Dissociative Identity Disorder: Treatment and Recovery (2023)

The treatment plan for DID centers around talk therapy, where you can learn to understand your symptoms, their causes, and ways to manage dissociative episodes.

Dissociation — when someone temporarily disconnects from their surroundings or emotions — is more common than many people think.

According to a 2004 study, between 26 and 74% of people have symptoms of derealization and depersonalization during their lifetime (two types of dissociation), but only 1–2% meet the criteria for clinically significant episodes.

DID is a mental health condition characterized by extreme dissociation involving “switching” between two or more distinct identities.

Once known as multiple personality disorder, the causes and treatment options for DID haven’t always been well understood. This has lead to stigma and confusion among society and even experts.

That’s all changing though, thanks to more research, a better understanding of neurobiology, and people speaking up about their lived experiences. Now we have a better understanding of the treatments, tools, and self-care strategies that can help when living with DID.

Most treatment plans for people with DID focus on talk therapy (aka psychotherapy). Talk therapy can help you understand why you dissociate and give you the tools to cope.

Other treatment options include medication for co-occurring issues and hospital visits.

Treatment aims to help you reduce and cope with the symptoms of DID, which include:

(Video) What is the Best Treatment for Dissociative Identity Disorder (DID) #AskATherapist

  • Identity shifts. DID involves switching between at least two identities, also known as personality states, alters, multiples, splits, or plurals.
  • Amnesia. This is different from occasional forgetfulness; it refers to a gap in time during everyday events, the inability to recall personal information, or forgetting your activities, such as waking up somewhere and not being able to recall how you got there.
  • Depersonalization. This is the feeling of being disconnected from your physical self or having an “out of body” experience, like observing yourself from a passenger’s perspective or watching a movie of yourself.
  • Derealization. This is the sensation of being disconnected from your physical environment, experiencing your surroundings as dream-like, or feeling like people and events aren’t real.
  • Identity confusion. This means you may have a difficult time pinning down your core interests, goals, style, opinions, values, and beliefs.

Your treatment should also aim to help with any co-occurring issues, which might include:

  • PTSD
  • anxiety
  • depression
  • borderline personality disorder
  • eating disorders
  • sleep disturbances
  • self-harm or suicidal thoughts
  • substance use issues

We take a closer look at the treatment options below.

For some people, living with the symptoms of DID can be frightening, isolating, or confusing.

Research has found that people with DID are more likely to harm themselves, and more than 70% of outpatients have attempted suicide.

For this reason, working closely with a compassionate, knowledgeable mental health professional is considered the first-line treatment for DID. Talk therapy has been shown to improve symptoms of DID in the long term.

Your therapist can help you understand what you’re experiencing and why. Therapy also gives you the space to explore and understand the different parts of your identity that have dissociated, and ultimately, to integrate them.

Dissociative disorders often stem from childhood trauma. In fact, as many as 90% of people with DID have a history of childhood abuse or neglect.

Dissociation is your body’s way of distancing you from an intolerable experience, which is an effective survival strategy in the moment — but over time, chronic dissociation can form separate identities from your “core” or “main” personality, leading to the symptoms of DID.

Besides helping you understand the reasons behind your dissociation, your therapist can help you deal with dissociative states and develop useful coping mechanisms.

(Video) Dissociative disorders - causes, symptoms, diagnosis, treatment, pathology

Your treatment plan will be based on your own unique needs, but may include:

  • education about dissociation and DID
  • body movement therapy to release trauma that’s held in the body
  • relationship support
  • trigger management
  • impulse control
  • mindfulness and self-awareness
  • coping methods to tolerate difficult emotions

Some specific therapies used to treat DID include:

  • cognitive behavioral therapy (CBT)
  • dialectical behavioral therapy (DBT)
  • eye movement desensitization and reprocessing (EMDR)

If you need support:

There are no medications recommended to directly treat DID, at least not yet. But there are some options to help with co-existing conditions and symptoms, like anxiety, depression, and substance use.

Your doctor may prescribe an antidepressant medication, like a selective serotonin reuptake inhibitor (SSRI). Common ones include:

(Video) What is the Treatment for Complex Dissociation?

  • fluoxetine (Prozac)
  • sertraline (Zoloft)

Anti-anxiety meds may also be recommended, depending on your symptoms.

If psychosis is present, an antipsychotic medication might help you manage symptoms and feel more in control.

If symptoms for you or someone you love are becoming severe, or suicide is a possibility, you can seek emergency medical attention at your nearby hospital right away.

This can help doctors rule out the possibility of an underlying condition, like a brain injury, and provide a safe, stable environment to talk about next steps.

In real life, an inpatient stay at a psychiatric facility is very different from what you’ll see in the media, which is often sensationalized.

An inpatient stay may last a few days to several weeks, which will give doctors ample time to work with you in individual and group therapy settings, discuss medications, and form a solid discharge plan.

Self-help strategies

(Video) I REMEMBERED!: Our Recovery Journey | Dissociative Identity Disorder/Dissociative Amnesia

Balanced nutrition

There’s no recommended food protocol for DID, but a diet rich in whole, unprocessed foods is a great way to make sure that your body and mind are getting all the nutrients and energy needed.

Get daily movement

Thanks to a rush of endorphins, exercise may boost your mood and help release any stored up tension. It doesn’t have to be intensive, either.

If you’re trying to build a habit, start with just enough to get your heart rate up, like a brisk walk around your neighborhood. The Centers for Disease Control and Prevention (CDC) recommends 30 minutes per day, 5 days a week.

Get enough sleep

Do your best to maintain a sleep schedule and practice sleep hygiene before bed.

Try to get at least 8 hours of sleep each night so that your brain has time to rest and your tissues have time to repair themselves. In other words, it will help keep you performing at your optimal level.

Develop a meditation practice

While more research is needed on complementary treatments for dissociative disorders, a small 2016 study found that some symptoms improved for young participants enrolled in a mindfulness program over the course of 6 weeks. You could start by checking out some meditation apps.

Roll out your yoga mat

Yoga has long been studied for its positive effects on mood. Research has shown that a regular yoga practice can help people with trauma increase their emotional regulation, among other mental health benefits.

It might be important for you to seek a trauma-informed practice, because yoga can feel overwhelming for some people with a history of trauma.

When symptoms of DID impact your everyday routine, it may feel difficult to — as they say — “live your best life.” The good news is, we understand a lot more about this condition than we once did.

(Video) How doctors treat Multiple Personality Disorder | 60 Minutes Australia

Learning more about dissociation and DID can help you manage your symptoms.

To this end, trauma researcher Dr. Janina Fisher published a book in 2017 called “Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation.” The book offers information on the neurobiological basis of trauma and dissociation, along with treatment information for both therapists and clients.

See if you resonate with any of these resources:

  • For an illuminating interview about DID, Med Circle talks with Encina, who has 11 distinct personalities. At the 54:10 minute mark, viewers meet one of her alters, Minnie, a 3-year-old girl.
  • The System Speak podcast explores what it’s like for Emma, diagnosed at age 36, to live with DID. She regularly brings on experts to talk about managing symptoms and trauma recovery.
  • Comedian Roseanne Barr, musician Adam Duritz, and retired NFL athlete Herschel Walker have all spoken about being diagnosed with DID. Walker wrote a book about it, called “Breaking Free: My Life With Dissociative Identity Disorder.”

FAQs

Can you recover from dissociative identity disorder? ›

Yes. If you have the right diagnosis and treatment, there's a good chance you'll recover. This might mean that you stop experiencing dissociative symptoms. For example, the separate parts of your identity can merge to become one sense of self.

How do you accept that you have DID? ›

For those just starting out in their diagnosis, start out with a book written for people with DID. You will gain insight and a better understanding of the ins and outs of DID. Understanding DID will help you better understand yourself and make coping with your diagnosis a little easier.

How long does it take to treat dissociative identity disorder? ›

Treatment for DID consists primarily of individual psychotherapy and can last for an average of five to seven years in adults. Individual psychotherapy is the most widely used modality as opposed to family, group or couples therapy.

How do you break dissociative identity disorder? ›

The best treatment for dissociation is to go to therapy. An inpatient adult psychiatric program can be especially effective if your symptoms of dissociation are particularly intense, or if they are the result of sexual abuse.

Can a person with dissociative identity disorder live a normal life? ›

But with effective treatment from mental health providers who are trained in trauma and dissociation or able to receive consultation with someone trained, people with DID can and do recover. People with DID can live full and productive lives.

What is the best way to treat DID? ›

Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional.

What to do after being diagnosed with DID? ›

Some medications may help with certain symptoms of DID, such as depression or anxiety. But the most effective treatment is psychotherapy. A healthcare provider with specialized training in mental health disorders, such as a psychologist or psychiatrist, can guide you toward the right treatment.

How do you have a relationship with someone with DID? ›

3 Tips for Partners Who Love Someone Living With DID

When I asked my partner what she'd say to someone in a relationship with a person with DID, this is what she said: Know and maintain your own boundaries. You can't support others if you aren't supporting yourself. You're going to let your partner down sometimes.

What happens if dissociative identity disorder is left untreated? ›

Consequences of Untreated Dissociative Identity Disorder

People with untreated DID typically have significant problems in everyday life, including at work, at school, and in relationships. Suicidal behavior and other types of self-harm are especially common in people who suffer from this disorder.

Does dissociation ever go away? ›

Dissociation is a way the mind copes with too much stress. Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months). It can sometimes last for years, but usually if a person has other dissociative disorders.

How do you bring out an alter? ›

A positive trigger is something non-trauma related and is pleasant enough to cause an alter to come forward and experience happy emotions, such as a special toy, cute puppies, or a favorite ice cream flavor. A positive trigger, in some instances, can be used to bring forth an alter.

How do therapists treat people with DID? ›

Psychotherapy for DID

This form of treatment may use several different types of therapeutic approaches, including cognitive behavioral therapy, dialectical behavioral therapy, psychodynamic psychotherapy, eye movement desensitization and reprocessing (EMDR) therapy, and schema therapy.

What medication is best for dissociation? ›

Studies show that a combination of selective serotonin reuptake inhibitors (SSRI), a specific kind of antidepressant medication, and lamotrigine, an anticonvulsant and mood stabilizer, is an effective treatment for dissociative disorders, especially depersonalization-derealization disorder.

How does it feel to come out of a dissociative episode? ›

You could feel as though you're observing yourself from the outside in — or what some describe as an “out-of-body experience.” Your thoughts and perceptions might be foggy, and you could be confused by what's going on around you. In some cases, dissociation can be marked by an altering of your: personality. identity.

What causes a person to develop dissociative identity disorder? ›

Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that's frightening or highly unpredictable.

What triggers dissociation? ›

For many people, dissociation is a natural response to trauma that they can't control. It could be a response to a one-off traumatic event or ongoing trauma and abuse.

Does dissociative identity disorder get worse? ›

Individuals who do not receive treatment for dissociative disorders tend to get worse, as alternate personalities cannot integrate on their own. Untreated dissociative identity disorder makes an individual susceptible to further exploitation and mistreatment by others.

Are there ways to make living with DID easier? ›

Work on all aspects of self-care.

Go to bed and get up at the same time each day to stay rested. And stick with a healthy diet and regular exercise regimen. If you need medication for other mental illnesses, like depression, stick with it and talk with your doctor if you feel a change is needed.

What does switching feel like DID? ›

Some indicators that a switch may be about to occur include the following: feeling "spacey", depersonalized, or derealized; blurred vision; feeling distanced or slowed down; feeling an alter's presence; or feeling like time is beginning to jump (indicating minor episodes of time loss).

How do psychiatrists treat DID? ›

Cognitive behavioral therapy and dialectical behavioral therapy are two commonly used types of therapy. Hypnosis has also been found to be helpful in treatment of dissociative identity disorder. There are no medications to directly treat the symptoms of dissociative identity disorder.

What it's like to live with dissociative identity disorder? ›

Living with dissociative identity disorder (DID) can create confusing and distressing times. People with DID experience amnesia and "waking up" in one personality only to find that another personality has previously done something he or she would consider completely out of character.

What happens to your brain when you have DID? ›

When compared to the brains of normal controls, DID patients show smaller cortical and subcortical volumes in the hippocampus, amygdala, parietal structures involved in perception and personal awareness, and frontal structures involved in movement execution and fear learning.

Do you need PTSD to have DID? ›

Much like in posttraumatic stress disorder (PTSD), people with DID often have a history of trauma and/or abuse. But is trauma always a requirement for DID? A history of trauma is not one of the diagnostic criteria for a diagnosis of dissociative identity disorder, according to the DSM-5.

Does a person with DID know they have it? ›

At the time a person living with DID first seeks professional help, he or she is usually not aware of their condition. A very common complaint in people affected by DID is episodes of amnesia, or time loss. These individuals may be unable to remember events in all or part of a proceeding time period.

What is a gatekeeper in a DID system? ›

Gatekeeper: A gatekeeper is an alter that controls switching or access to front, access to an internal world or certain areas within it, or access to certain alters or memories.

Does Adderall help with dissociation? ›

However, there are studies into the effects of Adderall on dissociation. For instance, a case study involving a woman with depersonalization and derealization disorder was reported in 2020. It showed that mixed amphetamine salts, the active ingredient in Adderall, noticeably reduced the dissociative symptoms.

What kind of trauma causes dissociation? ›

Any kind of trauma can cause dissociation. This could be assault, abuse (physical, emotional, or sexual), natural disasters, military combat, war, kidnapping, invasive medical procedures, neglect, or any other stressful experience.

Is dissociation a trauma response? ›

Dissociation can occur in response to traumatic events, and/or in response to prolonged exposure to trauma (for example, trauma that occurs in the context of people's relationships). Dissociation can affect memory, sense of identity, the way the world is perceived and the connection to the physical body 3.

Why is it so hard to stop dissociating? ›

Dissociation usually happens in response to a traumatic life event such as that which is faced while being in the military or experiencing abuse. In this way, dissociation is usually associated with trauma and post-traumatic stress disorder (PTSD).

What happens when you dissociate for too long? ›

Too much dissociating can slow or prevent recovery from the impact of trauma or PTSD. Dissociation can become a problem in itself. Blanking out interferes with doing well at school. It can lead to passively going along in risky situations.

What are the 5 types of dissociation? ›

There are five main ways in which the dissociation of psychological processes changes the way a person experiences living: depersonalization, derealization, amnesia, identity confusion, and identity alteration.

How long does an alter take to switch? ›

Transition from one personality to another is referred to as “switching.” This usually occurs within seconds to minutes, but can also be gradual, taking hours or days to complete. This is rarer.

What does switching alters look like? ›

They may appear to have fazed out temporarily and put it down to tiredness or not concentrating; or they may appear disoriented and confused. For many people with DID, switching unintentionally like this in front of other people is experienced as intensely shameful and often they will do their best to hide it.

What part of the brain has been linked to dissociative identity disorder? ›

This finding suggests that dissociative identity disorder is associated with relatively greater volume reductions in the amygdala than in the hippocampus. Our study had several limitations. As a group, the comparison subjects were significantly younger than the dissociative identity disorder patients.

Is dissociative disorder permanent? ›

Dissociation is a way the mind copes with too much stress. Periods of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months). It can sometimes last for years, but usually if a person has other dissociative disorders.

Is dissociative disorder reversible? ›

The classic dissociative disorders, such as dissociative amnesia and dissociative identity disorder, entail reversible memory failures associated with encoding experience in altered states.

Is dissociative identity disorder life long? ›

The symptoms are often lifelong, but treatments can help you cope. Treatment and recovery from DID look different for everyone. As part of treatment, your mental health professional may recommend treatments to help you cope with related issues, like post-traumatic stress, depression, and anxiety.

Is dissociative identity disorder brain damage? ›

A growing body of neuroimaging research suggests that dissociative identity disorder is associated with changes in a number of brain regions involved in attention, memory, and emotions.

What is the largest cause of dissociative disorders? ›

Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that's frightening or highly unpredictable.

What is the best treatment for dissociative disorder? ›

Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional.

What do dissociative identity disorder voices sound like? ›

Sometimes the voices are talking directly to the core person, while other times the voices are just talking among themselves. The voices can be very different: young or old, male or female, high-pitched or low-pitched. Sometimes, the voices all sound the same.

Who is most likely to get dissociative identity disorder? ›

People from all age groups and racial, ethnic and socioeconomic backgrounds can experience a dissociative disorder. Up to 75% of people experience at least one depersonalization/derealization episode in their lives, with only 2% meeting the full criteria for chronic episodes.

Can a brain scan show dissociative identity disorder? ›

This research, using the largest ever sample of individuals with DID in a brain imaging study, is the first to demonstrate that individuals with DID can be distinguished from healthy individuals on the basis of their brain structure.

Do victims of trauma go through dissociative disorders? ›

Most health professionals believe dissociation is a way the mind copes with too much stress. Many people with a dissociative disorder have had a traumatic event during childhood, although dissociation can also occur with other types of trauma. This is called Trauma-Related Dissociation.

Does exercise help with dissociation? ›

Why Physical Activity is Important to People with Dissociative Disorders. Being physically active increases blood circulation to the brain which has the potential to reduce anxiety, depression and negative mood swings. This in turn can boost a person's self-esteem and reduce social isolation.

Videos

1. Dissociative Identity Disorder Recovery: Meeting My Alters
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2. Dissociative Identity Disorders and Trauma: GRCC Psychology Lecture
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4. Healing from Dissociative Identity Disorder: What it Means for Your Work
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5. Dissociative Identity Disorder Treatment Expectations | HealthyPlace
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6. Dissociative Identity Disorder
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