Mental health conditions exist along a spectrum. All people feel depressed and anxious at times, for instance, but not everyone is diagnosed with clinical depression or an anxiety disorder.
In the same way, all people experience some degree of dissociation, which is a lack of connection between various aspects of the self, sometimes described as feeling unplugged in some way. Mild and common examples of dissociation include daydreaming, being fully absorbed in a movie or book, or driving somewhere familiar without remembering much of the drive later (sometimes called “highway hypnosis”).
When dissociation becomes a more serious problem, people may be diagnosed with dissociative amnesia, which causes people to have difficulty remembering important information about themselves, or depersonalization disorder, which involves feelings of detachment and unreality.
Another possible diagnosis is dissociative identity disorder (DID). The primary symptom of DID is the presence of two or more distinct identity states which alternate taking control. People will have significant gaps in their memory, often forgetting important personal information or being unable to recall everyday actions. To receive a DID diagnosis, the symptoms must be severe enough to cause significant distress or impair everyday functioning, and it must not be caused by another condition, such as a seizure or substance use disorder.
Separating DID Facts From Fiction
There’s been less research on DID than on many other mental health conditions, but scientific knowledge is growing. Unfortunately, new information is sometimes slow to reach public consciousness.
Some common misunderstandings and truths about DID include the following:
Myth: People with DID have multiple personalities.
Fact: Dissociative identity disorder was once known as multiple personality disorder, but the name was changed because experts felt that the term “personality” was misleading. Other terms include “identities,” “alters,” “states of consciousness” and “ego states.”
Therapists stress that despite how it looks or feels, all the identities are parts of one single person, with each identity expressing a part of the whole. The American Psychiatric Association notes, “people with this disorder do not have more than one personality but rather less than one personality.”1
Myth: Dissociative identity disorder is a rare condition.
Fact: DID is much more common than once thought, affecting 1.5 percent of American adults. The DID Research website notes that prevalence rates for DID are similar to those for major depressive disorder and obsessive compulsive disorder and more common than autism spectrum disorder and schizophrenia.2
Myth: The cause of DID is unknown.
Fact: Although it may not be possible to say with certainty why any one person develops DID, it’s thought to generally develop as a response to trauma, particularly in childhood. Dissociating is a way to escape feeling the full extent of a traumatic event and to run away mentally when it isn’t possible to run away physically. It appears that the younger a person is when the trauma occurs, the more likely it is for periods of dissociation to turn into completely dissociated identities.
Herschel Walker’s Struggle with DID
Legendary football star Herschel Walker, who has been diagnosed with DID, knows how it feels to experience trauma and its repercussions. “You talk about people who use coping mechanisms, because they don’t want to deal with the real pain they’re going through,” Walker explains in his interview with the Recovery Unscripted podcast.
“For myself, I was bullied as a little kid, and I was ashamed of myself. I didn’t love myself, and I wanted to be someone else.”5 Herschel Walker
There are also biological markers related to DID that are consistent with other stress-related disorders. The hippocampus and amygdala are brain regions that may change in reaction to stress. In patients with DID, the volume of the hippocampus was found to be 19 percent smaller, and the volume of the amygdala 32 percent smaller than in people without the condition.3
Myth: DID is always obvious.
Fact: The presence of dissociative identity disorder isn’t always obvious, either to onlookers or even to people who suffer from the condition themselves. In the beginning, people with DID may simply be aware of lapses in memory. Whether or not they’re aware of their tendency to dissociate, people can often function quite well with their disorder. When a person’s “alters” are fairly similar in the way they present themselves, the condition is harder to detect than when they’re more distinct.
Myth: DID is easily diagnosed.
Fact: Because the presence of DID isn’t always obvious, it can mimic other conditions and can co-occur with other disorders, it often takes time for people to receive the correct diagnosis. According to the Sidran Institute, an organization that deals with traumatic stress, people with DID are in the mental health system for an average of seven years before their condition is diagnosed correctly.4
Myth: The likelihood of recovery is low.
Fact: DID doesn’t generally resolve on its own, but Sidran Institute research indicates that when people receive and complete proper treatment, DID may carry a favorable prognosis, when compared to other severe psychiatric disorders.
Patients may receive benefit from a variety of treatment modalities, including traditional psychotherapy, art or music therapy, and eye movement desensitization and reprocessing (EMDR).
Sometimes, people with mental health conditions don’t seek help because they fear being stigmatized. Learning about other successful people with DID, such as Walker, can be helpful. “To make that initial one step, and that’s what it is, taking that one step first,” Walker says. “Whether it’s communication, whether it’s getting the information, or whether it’s just acknowledging that something is going on. I think that’s the brave part because once you’ve done that, now you’re ready to go forward.”5
If you or a loved one is suffering from DID, getting a diagnosis and proper treatment may not be a quick and easy process, but it is worth the effort.
By Martha McLaughlin, Contributing Writer
1 Spiegel, David. “Expert Q & A: Dissociative Disorders.” American Psychiatric Association, Accessed April 12, 2018.
2 “Prevalence.” DID Research, Accessed April 12, 2018.
3 Vermetten, Eric, et al. “Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder.” American Journal of Psychiatry, April 2006.
4 “What is a Dissociative Disorder?” American Psychiatric Association, Accessed April 12, 2018.
5 “Tackling Dissociative Identity Disorder with Herschel Walker.” Recovery Unscripted, December 7, 2017.