Dissociative Identity Disorder: It’s not what you’ve seen on TV

Dissociative Identity Disorder (DID), once called Multiple Personality Disorder, falls into the category of Dissociative Disorders, along with Depersonalization/Derealization Disorder and Dissociative Amnesia. DID has been portrayed in movies and TV so much that its status as a mental health condition has been largely overshadowed by superhero plot lines and Oscar races by the actors who inhabit “multiple personalities” for a role. Marvel’s Moon Knight is the latest in a long line of A-list productions to try to tackle DID. In reality, DID isn’t so sensational.

Dissociation refers to a disconnection between someone’s thoughts, memories, feelings, actions, and/or sense of who they are. Everyone experiences very mild dissociation from time to time. For example, we may “lose ourselves” in a great book or arrive at work and realize that we have no recollection of our commute that morning.

Oscar Isaac in the show Moon Knight, looking at himself in the mirror.
Oscar Isaac as Steven Grant in Marvel Studios' MOON KNIGHT. Photo courtesy of Marvel Studios. ©Marvel Studios 2022. All Rights Reserved.

People with DID experience dissociations more frequently and to a much greater extreme than the mild dissociations described above. This manifests as the existence of two or more distinct personalities, colloquially known as “alters.” People with DID will switch from their “original” personality to these alters, often as a way to cope during periods of stress.

People with DID may feel that they are merely observers of their own speech and actions, powerless to control their dissociation. Other personalities may have different names, ages, preferences, emotions, impulses, and reactions to the world around them. Someone with DID may feel as though they have completely lost themselves or they may not even be aware of the fact that they have other personalities. Common symptoms of DID are gaps in memory and recall of everyday events, personal information, and/or traumatic events that would not normally be forgotten. Typically, someone with DID will have problems functioning because of their symptoms.

People with DID may also experience what is called a “fugue state”, where they are not conscious of what their body is doing. They may become conscious of their surroundings minutes, hours, or days later, confused and scared by the seemingly sudden change.

In contrast to what you may have seen on TV or in the movies, true DID is very rare, occurring in less than 1% of the population. Sensational media coverage of DID has lead to stigma against people who have true DID.

DID is a controversial diagnosis, with experts disagreeing on the true prevalence, symptoms, and cause of DID. We do know that DID is highly associated with trauma (especially childhood trauma) and other mental health conditions. People who have been diagnosed with DID are at high risk of suicide.

DID is usually treated with psychotherapy and medications. Family therapy and education about the disorder can also help guide families and patients through this difficult diagnosis. 

If you are experiencing thoughts of suicide or self-harm, call the National Suicide Hotline at 800-273-8255 or 988 for immediate help and support. 

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