Multiple personality disorder

Multiple Personality Disorder

Multiple Personality Disorder (MPD), now more commonly referred to as Dissociative Identity Disorder (DID), is a complex psychological condition characterized by the presence of two or more distinct personality states or identities within a single individual. These distinct identities may have their own names, ages, histories, and characteristics, and they may take control of the individual's behavior at different times.

Overview

Dissociative Identity Disorder is classified under the category of dissociative disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is considered a severe form of dissociation, a mental process which produces a lack of connection in a person’s thoughts, memory, and sense of identity.

Symptoms

The primary symptom of DID is the presence of two or more distinct identities or personality states. Other symptoms may include:

• Amnesia: Gaps in memory for personal history, including people, places, and events, for both the distant and recent past.
• Depersonalization: Feeling detached from one's body or thoughts.
• Derealization: Feeling that the world around is not real.
• Identity confusion or alteration: A sense of confusion about who a person is.

Causes

The exact cause of DID is not fully understood, but it is believed to be a result of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse. The disorder is thought to be a coping mechanism, where the person dissociates themselves from a situation or experience that's too violent, traumatic, or painful to assimilate with their conscious self.

Diagnosis

Diagnosis of DID involves a comprehensive evaluation by a mental health professional, including:

• Clinical interviews
• Structured interviews and questionnaires
• Review of personal history

The diagnosis is often complicated by the presence of comorbid conditions such as depression, anxiety disorders, post-traumatic stress disorder (PTSD), and borderline personality disorder.

Treatment

Treatment for DID typically involves psychotherapy, also known as talk therapy. The goals of therapy are to integrate the separate identities into one primary identity and to help the person understand the cause of the disorder. Treatment may include:

• Cognitive-behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Eye movement desensitization and reprocessing (EMDR)

Medication may be used to address symptoms of depression and anxiety, but there is no medication specifically for DID.

Prognosis

The prognosis for individuals with DID varies. With appropriate treatment, many individuals can achieve significant improvement in their symptoms and quality of life. However, the process can be long and challenging, requiring a strong therapeutic alliance and a commitment to treatment.

Controversies

DID is a controversial diagnosis, with some professionals questioning its validity. Critics argue that the disorder may be iatrogenic, or induced by the therapeutic process itself. Others believe that it is underdiagnosed and that many individuals suffer without appropriate treatment.

Also see

• Dissociative disorder
• Post-traumatic stress disorder
• Borderline personality disorder
• Cognitive-behavioral therapy