Dissociative Identity Disorder Symptoms (the new name for Multiple Personality Disorder)

Individual with dissociative identity disorder describe a wide variety of symptoms, some of them resemble other mental disorders. Approximately 70 percent of the patients diagnosed with DID meet the DMS-IV diagnostic criteria for posttraumatic stress disorder (PTSD), both conditions being conceptualized as trauma-related disorders. The posttraumatic stress disorder symptoms exhibited by patients with DID include: intrusive symptoms, hyperarousal, and avoidance and numbing symptoms.

Approximately 40 to 60 percent of the DID patients meet the diagnostic criteria of somatoform pain disorder or conversion disorder due to the presences of multiple types of psychophysiological and somatoform (bodily) symptoms. Some of the somatoform symptoms present in patients with DID include: seizure-like episodes, headaches, abdominal, musculoskeletal, and pelvic pain, asthma and breathing problems.

Patients with DID also meet the criteria of mood disorders, especially depression. Some of the symptoms that resemble mood disorders, include: mood swings, depressed mood, dysphoria (mood state characterized by sadness, anxiety, irritability, or restlessness), anhedonia (inability to experience pleasure), suicide attempts and suicidal thoughts, self-mutilation, helpless, hopeless, and guilt feelings, or sleeping problems. Some of the DID symptoms can resemble traits of obsessive-compulsive personality disorder (OCPD) or obsessive-compulsive disorder (OCD) such as: obsessive counting, singing, arranging, checking, or washing. (4)

The main four symptoms of dissociative identity disorder are:

1. Amnesia. A very common manifestation of the disorder is amnesia or loss of time usually observed by those around the person. Patients with DID experience frequent memory gaps in personal history (as extreme as an overall loss of biographical memory for extended periods of time during childhood, adolescence, or adulthood years), past events (they can forget what had happened during a certain period of time such as 3 years in a row) or recent events (they find items in their house that they do not remember purchasing, written notes with a different handwriting than their, or evidence of activities they don't remember engaging in). Some experts hypothesis that amnesia might be possible due to the fact that passive identities tend to have more constricted memories, while the more hostile, controlling, or protective identities have more complete memories. "An identity that is not in control may nonetheless gain access to consciousness." (2)

Approximately, 98 percent of patients with DID display amnesia (from mild to severe forms) when an alternate personality surfaces. When the host personality takes charge, the time spent under the control of other alters is either completely lost to memory, or only remembered as confusing bits and pieces.

2. Depersonalization is a dissociation symptom characterized by an alteration in the perception or experience of self, in which the patient either feels that their body is unreal, changing or dissolving, or detached from it, similar with an outside observer of their own mental processes or body while having no control over the situation.

3. Derealization is also a dissociation symptom in which the external world is perceive as strange or unreal.

4. Identity disturbances is one of the most distinct symptoms of dissociative identity disorder. Individuals with DID usually have a main personality and several alters that take charge in different situations. The alternate identities "are intrapsychic entities that have a sense of self, have an emotional repertoire, and can process information." (9) Some of the alters handle and act out emotions the patient cannot deal with such as rage or terror, others (called internal self helpers) watch what is going on and give advice, or act as friends. Some alters can know, observe, and interact with one another in an extremely elaborated inner world, while others may not be aware of the existence of some alters. When they interact with one another, the patient can report hearing inner conversations which are usually diagnosed as auditory hallucinations. However, DID auditory hallucinations differ from schizophrenia auditory hallucinations due to their distinct qualities. In DID, the voices are perceived to be heard internally in the brain, while in schizophrenia the voices are perceived to come from outside the brain.