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When a person has dissociative identity disorder (DID), they present with more than two co-occurring and distinct personalities. These alternate personalities are often referred to as “alters,” which exist to protect the primary personality from extreme anxiety or perceived trauma.

DID is believed to be the result of the brain’s effort to protect a person from unbearable trauma in early childhood. This trauma can be physical, emotional, or sexual. In many cases, there is often a combination of all three.

How Dissociative Identity Disorder Presents

When people have DID, it can present in a variety of ways. Some are simply unable to cope with the knowledge of the trauma they have been through. For these individuals, there will be more situations where they will revert to their alternate personalities.

This will not be a conscious transition. The automatic response to perceived trauma will be reverting to one of many alters. Different situations may call for different alters. If a person is averse to conflict, they may have a stronger alter to cope with those situations. When they have issues with sexual situations, they may have another alter to deal with that part of relationships and interactions.

In these cases, the person will lose time and have blank spots in their personal narrative where an alter has taken over. They may need to rely on others to relate their behavior. Should they exhibit problematic behavior, the primary will not realize it until after they have regained control over their consciousness.

According to the European Journal of Psychotraumatology, “Most individuals with dissociative disorders (DDs) report engaging in self-injury.” This is often a way of externalizing the internal pain from depression and trauma. There is often less self-harm when DID is properly diagnosed through ongoing treatment through a partial hospitalization program (PHP).

Recognizing DID Symptoms and Receiving a Diagnosis

Unfortunately, there are a number of ways that DID can be misdiagnosed. People begin exhibiting symptoms at a very early age. Also, since trauma may have come at the hands of someone close to them, there can be a severe distrust in authority figures. This means that children will attempt to hide any trauma from others, leading to what will be seen as acting out. Loved ones and educators may punish the child or send them to therapy for the wrong reasons.

However, if a young person is brought to The Phoenix Recovery Center, there is room for a proper diagnosis utilizing up-to-date techniques. These will help rule out any possible misdiagnoses. 

The main way we recognize DID is with a full workup of an individual’s symptoms and personal history. 

Physical Assessment

One of the first things to be determined is whether the individual struggles with any physical conditions that can cause symptoms similar to DID. This can include:

  • Brain tumors
  • Head injuries
  • Sleep deprivation
  • Intoxication

Any of these can present symptoms such as a feeling of unreality or even temporary memory loss. It is important that a medical professional rule out each of these possibilities before moving on to diagnosing DID. This is the stage at which many people are misdiagnosed if the assessment is not done properly.

Mental Health Assessment

Following the physical assessment, there is a thorough mental component. This is done to rule out any non-DID diagnoses. These can include:

  • Depression
  • Anxiety
  • Borderline personality disorder (BPD)
  • Eating disorder
  • Mood disorders
  • Substance abuse
  • Self-harm and suicidal ideations

The problem with these issues is that DID often includes a variety of them. Therefore, should someone present with certain issues but not others, they may again be misdiagnosed one way or the other. It is important for medical professionals to take all of this into account as they build their assessments.

Background and Symptoms

Once these have been determined, the individual will be asked to discuss their background. For many, this can be quite painful as they do not wish to confront trauma. This is especially true for younger individuals who may not realize what has happened or is happening to them.  

A conversation will also include questions revolving around symptoms. This will include questions such as:

  • Do you suffer from periodic amnesia?
  • Do you forget people and events?
  • Do you have trouble recalling your own personal information?
  • Have you felt detached from yourself and your emotions?
  • Do you perceive people and things as unreal?
  • Do you have a blurred sense of identity?

People who answer in the affirmative to these questions and who have also gone through previous assessments can often be diagnosed with DID.

Next Steps for Dissociative Identity Disorder

Once the individual has been assessed and diagnosed, The Phoenix Recovery Center will begin the process of creating a plan of action to put that person on an individualized path to treatment. This will involve different types of intensive therapy. For some people, this may also include family therapy so that loved ones can be informed about what the individual is going through and what they can do to help.

It is important to remember that DID is not a curable disorder. In fact, DID is a condition that will be with a person for the rest of their life. However, with the right treatment program, they will be able to come to terms with this and learn how to properly live with their diagnosis. To get started in receiving a diagnosis or being treated by The Phoenix Recovery Center call us today at (801) 438-3185.


The Phoenix Recovery Center
489 W. South Jordan Pkwy
Suite 400
South Jordan, UT