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5 Myths About Dissociative Identity Disorder

DID is an extreme form of mental illness characterized by two or more separate personalities in one person. See more mental disorder pictures.
Photo courtesy of SAMHSA

Most of us have days when we don't feel like ourselves. Some of us have moments, sometimes more than moments, when we feel disconnected from our surroundings, our actions, ourselves. We've arrived at work with no clear recollection of the drive from home.

Taken to its most extreme level, that's what dissociative identity disorder (DID) feels like all the time.

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DID is an extreme form of mental illness. Characterized by two or more separate personalities in one person, it's the disease portrayed in "The Three Faces of Eve," "Sybil," and more recently "The United States of Tara," and it's a controversial diagnosis. Some doctors believe it occurs somewhat commonly in certain types of trauma survivors; others believe it's extremely rare, to the point of almost never occurring; and some don't believe it exists at all.

What's sure is that mental illness in general is far from rare. It can result from genetics, biology, environmental factors and/or some combination thereof. The World Health Organization estimates that 400 million people around the globe suffer from some type of mental-health problem. Compared with issues like depression, anxiety, addiction and obsessive compulsive disorder, dissociative identity disorder is a rare diagnosis, but it's out there. According to MedicineNet, 3 percent of institutionalized mental patients suffer from the condition.

This potentially debilitating disorder is one of the most misunderstood of all mental illnesses. Here, we'll look into some of the more common misconceptions about multiple personalities and find out the truth about the disease.

First up, myth 1: "It's also known as schizophrenia."

Lots of people confuse dissociative identity disorder with schizophrenia. They're actually two very different disorders.

Schizophrenics do not have multiple personalities at all. They have, in general, confusion about what is real and what is imagined. In schizophrenia, delusions are common. Delusions are beliefs or thoughts that are not based on anything real or justified. A "paranoid schizophrenic" may suffer from delusions of persecution, for instance. Some sufferers also hallucinate -- they see or hear things that aren't really there.

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There are, however, a few common threads between dissociative identity disorder and schizophrenia. Both may hear voices in their heads, and may withdraw from social interaction. Both are often accompanied by other mental illnesses, like depression or addiction. And both disorders carry an increased risk of suicide.

Next, myth 2: "They're faking it."

The primary personality is typically unaware of the presence of alters.
The primary personality is typically unaware of the presence of alters.
David McGlynn/Getty Images

Lots of people are skeptical of "multiple personalities," but there's actually good physical evidence suggesting the disorder is real. Studies have found that "alters" (secondary personalities) have different heart rates and blood pressures than the main personality.

Other dissociative disorders are widely accepted as real, including dissociative fugue, dissociative amnesia and depersonalization disorder. DID is the most extreme form of dissociation.

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Diagnosing it is difficult. People suffering from DID typically spend years in the mental health system before anyone considers they might have alters. There are some diagnostic criteria, though, that can help identify people as suffering from dissociative identities, including "lost time," frequent and extensive memory lapses, and often being accused of lying when they sincerely believe they are telling the truth. And of course, they have at least two separate personalities -- often with different names, appearances, mannerisms and attitudes -- that control behavior, thought and perception at different times. The primary personality is typically unaware of the presence of alters.

Many experts believe that people suffering from DID are genuinely ill. That doesn't mean, however, that no one is faking it. People accused of crimes and those suffering from Munchausen's syndrome have been found to pretend to have "alters" in order to escape jail or get attention, respectively.

Next, myth 3: "DID looks like 'Sybil.'"

Media representations of dissociative identity disorder evoke images of severe disturbance: alter Eve Black trying to kill primary Eve White's daughter, or Sybil walking away from her students and into a river, fully dressed. The 1953 movie "The Three Faces of Eve" was based on the real life of Chris Sizemore, and "Sybil" (1976) ostensibly told the story of Shirley Mason -- but like most media images, these portrayals are only partly true, dramatized for effect.

Dissociative personality disorder can lead to extreme behavior, but it is seldom so outwardly stunning. Symptoms associated with DID include profound memory loss and confusion, hearing voices, substance abuse, compulsive behavior, panic attacks, suicidal thoughts and actions, insomnia and depression. Most people who suffer from the illness had previously been diagnosed with one or more different disorders, and they go years, perhaps decades, before discovering they have alternate personalities.

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Next, myth 4: "DID isn't caused by trauma, because not all trauma survivors have DID."

No one knows what causes dissociative identity disorder. All signs point to extraordinary trauma, particularly during childhood. Some people object to that causation, though, because lots of children who go through traumatic experiences never develop multiple personalities.

On the other hand, not all smokers develop lung cancer.

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Childhood trauma, particularly repetitive trauma like physical or sexual abuse, is a notable common thread in a majority of DID cases. According to WebMD, at least 98 percent of people diagnosed with DID experienced extreme, possibly life-threatening ordeals. The hypothesis is that sometimes, these experiences can simply be too much for a child to integrate into conscious experience. The child's brain, as a coping mechanism, essentially "turns off" the conscious identity and creates alternate personalities to experience the pain.

It's possible that some minds are stronger than others, more capable of coping consciously with extreme trauma, so not all children in those situations develop split personalities.

Up next, myth 5: "It's a lost cause."

Most mental illnesses are treatable, and dissociative identity disorder is no different. The disorder can't be cured, but it can definitely be managed. It can take a long time, perhaps many years, and requires an intense commitment to treatment on the part of the patient, but it is entirely possible for someone suffering from DID to lead a normal, fulfilling life.

Recovering from dissociative identity disorder involves seeking treatment with a mental health professional like a psychiatrist, psychologist or clinical social worker. Treatment methods vary, and may include psychotherapy ("talk therapy"), medication (typically for accompanying conditions like depression or anxiety) and hypnotherapy. Some experts have found that alternate personalities may respond to the therapist under hypnosis, which allows not only the therapist but also the primary identity to gain information about the alters and what they have experienced.

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One aspect of treatment that has changed in the last decade is the ultimate goal regarding the alters. Once, therapist sought to integrate them into the primary personality. They found, though, that this could trigger a survival response -- that the other personalities felt the therapists was trying to eliminate them. Now, the goal is to facilitate a more peaceful coexistence between each of the alters and the main identity.

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