With scenes of crazed, manic criminals enacting chaos and destruction, movies and television have warped perceptions of what multi-personality disorder really is.

Personality disorders are marked by difficulty recognizing and connecting to situations and other people. ¹ In fact, multi-personality disorder is an outdated term that’s not used in practical medicine anymore.

So, to clear up the misconceptions, we invite you to follow along with our in-depth guide to this mental health condition.

What is Multi-Personality Disorder?

Multiple personality disorder (MPD) is an outdated term. Since 1994, the condition is known as dissociative identity disorder (DID). It’s marked by the experience of two or more distinct personalities that control your behavior at different times. ²

The condition is rare, only affecting 1.5% of the world’s population. It’s also been found to affect women more than men.

How is DID Diagnosed?

Before you can be diagnosed with DID, a medical professional must observe two different personalities in you. These are referred to as “alters” – your alternate personalities. While only a handful of alters are common, a person can have well over 100.

Alters are very distinct from one another. The identities could vary in terms of gender, ethnicity, interests, and approaches to interacting with their surroundings. ³

Other signs and symptoms a healthcare provider will look for include:

• Anxiety
• Delusions
• Depression
• Disorientation
• Memory loss
• Substance abuse disorder
• Suicidal ideation

No single test can diagnose DID. A healthcare provider will assess your symptoms and medical background, potentially conducting tests to eliminate any underlying physical factors, such as head trauma. ⁴

Difficulties in the Differential Diagnosis

A DID diagnosis is difficult to come to because it shares many similarities with other dissociative disorders. In fact, if you and your medical provider are unsure of a proper diagnosis, you may receive a few throughout your medical journey.

There’s a growing concern that patients with DID may not be believed by some psychologists and physicians. This is due to an increased rate of people complaining about dissociative symptoms and not receiving proper treatment. Many healthcare providers simply believe dissociation disorders are anxiety or bipolar episodes.

The Journal of Trauma & Dissociation touches on this issue further: “The difficulties in diagnosing DID results primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation.” ⁵

How is DID Treated?

Certain medications might alleviate specific symptoms of DID, like depression or anxiety. However, psychotherapy is the most effective treatment. ⁶ Psychotherapy will allow you to:

• Identify past trauma or abuse.
• Cope with sudden behavior changes.
• Consolidating separate identities into one identity.

How to Handle Multiple Personalities

Handling personality shifts isn’t easier. However, there are coping techniques to help ease symptoms and subsequent mood shifts. To get there, you must know yourself, your disorder, and how it manifests.

More specifically, you need to understand the triggers that cause shifts in personality. For example, a veteran might shift to an alter after hearing a loud noise, like a car backfiring. Such a sound leads to a state of shock and then disassociation.

The Link Between Trauma and Dissociation

Various types of traumas can lead to dissociative symptoms. Especially if those traumas occurred at an early and impressionable age. ⁷ DID is most common in those who experienced physical and sexual traumas at these ages.

In most cases, DID symptoms develop to distance or detach from traumatic experiences. ⁸ It’s common for people with DID to feel their lives play out like a movie. As though they are an audience member rather than an active participant.

Misconceptions of DID 

There are many misconceptions about DID. Most come from the media’s negative and deceptive portrayals of the condition. Many incorrectly believe that people with DID are a danger to themselves and others around them.

Other common DID misconceptions include:

• The condition isn’t real.
• DID’s dissociative shift episodes are obvious, and in some cases, extreme.
• Patients are insane and prone to being violent criminals.
• DID is a form of schizophrenia.

Busting the Myths Of DID

Claim: The condition isn’t real.

Reality: DID is a real disorder with classifications in the DSM-5 and has been a diagnosable mental illness since its addition to the DSM-3 in 1980.

Claim: DID’s dissociative shift episodes are obvious, and in some cases, extreme.

Reality: It’s more common for shifts in personality to be subtle, or even innocuous. This is part of what makes it so difficult to diagnose.

Claim: Patients are insane and prone to being violent criminals.

Reality: People with DID go through day-to-day life similar to anyone else (i.e. work, relationships, etc.). In fact, DID patients are more likely to have experienced violence, with the trauma from these events leading to symptoms.

Claim: DID is a form of schizophrenia.

Reality: Although DID and schizophrenia have similarities, they are different. Those who struggle with schizophrenia have symptoms like hallucinations and delusions. While these can be experienced in dissociative disorders, they aren’t always.

References

¹ Newlin E, Weinstein B. Personality disorders. Continuum (Minneap Minn). 2015 Jun;21(3 Behavioral Neurology and Neuropsychiatry):806-17. doi: 10.1212/01.CON.0000466668.02477.0c. PMID: 26039856.

² Mitra P, Jain A. Dissociative Identity Disorder. 2023 May 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 33760527.

³ Merckelbach H, Devilly GJ, Rassin E. Alters in dissociative identity disorder. Metaphors or genuine entities? Clin Psychol Rev. 2002 May;22(4):481-97. doi: 10.1016/s0272-7358(01)00115-5. PMID: 12094508.

⁴ Allen JG, Smith WH. Diagnosing dissociative disorders. Bull Menninger Clin. 1993 Summer;57(3):328-43. PMID: 8401385.

⁵ International Society for the Study of Trauma and Dissociation (2011): Guidelines
for Treating Dissociative Identity Disorder in Adults, Third Revision, Journal of Trauma & Dissociation,
12:2, 115-187. http://dx.doi.org/10.1080/15299732.2011.537247

⁶ Kluft RP. An overview of the psychotherapy of dissociative identity disorder. Am J Psychother. 1999 Summer;53(3):289-319. doi: 10.1176/appi.psychotherapy.1999.53.3.289. PMID: 10586296.

⁷ Ellason JW, Ross CA, Fuchs DL. Lifetime axis I and II comorbidity and childhood trauma history in dissociative identity disorder. Psychiatry. 1996 Fall;59(3):255-66. doi: 10.1080/00332747.1996.11024766. PMID: 8912944.

⁸ Boyer SM, Caplan JE, Edwards LK. Trauma-Related Dissociation and the Dissociative Disorders:: Neglected Symptoms with Severe Public Health Consequences. Dela J Public Health. 2022 May 31;8(2):78-84. doi: 10.32481/djph.2022.05.010. PMID: 35692991; PMCID: PMC9162402.