Dissociative Identity Disorder: Symptoms, Causes, & Recovery Plans

October 7, 2025

Authored by: Louise Hartnett, B.A.

Edited by: Emma Loker, BSc, PgDip

Until 1994, dissociative identity disorder (DID) was known as multiple personality disorder. While you may still hear the latter term, the current name is a more accurate descriptor of what this condition involves. It describes severe dissociation that impacts the formation of a whole and undivided identity. Plus, DID is not a personality disorder, and its old name suggests otherwise.¹

DID is the most severe type of dissociative disorder (DD) as it involves the most persistent and life-altering symptoms.² Therefore, it can be extremely distressing and debilitating to those who have it and their loved ones, and it’s also often complex to diagnose and understand.

However, once you have a DID diagnosis, there is a formal outline for treatment to address the trauma that caused it and render the protective “alters” unnecessary. In other words, with careful and compassionate mental health counseling, DID recovery is possible.⁷

If you’re concerned that you or a loved one is showing signs of DID, or if you already have a diagnosis, Mission Connection can discuss the right treatments for your needs. This article can also help clarify this condition and its treatment by discussing:

What dissociative identity disorder is and its symptoms
Causes of dissociative identity disorder
Different types of dissociation
Diagnosing dissociative identity disorder
DID treatment options, including medication and hospitalization

Dissociative Identity Disorder and Its Symptoms

Dissociative identity disorder (DID) is the most severe dissociative condition, characterized by persistent dissociative symptoms and amnesia. People with DID may also experience flashbacks, intrusive thoughts, suicidal thoughts, and self-harming behaviors. These DID symptoms can significantly impact someone’s ability to cope with work, school, and relationships.²

A key part of DID is the presence of “alters”. These are independent and autonomous identities that may have their own styles of speaking, expressing, and behaving. They could also even have their own memories that other alters can’t access.¹

Additionally, the alters may have their own histories, personalities, and names. Often, one alter has no memory of the traumatic past, while another is in control most of the time.² The experience of alters is sometimes described by people as though they’ve been “possessed.”³

Usually, someone will have a primary identity with their given name who might be depressed and withdrawn. The personalities of alters usually contrast with this primary identity, and some will either be in conflict with each other or deny the existence of other alters.³

The switching between alters may seem like an abrupt mood shift, which is another commonly reported symptom.² There also may be a clear indication that someone is switching between alters, such as eye rolling, changes in posture, and trance-like behavior.¹

Someone may be diagnosed with DID if they experience two or more distinct personalities. They might also experience gaps in their memory that cannot be explained by substance use or cultural practices.¹ Memory gaps can appear because dissociation involves emotional numbing, compartmentalization, and detachment from traumatic events.²

Most importantly, someone’s symptoms must cause a notable negative impact on daily activities for a clinical diagnosis to be made.¹

What Causes Dissociative Identity Disorder?

DID is associated with severe childhood trauma, including physical, emotional, and sexual abuse.¹

Factors such as neglect, disrupted attachment, and boundary violations can have a profound impact on the development of selfhood and identity.² Therefore, children who experience trauma before the age of five often struggle to develop a consistent sense of self and may instead create multiple identities.¹

Both DNA and our environments play a role in how we respond to trauma. For instance, children who experience fear and distrust of their caregivers may be more likely to respond to trauma by dissociating.⁴ This is why disorganized attachment styles and a lack of familial support are common in those with DID.²

Some believe there to be a threshold for trauma, in which the brain can cope with a certain amount until it is overwhelmed. Researchers suggest that age, genetics, and environmental factors change how high this threshold is and how someone responds to trauma. This is why two people can respond differently to the same trauma, and that, while PTSD and DID can co-occur, they can also exist independently.⁴

For children who experience trauma, dissociation may act as a coping mechanism. It’s a survival strategy that shields the mind from overwhelming physical and emotional impacts of traumatic events. While this may be helpful in the short term, persistent dissociation has a significant impact on mental health.²

Children may be more at risk of developing DID if their parents are authoritarian and rigid. Perhaps paradoxically, another risk factor is parents who invert the normal parent-child relationship. For example, a parent putting their child into the position of caretaker or confidant. This kind of boundary violation can disrupt the formation of healthy attachment and increase the risk of a disrupted sense of self.²

Types of Dissociation

Dissociative identity disorder is part of the wider spectrum of dissociative disorders.¹ Dissociation can come in many forms that differ in severity and duration. The following are some ways dissociation can show up:

Dissociation is a detachment from our thoughts, sense of identity, and memories, but it isn’t always a frightening thing. Many of us experience dissociation very mildly, in the form of daydreaming or getting “lost” in a book.⁴ It may also be a temporary response to something stressful, like a car accident – but it quickly subsides.

There’s also dissociative amnesia, which involves someone struggling to remember important information about themselves. This usually comes on quickly in response to a sudden or high-stress event and lasts for a single episode, which could be minutes, hours, days, or (rarely) years-long.⁵

People with DID may also experience persistent depersonalization (feelings of detachment from their own body) and derealization (feelings of detachment from their surroundings).²

To break these phenomena down further, they could be described as…

Depersonalization:⁶

Important memories or values feeling like they no longer belong to oneself
Feeling like an observer of one’s own thoughts, feelings, or actions
Not recognizing oneself in the mirror

Derealization:⁶

Feeling that the world is dreamlike
Feeling as though there’s a veil or glass between oneself and the outside world
Perceiving other people or objects as “flat,” “distorted,” or visually “strange”
Recognizing a close friend or loved one but feeling as though they are unfamiliar or a stranger
Being in a familiar place but feeling that it is strange or unknown

While these perceptions can be persistent in people with DID, people without DID can also experience them. In these cases, symptoms of depersonalization/derealization may be fleeting or persistent, but they’re not accompanied by amnesia or multiple identities. It can be helpful to understand these different types of dissociation so that people can understand their experiences and receive the most appropriate diagnosis and support.

Diagnosing Dissociative Identity Disorder

People with dissociative identity disorder commonly experience self-harming behaviors and substance misuse, so it’s important that they get the right diagnosis and treatment as quickly as possible.¹

DID is diagnosed in about 1.5% of the global population, but it can sometimes be misdiagnosed. For instance, since borderline personality disorder (BPD) also involves dissociation, these conditions can be confused with each other.¹

In fact, some experts believe there to be minimal differences between the symptoms of DID, BPD, and post-traumatic stress disorder (PTSD). Each of these is connected to childhood abuse and neglect, connecting them as trauma-related disorders. Further, some suggest DID and BPD could exist on a spectrum or that DID is an extreme form of PTSD.²

In order to reach a firm diagnosis and distinguish DID from other mental health disorders, healthcare providers typically use evaluation tools like the following:

Dissociative Experiences Scale: A self-report questionnaire with 28 items measuring the impact of depersonalization, derealization, and amnesia on someone’s life.
Dissociation Questionnaire: This questionnaire consists of 63 questions that measure someone’s identity confusion and fragmentation, amnesia, and loss of control.
Difficulties in Emotional Regulation Scale (DERS): This tool consists of 36 subjective questions about impulsivity, emotional responses, self-regulation of emotions, and how someone handles goal-directed tasks.¹

As well as these questionnaires, diagnosing DID properly often requires taking a detailed personal history to identify traumatic experiences that could have caused the condition. Any tests taken by people should be repeated over long periods of time to ensure clinicians understand symptoms more accurately.¹

People will also often be tested for neurological conditions such as autoimmune encephalitis (inflammation of the brain) to rule out this as a cause.¹

Having a diagnosis typically makes coping with dissociation easier because it leads to the next step: treatment.

Treatment Options for Dissociative Identity Disorder

Across the board, DID recovery plans typically have three crucial phases: stabilization, trauma work, and integration. Stabilization may mean ensuring someone’s safety and bringing them out of a point of crisis.⁷

After stabilization, someone is recommended to carefully explore their trauma in therapy. This is commonly done with psychodynamic therapy, which stems from the field of psychoanalysis. This therapy aims to unveil traumatic memories and help people tolerate them more easily. Clinicians will also likely help people process and integrate the trauma into the present.¹

Additionally, therapy for dissociative identity disorder may involve sharing memories and facilitating a dialogue between alters.¹ Alters are often sustained by someone having inner conflicts, distorted thoughts and memories, and defense mechanisms. So, therapy for DID aims to create “solutions” for the alters themselves, so that they’re no longer needed for protection.⁷

The other crucial element of treatment focuses on the person’s relationship to themselves and the world.¹ This is often easier when someone trusts their therapist and has a positive alliance with them because individual and relational wounds can be healed within this relationship.⁷

People with dissociative identity disorder may also be treated with hypnosis, trauma-focused cognitive-behavioral therapy (CBT), dialectical-behavioral therapy (DBT), or eye movement desensitization and reprocessing (EMDR).¹

CBT and DBT aim to target the unhelpful thought patterns and challenging emotions that often result from trauma. EMDR is only recommended when someone is stable and has cultivated a good range of coping skills. Alternatively, hypnosis may work for people with DID as it can help them access their alters and call on them to facilitate the therapeutic process.¹

In some cases, medication or inpatient treatment may be recommended for someone with DID. We discuss these treatment options in the following sections.

Medications for Dissociative Identity Disorder

Medication is not a primary treatment for people with DID, though it may be used to manage certain symptoms like agitation or sleep problems. For example, people may be prescribed antipsychotics, mood stabilizers, and stimulants. However, there is no medication that specifically treats DID.¹

Inpatient Treatment for Dissociative Identity Disorder

Inpatient treatment may be necessary if someone requires more intensive mental wellness support. For example, they may benefit from day treatment programs or hospitalizations if they struggle with self-harm, impulsivity, and intense mood swings.1

These settings can deliver effective treatment when they have a healthcare team made up of many different professionals. For example, psychiatrists, nurses, specialized therapists, trauma counselors, and peer counselors.

These multidisciplinary professionals can collaborate and develop a dissociation management plan from multiple angles, so that people are supported holistically.¹

Mission Connection: Get Dissociation Support Today

If the information in this article has resonated with you and you wish to seek mental health support, Mission Connection can help. We offer a range of therapies, including trauma-focused therapy, EMDR, CBT, and group therapy, among others.

Our focus is to provide a personalized mental health care plan that meets your unique needs and goals. We can also be flexible with online and in-person appointments, adapting treatment to your lifestyle. Get in touch to speak to our team about how we can support you in your recovery.

References

Mitra, P., & Jain, A. (2023, May 16). Dissociative identity disorder. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK568768/
Bistas, K., & Grewal, R. (2024). Unraveling the layers: Dissociative identity disorder as a response to trauma. Cureus, 16(5). https://doi.org/10.7759/cureus.60676
Psychology Today. (2021, September 21). Dissociative identity disorder (multiple personality disorder). https://www.psychologytoday.com/gb/conditions/dissociative-identity-disorder-multiple-personality-disorder
ScienceDaily. (2016, December 9). Can you unconsciously forget an experience? Retrieved September 10, 2025, from https://www.sciencedaily.com/releases/2016/12/161209081154.htm
National Alliance on Mental Illness. (2024). Dissociative disorders | NAMI. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders/
Murphy, R. J. (2023). Depersonalization/derealization disorder and neural correlates of trauma-related pathology: A critical review. Innovations in Clinical Neuroscience, 20(1–3), 53–59. https://pmc.ncbi.nlm.nih.gov/articles/PMC10132272/
Şar, V. (2014). The many faces of dissociation: Opportunities for innovative research in psychiatry. Clinical Psychopharmacology and Neuroscience, 12(3), 171–179. https://doi.org/10.9758/cpn.2014.12.3.171