Dissociative identity disorder is a real condition, and it’s not quite as rare as you might imagine.
Living with dissociative identity disorder (DID) means you may experience shifts between at least two separate identity states, or personalities.
Many people recognize the condition by its former name: multiple personality disorder. Yet DID is actually a dissociative disorder, not a personality disorder.
Sensationalized media portrayals and a general lack of understanding of what DID really involves have fueled plenty of myths and misconceptions about the condition.
Some of those myths are that:
- DID is not real.
- DID is rare, and many people fake the condition.
- At least one alternate identity is violent.
- DID is just a severe form of borderline personality disorder.
- The condition can’t be easily diagnosed or treated.
These myths — and the stigma they generate — can make it challenging for you to reach out for help if you recognize symptoms in yourself or a loved one.
We’ve got the facts to challenge these myths and help you better understand symptoms and treatment options — because DID can improve with professional support.
The new edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), also known as the DSM-5, categorizes DID as a dissociative disorder.
Dissociative disorders, which often develop after trauma, may involve:
- disruptions in processes related to memory, identity, and perception
- emotional disconnection and detachment
- disconnection from reality and surroundings
Nearly everyone dissociates on occasion — when you daydream or zone out while driving, for example.
The dissociation that happens with these mental health conditions, however, is persistent, causes distress, and may impede functioning in the world.
The dissociation in DID is unique. It involves shifts between at least two but often more distinct and separate identities. These shifts generally happen in response to some type of perceived threat or distress.
While DID is primarily recognized by the presence of alternate identities, or personality states, it involves other symptoms, too.
As with other mental health conditions, not all people with DID experience the same symptoms or the same intensity.
In general, other main symptoms of DID are:
- dissociative amnesia, or trouble remembering personal information or facts about your life
- dissociative fugue states, or experiences where you travel or wander with no memory of what happened
- blank spaces in your memory, including the inability to recall important events from either childhood or adult life
- sudden lapses in recent memories (such as what you did yesterday) or skills (from writing to making coffee)
- a sense of depersonalization, or watching yourself from the outside
- a sense of your body taking on different sizes or shapes
- vague, dreamlike memories of experiences
- feeling as if your body, thoughts, or feelings aren’t yours and you can’t control them
- noticeable changes in speech, behavior, and personal preferences
Not everyone with DID recognizes signs in themselves, and you may not necessarily notice the existence of separate identities.
Instead, others might describe what they consider puzzling behavior, such as an accent in your speech that comes and goes or a new habit that you exhibit.
Besides these symptoms, DID might also involve these signs:
Fears or phobias that ‘come and go’
You’re relaxing with your partner on the sofa when they suddenly say, “I had no idea you were so afraid of dogs. I thought you liked them.”
“I do,” you say, confused.
“It didn’t seem like it when we were out today! I still can’t believe we had to cross the street and turn the corner before you stopped shaking. That dog seemed so friendly, too.”
Completely stunned, you can’t think of a reply. You’ve never felt afraid of dogs. In fact, you’re pretty fond of them. What’s more, you have no memory of going out with your partner earlier.
Unusual or new behaviors
You suddenly realize you’re wearing clothes you absolutely hate. You cast your mind back to the morning to figure out why and realize your mind is completely blank: You have no idea what you’ve been doing all day.
Looking around your house, you notice it’s much cleaner than it was when you went to bed the night before. You live alone, so you’re the only one who could have conducted the cleaning spree, but you can’t remember any of it.
The vanilla candle on the coffee table also confuses you, since you never buy scented candles. You never play classical music, either, but that’s what you hear coming from your speakers.
Switching food preferences
At dinner with your partner, you give your order to the waiter. Your partner chimes in with, “Oh, but no tomatoes.” You look at them, completely confused.
After the waiter walks away, you ask, “Why did you tell them I didn’t want tomatoes? I’m fine with them.”
“What? You hate tomatoes. You went on and on about how much you hate them the other night when we had dinner at my place. It was kind of weird, actually. I’ve never heard you sound like that before. It sounded like you were channeling your younger self or something.”
You try to remember the night they’re talking about, but all you can pull up is a vague memory of watching a movie on the sofa.
According to stories from people living with DID, you may not experience completely distinct shifts or separations of identity.
Instead, you could feel as if you have a blurred identity or several identities at once.
Blurred identities mean that you may not hear only your own internal voice. You could also hear the voices of people with different personality traits, genders, likes and dislikes, and ideas about what to do.
These voices might all talk at once inside your head, discussing the best way to handle a situation. It might seem as if these identities are battling within you to win control. This can feel pretty overwhelming and confusing.
Other signs of DID you might notice
Plenty of other signs can suggest the presence of alternate identities, or alters:
- You keep finding a pair of glasses in your bag, even though you’ve never worn glasses.
- Your roommate says, “I heard you talking on the phone in your room the other day. Italian, right? I recognized a few words. I had no idea you spoke Italian.” (But you don’t. The only foreign language you know is German.)
- One morning, you open your refrigerator to find it full of food you don’t remember buying — food you usually don’t purchase.
- On your way out the door, you notice your favorite shoes are scuffed and muddy, though they were perfectly clean the last time you put them away.
- You find a piece of paper in your pocket with some notes scrawled on it. You recognize your memo pad and favorite green pen, but you don’t recognize the handwriting or remember putting the paper in your pocket.
There’s no DID test or quiz to identify the symptoms of the condition.
Only a trained mental health professional can make an accurate diagnosis. In general, they will follow DSM-5 criteria, which are:
- changes or disruptions in identity or sense of self, marked by at least two separate personality states. Others might recognize these identities by changes in behavior, attitude, or speech.
- repeated episodes of amnesia, large gaps in memory, or trouble recalling personal details, life events, or how to perform specific tasks
- persistent emotional distress related to these symptoms
Before diagnosing DID, mental health professionals will rule out other medical and mental health conditions, including substance use, seizure disorders, and psychosis.
Children and adults can be diagnosed with DID. That said, mental health professionals will rule out imaginary friends and other age-appropriate fantasy play before diagnosing the condition in children.
DID symptoms usually make daily life challenging and may cause plenty of emotional distress.
Most, though not all, people who meet criteria for DID often live with other mental health conditions or symptoms of trauma and distress, including:
- substance use disorders
- post-traumatic stress disorder
- obsessive-compulsive disorder
- sleep problems
- personality disorders
- eating disorders
- suicidal thoughts
- a history of self-harm
Not all mental health professionals recognize the signs of DID and some have questioned its existence. This means that many people with DID live with the condition for years before receiving the correct diagnosis.
DID is, however, a formal and accepted diagnosis in the DSM-5 — the most commonly used diagnostic tool for mental health disorders.
Popular media portrayals of DID have brought the condition to the forefront. A few include TV shows like “Mr. Robot” and “The United States of Tara” and movies like “Split,” “Identity,” “Fight Club,” and “Psycho.”
Not all of them have portrayed it accurately, though.
These shows and movies get some things right, such as the fact that DID tends to stem from trauma in early life. The therapist in the movie “Split” also makes it clear that DID is, in fact, a real condition.
Still, not all press is good press.
Everything these depictions get wrong about DID can easily fuel more confusion and fear of the condition — not to mention the tired and wholly inaccurate idea that mental health conditions are linked to violent behavior.
Let’s clear up a few common myths:
First of all, DID doesn’t make someone violent.
Symptoms like suicidal thoughts and self-harm may present with DID. People living with the condition may be more likely to harm themselves than anyone else.
DID doesn’t always involve a drastic “switch” or shift in personality.
People very close to you might notice some changes in your behavior or speech. But, then again, these differences are often subtle, so they may not notice anything at all. You may not notice, either.
And not everyone experiences DID in the same way.
Not real or very rare
DID isn’t all that rare.
Studies from around the world suggest varying rates of prevalence, but it seems to occur in around 1.1% to 1.5% of the general population.
And finally, DID isn’t the same as possession that happens as part of spiritual, cultural, or religious beliefs.
According to the DSM-5, identities that resemble supernatural or spiritual beings are called “possession-form identities.” Someone with this type of DID would be diagnosed only when:
- the shifts in identity are unwanted
- the other identities cause distress
- identity shifts happen alongside amnesia or other memory gaps
For the most part, experts agree that DID tends to develop in response to trauma.
Trauma might include:
- physical, sexual, or emotional abuse
- mistreatment or neglect
- childhood medical trauma, such as a frightening or painful hospital experience
- war or terrorism
Trauma is, however, an intimate and unique experience. What’s traumatic to you may not be for someone else. The impact the experience has on you is what accounts for the trauma.
Experiencing either sexual or physical abuse can increase your chances of developing DID.
According to the American Psychiatric Association, around 90% of people diagnosed with this disorder in the United States, Canada, or Europe experienced abuse or neglect as children.
The DSM-5 also notes several factors that could worsen your symptoms, such as:
- co-occurring mental health conditions
- serious physical illness
- repeated or ongoing abuse
- lack of treatment
Auditory hallucinations, sometimes described as “hearing voices,” commonly happen with schizophrenia.
Some mental health professionals may assume a person describing the internal voices of their different identities is actually hallucinating. This may lead them to diagnose schizophrenia instead of DID.
Yet schizophrenia involves many other symptoms not typically associated with DID, such as:
- disorganized speech and thoughts
- difficulty expressing emotions
- isolation and withdrawal
It’s not impossible for someone with DID to also have schizophrenia, but these are two separate conditions, with very different treatments.
Misdiagnosis usually leads to treatment with antipsychotic medications, which won’t improve DID symptoms.
Depersonalization-derealization disorder involves repeated episodes of:
- Depersonalization: feeling detached from your body and actions, thoughts, or sense of self
- Derealization: feeling disconnected from your immediate surroundings and the world in general
People with DID can experience similar episodes of detachment from reality.
Unlike DID, though, depersonalization-derealization disorder doesn’t involve amnesia or separate identity states. You might lose touch with your sense of self, but you don’t develop a separate identity.
Experts have yet to discover a cure for DID.
That said, the idea that DID is impossible to treat is just another myth.
Treatment can go a long way toward improving symptoms and helping you regain control over not just your life, but your sense of self.
A trained therapist who works to recognize, communicate with, and support all of your identities can help you begin to manage distress without shifting identity states.
Other goals of therapy for DID might include:
- identifying and exploring sources of past trauma
- recognizing and reframing cognitive distortions
- treating co-occurring mental health symptoms
- integrating alternate identities
Recommended therapy approaches might include:
- cognitive behavioral therapy
- dialectical behavior therapy
- eye movement desensitization and reprocessing
Medication won’t relieve symptoms of DID, but a mental health professional may recommend medication to help ease severe symptoms of anxiety or depression, especially when symptoms make progress in therapy difficult.
DID, which might develop as a coping mechanism, is a real mental health condition that causes real distress.
If you or someone you love experiences shifts in identity, dissociative amnesia, or other symptoms of this disorder, working with a supportive, compassionate mental health professional can make a big difference.
You’re not alone, and treatment can help.
To learn more about treatment options and find providers near you, visit:
- An Infinite Mind
- Sidran Institute
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Find a Psychologist tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Psychologist tool
- National Alliance on Mental Illness Helplines and Support Tools
- National Institute of Mental Health’s Helpline Directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists