Dissociative identity disorder is chronic and potentially disabling, although many individuals function very well and lead creative and productive lives.
Several symptoms are typical of dissociative identity disorder.
Amnesia may involve the following:
- Gaps in the memory of past personal events: For example, individuals may not remember certain periods of time during childhood or adolescence.
- Lapses in memory of current everyday events and well-learned skills:
- For example, individuals may temporarily forget how to use a computer.
- Discovery of evidence of things that they have done but have no memory of doing.
Individuals may sense that they are missing a period of time.
After an episode of amnesia, individuals may discover objects in their closet at home or samples of handwriting that they cannot account for or recognise.
They may also find themselves in different places from where they last remember being and have no idea why or how they got there.
They may not be able to recall things they have done or account for changes in their behaviour. They may be told they said or did things that they cannot remember.
More than One Identity
In the possession form, the different identities are readily apparent to family members and other observers.
The individuals speaks and acts in an obviously different manner, as though another individual or being has taken over.
In the non-possession form, the different identities are often not as apparent to observers.
Instead of acting as if another being has taken them over, individuals with this form of dissociative identity disorder may feel detached from aspects of themselves (a condition called depersonalisation), as if they were watching themselves in a movie or as though they were seeing a different person.
They may suddenly think, feel, say, and do things that they cannot control and that do not seem to belong to them. Attitudes, opinions, and preferences (for example, regarding food, clothing, or interests) may suddenly change, then change back. Some of these symptoms, such as changes in food preferences, can be observed by others.
Individuals may think that their body feels different (for example, like that of a small child or someone of the opposite sex) and that their body does not belong to them. They may refer to themselves in the first person plural (we) or in the third person (he, she, they), sometimes without knowing why.
Some of am individual’s personalities are aware of important personal information of which other personalities are unaware.
Some personalities appear to know and interact with one another in an elaborate inner world. For example, personality A may be aware of personality B and know what B does, as if observing B’s behaviour. Personality B may or may not be aware of personality A, and so on with other personalities present. The switching of personalities and the lack of awareness of the behaviour of the other personalities often make life chaotic.
Because the identities interact with each other, affected individuals may report hearing voices. The voices may be internal conversations among the identities or may address the individual directly, sometimes commenting on the individual’s behaviour. Several voices may speak at the same time and be very confusing.
Individuals with dissociative identity disorder also experience intrusions of identities, voices, or memories into their everyday activities. For example, at work, an angry identity may suddenly yell at a co-worker or boss.
Individuals with dissociative identity disorder often describe an array of symptoms that can resemble those of other mental health disorders as well as those of many physical disorders. For example, they often develop severe headaches or other aches and pains.
Different groups of symptoms occur at different times. Some of these symptoms may indicate that another disorder is present, but some may reflect the intrusion of past experiences into the present. For example, sadness may indicate coexisting depression, but it also may indicate that one of the personalities is reliving emotions associated with past misfortunes.
Many individuals with dissociative identity disorder are depressed and anxious. They are prone to injuring themselves. Substance abuse, episodes of self-mutilation, and suicidal behaviour (thoughts and attempts) are common, as is sexual dysfunction. Like many individuals with a history of abuse, they may seek out or stay in dangerous situations and are vulnerable to retraumatisation.
In addition to hearing voices of other identities, individuals may have other types of hallucinations (of sight, touch, smell, or taste). The hallucinations may occur as part of a flashback.
Thus, dissociative identity disorder may be misdiagnosed as a psychotic disorder such as schizophrenia. However, these hallucinatory symptoms differ from the typical hallucinations of psychotic disorders.
Individuals with dissociative identity disorder experience these symptoms as coming from an alternate identify, from inside their head. For example, they may feel as if someone else is wanting to cry using their eyes.
Individuals with schizophrenia usually think the source is external, outside of themselves.
Often, individuals try to hide or play down their symptoms and the effect they have on others.