Am I Really Me? Understanding Dissociative Identity Disorder (DID) in Teens.

Image Credit: Freepik.

Have you ever thought about what it would be like to be another person, or played games where you pretended to be someone else? What if you really could be someone else, but you couldn’t control who you would be, or when you would turn into them? Well, for some people, that isn’t just the start of a “would you rather” question, but it is their reality, and it is called Dissociative Identity Disorder (DID). In this post you can find out exactly what DID is, who it affects, how it impacts your life, its symptoms, risk factors, the science of the brain behind it, and its treatments.

So, what exactly is Dissociative Identity Disorder?

Dissociative Identity Disorder (DID), formerly called Multiple Personality Disorder, is the existence of 2 or more identities in a singular person. People with this disorder will experience significant gaps in their memory, which is confusing and stressful. People with DID often say they don’t feel like themselves, or like they aren’t actually in their own bodies, or realities (APA, 2022). It’s a myth that people with DID are dangerous; most people with DID are actually victims of childhood trauma and DID symptoms are the brain’s way of protecting itself, in a misguided way (Pedersen, 2022).

Symptoms

Common symptoms are:

●     You don’t feel like yourself (division in your identity).

●     Feeling of detachment from your body, mind or self (de-personalization).

●     Watching yourself from an outside perspective (de-realization).

●     Gaps in memory.

○     Forgetting big life events (i.e. graduation), cannot recall childhood.

○     Forgetting learned skills (i.e. playing an instrument).

○     Finding items you don’t remember owning.

●     Cannot control your own emotions and actions.

●     Very fast changes in personality.

○     Rapid changes in religious beliefs, gender, sexual identity, or what your favourite foods are.

Complex symptoms include:

●     Voices in your head that don’t seem to be your own.

○     This can include your own voice sounding different, or a different voice entirely.

○     The voice may comment on your thoughts or behaviours.

●     Hearing multiple, independent, uncontrollable thoughts at the exact same time.

●     Hallucinations

●     Change in names, wardrobes, hairstyles, handwriting or accent.

(American Psychiatric Association, 2022).

How does DID affect your life?

Living with DID could add additional stress to your life as well as stress to the family you live with or interact with daily. Dissociative Identity Disorder may cause you to fall behind on tasks like work and school, as well as drop lower in social class. Teenagers might feel confused, and upset, by missing gaps in memory, called dissociative amnesia, and unpredictable personality switches can leave the Host (original and main personality) in a state of exhaustion. DID also causes higher risk for suicide, hospitalization, and depression (American Psychiatric Association, 2022).

Risk Factors

There are two main risk factors that determine whether or not you or someone you know may have DID, your genetics and your environment.

Genetics

It is thought that there are many genes that make a brain more likely to dissociate when it encounters a traumatic situation, and these genes are likely passed down through your family tree. It is possible that these genes are further altered after experiencing trauma, but more research needs to be done to figure out how genetics contributes to someone’s risk for developing DID (Rajkumar, 2022).

Environment

DID is a type of PTSD meaning you would need to go through a very terrible experience for a long time to develop this disorder, usually before the ages of 5-6 years old, when you haven’t had time to build one single solid personality. 90% of cases are related to abuse and/or neglect by someone inside the home or within the neighborhood (like at school). The rest of DID cases occur from other traumatic experiences such as severe bullying, multiple painful medical procedures, trafficking, terrorism, and war (American Psychiatric Association, 2022).

Other Associated Diagnoses

DID is an uncommon disorder so sometimes it may be misdiagnosed as something else such as bipolar disorder, major depressive disorder, Post-Traumatic Stress Disorder (PTSD), substance use disorder, or schizophrenia. Sometimes if you have DID you may also have other disorders too like OCD, depression, various personality disorders, PTSD, substance use disorders, and eating disorders (American Psychiatric Association, 2022). If you already have one of these diagnoses, DID may be worth looking into if things still don’t feel right.

What’s happening in your brain?

Before we can get into what happens in the brain with DID, we first need to know what the relevant parts are:

Amygdala: This is your brain’s alarm bell, it is what causes you to feel aggression and fear (American Psychiatric Association, 2022).

Ventromedial Prefrontal Cortex (vmPFC): The part of your brain that regulates your emotions, you can imagine that the vmPFC is holding the amygdala on a leash.

Image Credit: National Institute of Mental Health.

Now to understand what DID does to your brain, we first need to understand what regular PTSD looks like when triggered. During an episode the vmPFC loses control of your emotions, at the same time the amygdala who’s now off the leash starts ringing its alarm bells causing you to panic. DID though, when triggered does the complete opposite. By dissociating, your brain is essentially cut off from the event, causing you to get that disconnected feeling or like it is happening to someone else. The amygdala’s alarm bells can’t reach you which helps the vmPFC maintain control of your emotions (Lebois et al., 2022).

Outside of a trigger, other parts of the brain such as the hippocampus, the part for creating memories, have also been implicated as part of the experience of DID however further research is needed to see exactly how (American Psychiatric Association, 2022).

Treatment

Although DID does not have a “cure”, but there are therapies, such as Trauma-Focused therapy (involving interviews about the trauma), which can help reduce symptoms and help improve daily functions. Doctors may also prescribe antidepressants or anti-psychotics to be paired with therapy to assist in coping with the disorder (Frothingham, 2018).

Closing

Dissociative Identity Disorder is a complex disorder so symptoms found in one person may not be the same for you, and if you believe you or someone you know might have DID, we recommend talking to a psychologist. DID doesn’t disappear, so management of the various symptoms using differing treatments will help you live a more fulfilling life.

Call-to-Action

We encourage those with a personal experience of DID to share their story in the comments. You can also share this article with friends and family, so they can learn more about DID too. If you want more information on other disorders that are associated with DID, we recommend looking at the other blog posts on this website. Remember, you matter, and so does your mental health!

Image Credit: Freepik.

References

American Psychiatric Association, issuing body. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed, text revision.)

Brand, B. L., Sar, V., Starvropoulos, P., Kruger, Korzekwa, M., Martinez-Taboas, A., & Middleton, W. (2016) Separating fact from fiction: An empirical examination of six myths about dissociative identity disorder. Harvard Review of Psychiatry, U.S. National, 24(4), 257–270. doi: 10.1097/HRP.0000000000000100

Frothingham, S. (2018). Dissociative identity disorder: Symptoms and treatment. Healthline. https://www.healthline.com/health/dissociative-identity-disorder

Hull, M. (2018). Dissociative Identity Disorder Treatment. The Recovery Village Drug and Alcohol Rehab. https://www.therecoveryvillage.com/mental-health/dissociative-identity-disorder/treatment/

Lebois, L. A. M., Ross, D. A., & Kaufman, M. L. (2022). “I Am Not I”: The Neuroscience of Dissociative Identity Disorder. Biological Psychiatry (1969), 91(3), e11–e13. https://doi.org/10.1016/j.biopsych.2021.11.004

Myers, D. G., DeWall, C. N., & Gruber, J. (2023). Psychology (14th ed.). Macmillan Higher Education.

Pedersen, T. (2022). Dissociative Identity Disorder (DID): Myths vs. facts. Psych Central. https://psychcentral.com/disorders/dispelling-myths-about-dissociative-identity-disorder

Rajkumar, R. P. (2022). The molecular genetics of dissociative symptomatology: a transdiagnostic literature review. Genes, 13(5), 843.

Young, M., Almaskati, M., Vrabtchev, S., & Kuruvilla, T. (2024). Dissociative identity disorder: a review of the diagnosis that divides. Progress in Neurology and Psychiatry (Guildford), 28(2), 23–27. https://doi.org/10.1002/pnp.834