Dissociative identity disorder

Dear Frightened of who I may be,

It’s not uncommon for people to have memories that are more or less clear than others. You mentioned that you’ve been confusing the chronological order of some experiences and have been addressing yourself as “you.” Only a health care provider or mental health professional could make a diagnosis of dissociative identity disorder (formerly known as multiple personality disorder), and they use much more information to make a diagnosis than provided in this question. It’s also possible that you’re experiencing symptoms similar to DID that are due to other underlying causes. In any case, it might be good to talk with a mental health professional to determine the cause of your symptoms and appropriate course of treatment.

DID is one of several dissociative disorders; other common ones include dissociative amnesia and depersonalization-derealization disorder. Dissociative disorders are marked by major disturbances in how a person's memory, identity, perception, and consciousness mesh together. According to the Diagnostic and Statistical Manual of Mental Disorders (DMS-V), those with DID present with the following symptoms:

• Experience at least two distinct identities or personality states that take control of their behavior; these states may vary in gender, age, mannerisms, etc.
• A fragmented identity due to the inability to recall very personal bits of information about their actual identity.

People living with DID seem to switch between at least two identity or personality states and this switch is often preceded by feelings of stress. Research and clinical reports suggest that many people living with DID have experienced some type of physical or emotional trauma and may cope by mentally dissociating (intentionally or unintentionally placing themselves in another place, time, body, etc.) while the trauma is occurring. This could lead to forgetting part or all of an event, referred to as dissociative amnesia.

Although DID is a rare psychological disorder, many people experience symptoms of dissociation and memory loss or confusion without meeting the criteria for DID. Symptoms of this disorder, which are similar to other psychological disorders, include:

• Feeling detached from yourself or others
• Feeling as though the world around you doesn't feel real or is distorted
• Amnesia
• Depression
• Mood swings
• Anxiety
• Trouble eating
• Trouble sleeping or sleeping disturbances
• Problems with sexual functioning
• Substance abuse (including alcoholism)
• Hallucinations
• Self-injury (such as cutting or burning)

Another common symptom is suicidal ideation. It’s worth noting that 70 percent of people who have DID have attempted suicide. If you're currently feeling suicidal, the National Suicide Prevention Lifeline is always available at 1-800-273-8255 (1-800-273-TALK).

You mention a lack of clarity and chronological order during a specific time frame. In order to dig a little deeper into the details of your experience, you may take some time to consider the following questions: what types of experiences did you have during that time? If you experienced any trauma, how have you coped with it? Are there certain situations when you’re more likely to talk to yourself as "you"? Are there other symptoms that lead you to question whether you might be experiencing DID? For instance, have others told you that you switch into different personality states? Answering these questions may help you better understand your experiences and be able to provide more detailed information for a health care provider.

Given the symptoms you’ve experienced, you might want to speak with a mental health professional about your concerns. It might be good to seek out someone with advanced training or experience working with people who’ve experienced past traumas. A provider with this type of experience or training is better equipped to help a patient understand the cause of their condition and work through the appropriate coping mechanisms in response to stressful circumstances. They'll also be able to rule out underlying causes such as cognitive disorders or brain injury, which may explain some of the symptoms that you describe. If you’re wondering how to find a therapist, your school health system, health insurance company, or primary health care provider could point you in the direction of a mental health professional. If you don’t have health insurance, you could try looking into community mental health centers for no or low cost counseling. After a careful evaluation and guidance from a mental health professional, you might be able to recognize and seek appropriate care for your symptoms, whether or not you're living with DID.

If you decide to make an appointment, it will be helpful to think about or write down some key information beforehand, such as:

• Any symptoms you’re experiencing, including any recent behaviors that may have caused confusion for you or your loved ones. 
• Key personal information, including major stresses or recent life changes. It’s also good to make note of events from your past (including your childhood) that could have caused trauma or any periods of time that you aren't able to recall. 
• Medical information, including other physical or mental health conditions you may have, as well as any medications, vitamins, or supplements you're currently taking. 
• Questions to ask the provider related to your symptoms. This may help you make the most of your time and understand any information you're unclear about. 

DID has been successfully treated with a combination of psychotherapy and medication. Though there’s no medication specifically formulated to treat dissociative disorders, it's usually used to help control related mental health symptoms, such as depression, anxiety, or psychosis. According to the American Psychiatric Association, with appropriate treatment, people with DID improve their ability to function and are able to live a productive, fulfilling life. No matter the cause for your current experience, here’s to seeking out and receiving the answers and care you need.

With support,