The Dissociative Identity Disorder, also as multiple personality disorder known, describes a disease in which different personalities or partial identities control the behavior of a person.
What is dissociative identity disorder?
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It is characteristic of dissociative identity disorder that the person himself is not aware of his or her own different personalities, since usually one personality does not know anything about the other identity (s). Because of this, the person may temporarily be unable to remember certain personal things or actions. These actions are linked to another personality and are only present in the subconscious at the moment.
Dissociative identity disorder is not to be equated with schizophrenia, which can sometimes have the same symptoms. The clinical picture of multiple personality disorder was already described by psychiatrists at the end of the 19th century, but was not recognized as an independent disease until the 1970s.
causes
The multiple personality disorder does not arise from alcohol abuse or drug use, but is often due to severe, traumatic experiences in childhood. The dissociation or dissolution of the person into different sub-personalities is a protective mechanism of the brain in order to be able to process traumatic events.
The person who experiences these traumatic events splits into several personalities. Only one personality experienced the terrible, which is erased from memories and buried in the subconscious, as long as another personality controls the person's actions.
Childhood sexual abuse, physical violence, neglect, and other traumatic events are believed to be major causes of multiple personality disorder, which affects women much more often than men.
Children who are intimidated under threats and who are often helplessly at the mercy of what is happening split their own person into different personalities: a personality who experiences the terrible and one or more others who control actions in normal everyday life and nothing about the terrible events knowledge.
Traumatic experiences and abuses are only perceived by a personality who lives unrecognized in everyday life in the subconscious and does not allow the traumatic experience to reach the surface of consciousness.
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With this disease, those affected suffer from serious psychological complaints and moods. These can make everyday life much more difficult and restrictive, so that other people can also experience various social complaints. In the worst case scenario, it can also lead to thoughts of suicide or further suicide.
First and foremost, those affected have a personality disorder. This leads to significant memory lapses and also to depression. The patients can no longer remember simple events and are therefore extremely limited in their lives. This can also lead to an anxiety disorder, which can have a very negative effect on contact with other people.
Often those affected break off all contact with other people and suffer from aggression or severe irritability. It can also lead to eating disorders if the disease is not treated properly. This leads to weight loss and various deficiency symptoms in the patient. Those affected often also suffer from depression.
In some cases, the condition is associated with phobias or with various compulsions. Whether this will result in a reduced life expectancy cannot generally be predicted. However, permanent psychological complaints always have a very negative effect on the patient's health.
course
Dissociative identity disorder is characterized by at least two different personalities who take turns controlling the person's actions. The main personality is called the host, while the other or other personalities are called age (cases have been documented in which up to 100 different personalities are united in one person).
The main symptom is a lack of memory about personal matters that cannot be traced back to other mental illnesses such as dementia. The main personality cannot remember the actions and experiences of the other personalities and vice versa. For example, it can happen that the person can no longer remember how they got to a certain place or they do not recognize people from their personal environment.
The different personalities have different names and often also differ from the other personalities by contradicting preferences.
The secondary symptoms are headaches, self-aggression, depression, eating disorders, compulsive behavior, strange voices in the head (mostly those of other personalities) up to suicide attempts.
Complications
Some people with dissociative identity disorder avoid medical help when it is not strictly needed. This avoidance is often the result of trauma - but it can also be based on feelings of shame, low self-esteem, or experienced neglect. This means that medical complications are possible even in the case of physical illnesses that are actually easily treatable.
Other people with dissociative identity disorder, on the other hand, seek solace and confirmation from medical treatment and care. Some of these sufferers tend to exaggerate, self-evoke (for example, self-harm), or simulate actual symptoms. The subsequent examination and treatment increases the likelihood of treatment errors and side effects - for example with medication for symptoms that do not exist.
However, with dissociative identity disorder, certain somatic symptoms can also occur more frequently. This includes different types of pain. Abdominal pain and headaches are particularly common. Breathing problems and neurological complaints can also appear as complications of multiple personality disorder. Other forms of dissociation and other psychological disorders are also possible.
In addition, psychotherapy can trigger complications. Especially with trauma therapy and the integration of personality parts, there is often a temporary enormous psychological burden for the person concerned. A stable environment and a good relationship of trust with the therapist are therefore particularly important.
When should you go to the doctor?
As soon as there are noticeable changes in a person's behavior and personality, a doctor should be consulted. Multiple personality disorder is often associated with other mental illnesses. Identity disorders can also occur as a result of excessive alcohol or drug consumption, after a severe stroke of fate, trauma in childhood or after a brain injury. Anyone who discovers these factors in themselves or another person should consult a doctor or therapist.
If the person concerned cannot be helped, placement in a clinic can also be ordered by the authorities. Before taking this route, however, a comprehensive medical and psychological assessment is required. This should take place at the latest when the person concerned carries out irrational acts and thereby poses a danger to himself and others. Symptoms such as sleeping and eating disorders, alcoholism, depression and behavioral disorders must be clarified immediately. If the person concerned expresses suicidal thoughts, he or she must be referred to a therapist or, in the case of a dissociative identity disorder, taken to the nearest specialist clinic.
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Treatment & Therapy
The therapy of dissociative identity disorder is medicated with sedatives and antidepressants as well as psychotherapeutic with the aim of bringing the different personalities closer to the main personality or merging with it.
In trauma therapy, patients with multiple personality disorders learn to psychologically process traumatic experiences from childhood in order to eliminate the causes of the dissociative identity disorder.
Therapy for multiple personality disorder can take several years and consists of several phases. The first phase is aimed at stabilizing everyday life. The next phase focuses on bringing together the individual personalities or partial identities and concludes with the psychological coping with the trauma.
Outlook & forecast
Most patients have a poor prognosis for dissociative identity disorder. Often there is a chronic course of the disease that makes the prospect of a cure impossible. The triggers of the disease must be found and treated. In the case of traumatic experiences, this can last for several years.
The symptoms of the disease can resolve within one treatment, regardless of the underlying disease. However, there is often no permanent cure for the disorder. Relapse is possible at any time. Many patients experience individual phases ranging from several weeks to years without symptoms. However, as soon as a triggering event occurs or repressed experiences come to the fore, the symptoms reappear. The intensity of the symptoms often differs with a repeated outbreak.
Symptom relief is not achieved in many patients. In these cases, the aim of treatment is to integrate the symptoms into everyday life in order to improve wellbeing. The prognosis worsens as soon as other mental illnesses occur at the same time. If mood disorders, eating disorders, personality disorders or addiction disorders are diagnosed, relief and healing will take several years. In some cases, the diseases persist for life. If the dissociative identity disorder goes unnoticed for a long time, the prospect of a cure deteriorates considerably.
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➔ Medicines to calm down and strengthen nervesprevention
There are no preventive measures to avoid the development of multiple personality disorder as the triggers are severe traumatic experiences. Raising awareness of the person's environment could, however, help ensure that therapy is started as soon as the first symptoms appear, in order to prevent the manifestation and chronic course of the multiple personality disorder.
You can do that yourself
In the case of dissociative identity disorder, distinguishable identities take control of the person concerned. This mental disorder is usually associated with considerable memory lapses and also maneuvers those affected into social situations that are regularly perceived as embarrassing or even humiliating and often even prevent the exercise of a job.
People who feel the first signs of multiple personality disorder should seek professional help immediately. The family doctor can also be the first point of contact. If the disorder is treated promptly, there is a good chance of recovery, even if the therapy usually takes several years. If left untreated, dissociative identity disorder can become chronic.
An important step towards self-help is therefore to correctly interpret the symptoms and to seek professional help quickly. Often family members and friends notice the mental illness long before the patient becomes aware of it. In this case, the person affected should be confronted with the disorder sensitively but consistently. The goal must be to start treatment quickly.
Patients with multiple personality disorder should seek out an experienced trauma therapist. The Medical Association can provide information on appropriately qualified specialists.
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