood. The reports of patients with DID are often validated by objective evidence. Physical evidence may include variations in physiological functions in different identity states, including differences in vision, levels of pain tolerance,symptoms of asthma, the response of blood glucose to insulin and sensitivity to allergens. Other physical findings may include scars from physical abuse or self-inflicted injuries, headaches or migraines, asthma and irritable bowel syndrome. DID is found in a variety of cultures around the world. It is diagnosed three to nine times more often in adult females than males. Females average 15 or more identities, males eight identities. The sharp rise in the reported cases of DID in the U.S. may be due the greater awareness of DID's diagnosis, which has caused an increased identification of those that were previously undiagnosed. The average time period from DID's first presentation of symptoms to its diagnosisis six to seven years. DID may become less manifest as patients reach past theirlate 40's, but it can reemerge during stress, trauma or substance abuse. It is suggested in several studies that DID is more likely to occur with first-degree biological relatives of people that already have DID, than in the regularpopulation.

The causes of dissociative identity disorder are theoretically linked with the interaction of overwhelming stress, traumatic antecedents, insufficient childhood nurturing, and an innate ability to dissociate memories or experiencesfrom consciousness. Prolonged child abuse is frequently a factor, with a veryhigh percentage of patients reporting documented abuse often confirmed by objective evidence.

Symptoms:

Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states 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 "alters" or different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters 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. When under hypnosis, the person's different "alters" or identities may be very responsive to the therapist's requests.

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 (insomnia, night terrors, and sleep walking).

  • Anxiety, panic attacks, and phobias (flashbacks, reactions to stimuli or "triggers").

  • Alcohol and drug abuse.

  • Compulsions and rituals.

  • Psychotic-like symptoms (including auditory and visual hallucinations).

  • Eating disorders.

Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn't normally do such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.

Diagnosis:

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. In fact, many people who have dissociative disorders also have secondary diagnoses of depression, anxiety, or panic disorders.

The DSM-IV provides the following criteria to diagnose dissociative identity disorder:

    Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.

  • At least two of these identities or personality states recurrently take control of the person's behavior.

  • The person has an inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

  • The disturbance is not due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).

Treatment:

While there's no "cure" for dissociative identity disorder, long-term treatment is very successful, if the patient stays committed. Effective treatment includes talk therapy or psychotherapy, medications, hypnotherapy, and adjunctive therapies such as art or movement therapy.

Because oftentimes the 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.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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