Dissociative Identity Disorder (Multiple Personality Disorder)

What is dissociative identity disorder?

Dissociative identity disorder (DID), formerly known as multiple personality disorder and split personality disorder, is a mental health condition where you have two or more separate identities.

“Dissociate” means to separate or disconnect. People with dissociative identity disorder may experience several different personalities, usually referred to as alters. Each identity may have different behaviors, memories, thought patterns or expressions. The identities might have different gender identities, ethnicities and ways of interacting with their environments.

These personalities may control your behavior at different times. Memories may not transfer from one identity to another, which can cause amnesia (gaps in memory). The presence of amnesia is often an important symptom that raises concern for the diagnosis.

DID interferes with your ability to function in your day to day. It can impact your relationships with others and performance at school or work. 

DID is one of several dissociative disorders. These disorders affect your ability to connect with reality.

What are the types of dissociative identity disorder?

There are two types (or forms) of DID:

• Possession: Identities present as if an outside being or spirit took control of your body. You might speak or act differently in a way that’s obvious to others. It’s an unwanted identity and the personality switch is involuntary.
• Nonpossession: Identities are less known to others. You might feel a sudden change in your self-identification, as if you’re watching yourself in a movie (an “out-of-body” experience) instead of being in control of your speech, emotions or behaviors.

It’s important to note that possession is a common belief of different cultures and religions around the world, but these voluntary spiritual practices aren’t associated with DID.

How common is dissociative identity disorder?

DID isn’t common. One small U.S. study found that DID affects an estimated 1.5% of people.

Current estimates on how common this condition is may vary based on new diagnostic criteria introduced in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5).

What are the symptoms of dissociative identity disorder?

The symptoms of DID include:

• Having at least two identities (personality states). These affect your behavior, memory, self-perception and ways of thinking.
• Amnesia or gaps in memory regarding daily activities, personal information and traumatic events.
• Different identities affect your ability to function in social situations or at work, home or school.

Other mental health symptoms that can (but not always) be found along with DID include:

• Anxiety.
• Delusions.
• Depression.
• Self-harm.
• Substance use disorder.
• Thoughts about suicide (suicidal ideation).

What does a person with DID feel like?

If you have DID, you might feel or experience the following:

• Detached from reality, your emotions and your sense of self.
• Confused by what others may tell you about your behavior.
• Frustrated about gaps in your memory.
• Stressed about not being in control.
• Like a bystander, watching yourself from the outside.

It doesn’t feel like you’re “you” with DID. This can look and feel different for each person who experiences it. If something doesn’t feel right or your experiences and memories aren’t lining up, reach out to a healthcare provider for an evaluation.

Can someone have DID without knowing?

Yes, it’s possible that someone can have DID without knowing. While some people are aware of their identities, many people don’t know when a new identity takes over. When a new identity steps in, you may not remember some events because another personality experienced them. This causes gaps in memory, called amnesia.

What causes dissociative identity disorder?

DID causes may include:

• Stressful experiences.
• Trauma.
• Abuse.

These events typically happen during childhood. DID is a way for you to distance or detach yourself from the trauma.

DID symptoms may trigger (happen suddenly) after:

• Removing yourself from a stressful or traumatic environment (like moving homes).
• Close relatives or your children reaching the age at which you experienced trauma.
• A recent traumatic or stressful experience (like a vehicle accident).
• An abuser passing away or experiencing a life-threatening illness.

What are the risk factors for dissociative identity disorder?

You may be more at risk of developing DID if you experienced:

• Physical or sexual abuse.
• Neglect.
• Multiple medical procedures during childhood.
• War or terrorism.

What are the complications of dissociative identity disorder?

You’re at an increased risk of suicide with DID. More than 70% of people diagnosed with DID attempt suicide or practice self-injury behaviors.

If you’re thinking about hurting yourself, call or text 988, the Suicide & Crisis Lifeline (U.S.). You don’t have to be in a crisis to dial 988. Someone is available to talk, no matter your situation, so you can feel better in your time of need.

How is dissociative identity disorder diagnosed?

A healthcare provider, usually a psychologist and/or psychiatrist, will diagnose DID after taking a detailed medical history and learning more about you and your symptoms. Your provider may gather more information from people who know you best or spend the most time with you. Usually, someone close to you will be the first to notice a change in your personality and raise concerns.

There isn’t a single test that can diagnose DID. A provider will likely run a physical exam and neurological exam, among other tests, to rule out any conditions that could cause symptoms. They’ll review your symptoms and compare them to the criteria presented in the American Psychiatric Association’s Diagnostic and Statistical Manual, 5th edition.

In addition, your provider may use different questionnaires or scales to evaluate dissociative behavior. These include:

• Dissociative experiences scale: It features 28 questions about your day-to-day experiences.
• Dissociation questionnaire: This includes 63 questions to evaluate the severity of identity dissociation.
• Difficulties in emotion regulation scale: These 36 questions focus on how you regulate your feelings and emotions.

Your provider will also ask you questions to learn more about your risk of suicide, as it’s common among people who experience DID.

When is dissociative identity disorder diagnosed?

Symptoms of DID often show up in childhood, between the ages of 5 and 10. But it’s common for parents, other family members, guardians, teachers or healthcare providers to miss or mistake the early signs. They may confuse DID with other behavioral or learning challenges, such as attention-deficit/hyperactivity disorder (ADHD). For this reason, DID usually isn’t diagnosed until adulthood.

Due to the rarity of DID and the large variation in symptoms, it may take even experienced healthcare providers time to make an accurate diagnosis.

How is dissociative identity disorder treated?

Treatment for DID includes:

• Medications to manage symptoms like depression and anxiety.
• Psychotherapy (cognitive behavioral therapy or dialectical behavioral therapy).

The first step of treatment is always to make sure you’re safe. A healthcare provider with specialized training in mental health disorders can guide you toward the right treatment. Treatment focuses on meeting your specific needs.

Therapy for dissociative identity disorder

Therapy for DID focuses on:

• Identifying and working through past trauma.
• Managing sudden behavioral changes.
• Merging separate identities into a single identity.

You may benefit from individual, group or family therapy.

Participating in therapy is challenging. You’ll need to work through events that bring strong emotions. These can make you feel anxious, helpless, scared and alone. But you’re not alone. Your therapist and loved ones are willing to help and support you as you navigate treatment for DID.

Can hypnosis help with DID?

Some healthcare providers recommend hypnotherapy in combination with psychotherapy. Hypnotherapy is a form of guided meditation. It may help you recover suppressed memories.

Can dissociative identity disorder be prevented?

There’s no way to prevent DID. However, identifying signs as early as possible and seeking treatment can help you manage symptoms. Parents, caregivers and teachers should watch for signs in young children. Treatment soon after episodes of abuse or trauma may prevent DID from progressing.

Treatment can also help identify triggers that cause personality or identity changes. Managing stress and avoiding non-prescribed drugs and overconsumption of alcohol may help reduce the frequency of different alters controlling your behavior.

Will dissociative identity disorder go away?

There isn’t a cure for DID. But your symptoms can get better. You’ll need to manage the condition for your entire life. This can feel overwhelming, but your provider will help you find the right treatment or combination of treatments so symptoms don’t take over.

Are there ways to make living with DID easier?

Always follow your provider’s treatment plan. This could include taking medications as directed and continuing treatment, even if you feel better. If things are difficult or you notice things get worse instead of better, let your provider know immediately. They can work with you to adjust your treatment plan throughout your life.

A strong support system can make living with DID more manageable, too. Make sure you have healthcare providers, family members and friends who know about and understand your condition. Communicate openly and honestly with the people in your support system. Don’t be afraid to ask for help when you need it.

If a loved one has DID, how can I help?

Having a loved one with DID can be confusing and overwhelming. You may not know how to respond to their different alters or behaviors. You can help by:

• Learning about DID and its symptoms.
• Offering to attend family counseling or support groups with your loved one.
• Staying calm and supportive when sudden behavior changes occur.

When should I see a healthcare provider?

It’s easy to minimize the impact that your symptoms have on your daily routine. If you suspect something isn’t right about your sense of self, your memory or how you’re able to function, contact a healthcare provider.

If you or someone you know has DID and exhibits any of the following, seek medical attention right away:

• Self-harm.
• Suicidal thoughts.
• Violent behavior.

In the U.S., you can call or text the Suicide and Crisis Lifeline by dialing 988. This hotline connects you to a network of local crisis centers that provide free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, seven days a week.

If you or a loved one are in immediate danger, call 911 or your local emergency services number.