Dissociative Identity Disorder

Okay.

Let me ask you, have you ever heard about one of the rare disease - Dissociative Identity Disorder?

If yes, how deep is your knowledge about this disease?

And if no, let’s together with me discover the exact disease named Dissociative Identity Disorder.

At first, Dissociative Identity Disorder (DID) is known as Multiple Personality Disorder until 1994. Why the name changed? Sit back and wait. I’ll explain it later.

DID is a condition which an individual has two or more distinct identities or personality states. These different personalities, called as alters, alternately take control of the patient and what awful is the patient will experience memory loss that's totally different to ordinary forgetfulness. That is why the patient cannot be able to maintain a clear sense of memory or self during the switches.

Sometimes, we forget to bring our book or forget to do what we should do. But hey, do not worry, these have no relation with DID.

Taken from http://image.slidesharecdn.com/dissociativeidentitydisordermentalhealthpowerpointpresentation-13291113956152-phpapp02-120212233936-phpapp02/95/dissociative-identity-disorder-mental-health-powerpoint-presentation-1-728.jpg?cb=1329090135

             

The name changed after 1994 after the psychiatrist discovered that this disorder is actually a fragmentation or splintering of identity rather than growth or procreation of separate identities.“Some people do have what scientists now call “dissociative identity disorder” (DID), a name change made official in 1994, when the American Psychiatric Association published the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders.” (The Dana Foundation, 2008, as cited in David Spiegel, 2006)

For your information, the patient of DID is like an actor that act in different drama with different personalities. In this drama or movie, he might be a villain, but the other drama he might be a saint. Or simply explained by Kirstin Fawcett, 2015 “One minute, someone with DID is saying something; the next, another element of his identity emerges and he brings up a new topic midstream.” This also explained well that the alter causes patient have a different names, different history and different self-perceptions.

Taken from http://322059845980466529.weebly.com/uploads/1/5/3/1/15312570/414985047.jpg?292

According to Sue-Mei Slogar’s (2011, as cited in Rubin & Zorumski, 2005) this disorder estimated prevalence of DID ranges from 1 to 5%, while females mostly the victim of DID at a ratio of 9:1 (as cited in Lewis-Hall, 2002). Based on these research, we can conclude that this disorder is still rare since it is hard to detect. 

Why? 

This is because according to what has been reported by Robert J. Waldinger in his own book (p. 213) that the patient and the alters may or may not aware her or his own condition that have several personalities. In fact, National Alliance on Mental Illness (NAMI) revealed, “A person living with DID may have as few as two alters or as many as 100. The average number is about 10.” 

Isn’t that quite amazing yet awful?

Children are gift of God

Every little child was born not to be neglected. They are the precious gift of God to make the world more merrier with their innocent laugh and talks. However, they are some parents or people out there being a monster who always neglects the children as if the children are toys. 

What is neglects and what is the relation between the disorder?

According to American Human Association, neglects is defined as "a  type of maltreatment that refer to the failure by the caregiver to provide needed, age-appropriate care, although financially able to do so or offered financial or other means to do so." (American Humane Association, 2013, as cited in USDHHS, 2007). Neglect also including physical neglect, educational neglect, emotional/psychological neglect and medical neglect. 

It does not matter what kind of neglect that you have done with the kids. If their behavior goes wrong like being depressed or become silent, then there is must be something. However, mostly DID is caused by trauma of physical abuse and emotional abuse.

Dissociative Identity Disorder’s patient usually most of them has a bad history background especially during his or her childhood. They might have severe trauma that often came from physical or sexual abuse likely the parent, teacher or neighbor did. This causes an individual to have a loss of control over one’s body since the durability of traumatic stress is helpless.

Taken from http://divorceministry4kids.com/wp-content/uploads/2011/09/child-abuse.jpg

That is why, when they being assaulted or had very serious injury, the victim seems dazed and unaware their condition either bad or not. They felt that they are having a dream and when they back to reality, they tend to become into a creator of their imaginary playmates or imagined themselves as the protector to save them from pain. 

This can be proved by Goldberg, J, 2014, “As many as 99% of individuals who develop dissociative disorders have recognized personal histories of recurring, overpowering, and often life-threatening disturbances at a sensitive developmental stage of childhood (usually before age 9). Dissociation may also happen when there has been insistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse.”

Taken from http://www.novabucks.org/images/ChildAbuseImageWithHand1.jpg

At the end, we now realize, that child abuse either physically or sexually can lead them into being Dissociative Identity Disorder patient. We might think that they will recover anytime either mentally or physically. But, who knows actually, they are more hurt inside and they don't have someone to rely on, literally changed them and also changed their perspective to the world.

Now, let’s us take a look on what kind of symptoms that the patient have?

Since the DID patient had a very heart-breaking childhood memories, they are always being depressed or low self-esteem and has no motivation to live. Even, they might think of suicide! According to National Alliances Mental Illness (NAMI), some of them probably affect auditory or visual hallucinations.

Below are the list of further symptoms that the victim tends to have in experiencing separate identities:

1. Confusion
•  They might have confusion when they realize that what not belong to them was theirs or maybe some strangers suddenly acknowledge them.
2. Phobia
•  They may have a phobia towards some places that they being abused, or some people that abused them.
3. Selective of loss memory
• They don't remember for certain time period, events including recognizing their cliques
4. Personality change
• They might immediately change into different personality like shy, aggressive, straightforward or daring. They also tend to change gender either become woman or man
5. Anxiety/Panic attacks
6. Headaches
7. Flashbacks

Don't worry. We got some treatments to treat the patient.

At first, the patient will go through psychotherapy with hypnosis. At this state, the therapist will make contact with all alters as possible as they can do in order to understand their roles and functions in the patient’s life. The therapist aims basically to find the one (alter) that have relation with the patient’s past and by that, the therapist will breakdown the wall between the patient’s separate identities and unite it into a single identity.

Taken from http://www.samahospital.com/blog/wp-content/uploads/2015/08/psychotherapy.png

Why therapist want to find alter that have the relation with the past?

This is because, the memories of trauma are really important for a person who live with DID. It is a must for a therapist to help the patient to retrieving and dealing with the trauma so that they can face the reality and recover the pain that they had.

Next, some psychotherapists are using anxiolytics and antidepressants which are the drugs. Below these group of drugs, carbamazepine is useful for abnormalities while prazosin is specialist in nightmares and naltrexone is for self-injurious behavior. According to Sue-Mei Slogar (2011, as cited in Ballew, Morgan and Lippmann, 2003) a drug known as diazepam is proved useful for assisting in memory retrieval in cases of DID where memories contain traumatic materials. In this study, diazepam was used to successfully facilitate memory retrieval in an amnestic client who was unable to recall his location or identity.

However, DID patient need the therapist in order to help themselves regain their own body from being controlled by other alters. The usage of drug without any help from therapist are hopeless.

Taken from http://www.kcl.ac.uk/departmentalimages/student-advice/intsupport425.jpg

What we can do is now, do not ignore or isolate people who have Dissociative Identity Disorder. The family member and friend of the patient can show the support in many ways like:

• Be informed
• Learn about DID as more as you can. Did some research
• Find a therapist
•  You may search some information about therapist who is trained and experienced in treating DID. Don’t forget to encourage them to attend the therapy appointment regularly
• Be universal
• During the switches, sometimes the patient has no idea about you. What you can do is introduce yourself and offer reassurance if they are frightened. Become friends to the other personalities.
• Be aware
• Sometimes, they tend to suicide. Be alert and make a call for help.
• Listen
• Willing to listen everything that they wants to talk about. Listen and don’t judge. Some talks may need solution, then help them to solve it. And some of talks need an ear to listen.

Show them that you care. DID patients really need support from people around them because they really trust people that close to them. Only families and friends can help them to gain strength to fight and win the war of the alters!