Imagine feeling like different parts of you are separate, distinct people, each with their own memories, feelings and even names. This complex and often misunderstood mental health condition is called dissociative identity disorder (DID), previously known as multiple personality disorder.

Dissociative identity disorder is a severe form of dissociation, a mental process where a person disconnects from their thoughts, feelings, memories or sense of identity. While many people experience mild dissociation, like daydreaming or zoning out, dissociative identity disorder involves much more profound and lasting separations.

It’s like the mind’s way of protecting itself from overwhelming trauma, especially severe and repeated trauma that happens during childhood, such as ongoing or extreme forms of abuse. The child’s mind creates different parts or alters (identities) to handle experiences that are too painful or unbearable for one cohesive self to manage.

Dissociative identity disorder is estimated to affect about 1.5% of the general population worldwide, which is more common than some may think. It can affect anyone, regardless of age, gender or background.

What are the symptoms of dissociative identity disorder?

The symptoms of DID can deeply affect a person’s daily life, making it incredibly hard to function. These symptoms can include:

• Distinct identities or alters — The presence of two or more separate identities or personality states, each with their own unique way of thinking, relating to the world and remembering. These alters may have different voices, mannerisms, ages and even genders.
• Amnesia — Gaps in memory that are too extensive to be explained by ordinary forgetfulness. This may include forgetting everyday events, important personal information or even skills. Someone may lose time and find themselves in a different place without remembering how they got there.
• Fugue states — Periods where a person suddenly travels away from home or work and can’t recall their past.
• Depersonalization — Feeling detached from one’s own mind or body, as if observing oneself from outside.
• Derealization — Feeling that the world around them is unreal or distorted.
• Other mental health symptoms — People with dissociative identity disorder often also experience symptoms of depression, anxiety, panic attacks, eating disorders, substance use disorders, self-harm and suicidal thoughts.

Living with dissociative identity disorder can be incredibly isolating and distressing, but it’s important to know that healing is possible. With the right treatment and support, people can learn to manage their symptoms, integrate their identities and live more connected and fulfilling lives.

2 effective treatment options for dissociative identity disorder

Treating dissociative identity disorder is a long-term journey that requires a specialized and compassionate approach, usually centered around psychotherapy. The main goal of treatment isn’t to eliminate alters, but to help them work together, communicate and eventually integrate into a more cohesive sense of self, while also processing the underlying trauma. 

Psychotherapy

Psychotherapy, or talk therapy, is the primary and most effective treatment for dissociative identity disorder. It creates a safe space for people to explore their experiences and learn healthy coping skills. Here’s how different therapy approaches can help:

Trauma-informed therapy

This is a broad approach that recognizes the deep impact of trauma on a person’s life. It focuses on creating a safe environment, building trust and empowering the person, rather than re-traumatizing them. All therapists for dissociative identity disorder should be trauma-informed. 

Cognitive behavioral therapy (CBT)

While not the sole treatment for dissociative identity disorder, elements of cognitive behavioral therapy can be very helpful. It can help people identify and change unhelpful thinking patterns and behaviors. For dissociative identity disorder, this may involve:

• Challenging negative beliefs about oneself or the world.
• Developing strategies to manage anxiety or depression that often happen alongside dissociative identity disorder.
• Improving coping skills for dealing with triggers.

Dialectical behavior therapy (DBT)

Dialectical behavior therapy is excellent for teaching skills to manage intense emotions, reduce impulsive behaviors, like self-harm, and improve relationships.

These skills can be particularly beneficial for someone with dissociative identity disorder who may struggle with emotional regulation due to past trauma. This technique focuses on four key areas:

• Mindfulness — Being present and aware of the moment.
• Distress tolerance — Learning to cope with difficult feelings without making things worse.
• Emotion regulation — Understanding and changing intense emotions.
• Interpersonal effectiveness — Improving communication and relationship skills.

Eye movement desensitization and reprocessing (EMDR)

Eye movement desensitization and reprocessing is a highly effective therapy specifically designed to help people process traumatic memories. It involves focusing on distressing memories while engaging in specific eye movements or other forms of bilateral, back-and-forth stimulation.

For people with dissociative identity disorder, this approach can help process traumatic events linked to specific alters, allowing those memories to be stored in a less distressing way. It’s often used after a sense of safety and stability has been established. 

Schema therapy

This therapy helps identify and change long-standing, deeply rooted, negative schemas or patterns of thinking and feeling that developed from early, often traumatic, experiences.

For dissociative identity disorder, this can mean addressing core beliefs like “I am unlovable” or “The world isn’t safe,” which were formed due to childhood trauma. By challenging these schemas, people can develop healthier ways of relating to themselves and others. 

Sensorimotor psychotherapy

This approach recognizes that trauma isn’t stored just in the mind, but also in the body. It helps people become aware of physical sensations related to trauma and teaches them how to complete fight, flight or freeze responses that may have been interrupted during the traumatic event. This can help release stored tension and regulate the nervous system. 

Internal family systems (IFS)

This approach views the personality as being made up of various parts, similar to alters in dissociative identity disorder, but it’s a model applicable to everyone.

It can help people understand these parts, build compassion for them and help them work together under the guidance of a self, which is the core, wise part of a person.

This approach can be very helpful for dissociative identity disorder as it encourages internal communication and healing among the different identities. 

Medications for co-occurring conditions

There isn’t a specific medication that can cure dissociative identity disorder or that directly targets the dissociative symptoms themselves.

However, medications are often used to help manage other mental health conditions that commonly happen alongside dissociative identity disorder. These can make the therapy process easier by reducing overwhelming symptoms.

• Antidepressants — These can help with symptoms of depression, anxiety or panic attacks.
• Antianxiety medications — Used cautiously for short-term relief of severe anxiety or panic.
• Mood stabilizers — May be used if there are significant mood shifts, similar to those seen in bipolar disorder.
• Antipsychotics — Low doses of antipsychotic medications may be used to address very specific symptoms such as intrusive thoughts, hallucinations or severe agitation, especially if the person is experiencing symptoms between alters that are very distressing or feel out of control. However, these are used sparingly and with careful monitoring.

Medication is almost always used as an add-on to psychotherapy, not as the main treatment. Therapy is essential for addressing the root causes and helping the person work toward integration and healing.

Moving forward with support from Guidelight

Dealing with dissociative identity disorder can feel lonely, but no one has to go through it alone. Each therapy session, each coping skill, each shared moment of safety is a step toward healing.

At Guidelight Health, we believe in compassion, personalization and hope. We specialize in treating co-occurring conditions like PTSD, anxiety, depression and emotional dysregulation that often come with dissociative identity disorder.

Our goal is to support growth and stability, helping people build healthier, more connected lives, identity by identity.

Everyone has a seat at Guidelight. Contact our team online or call us today for more information about how we can help address DID or to schedule an initial evaluation.