Symptoms of Dissociative Identity Disorder: Dissociation Signs and Diagnosis
October 7, 2025
Dissociative identity disorder (DID) is a complex condition characterized by two or more distinct personality states (commonly called “alters”), feelings of dissociation, and amnesia.
Since DID is caused by trauma at a young age, it shares similarities with other trauma-related disorders like borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD). Sometimes these similarities can make it difficult to get the right diagnosis and mental health support.
However, there is a clear process for diagnosing DID and, once it’s confirmed, a formal pathway for treatment. If you’re concerned about potential signs of DID in yourself or someone you care about, professional mental health advice can ensure that your recovery is on the right track.
This article can also help you better understand the steps that come before DID treatment, as it explores:
- What dissociative identity disorder is and its causes
- DID symptoms and the process of getting a diagnosis
- DID evaluation tools
- Symptoms of other trauma-related conditions, such as borderline personality disorder
What Is Dissociative Identity Disorder?
Dissociative identity disorder (DID) is the most severe type of dissociative disorder (DD) because its symptoms are the most persistent and typically have a significant impact on daily life. It’s characterized by amnesia, consistent dissociation, and multiple identities or “alters.”2
Dissociative identity disorder is caused by trauma and neglect at a very young age, whether this is physical, emotional, or sexual abuse. These types of trauma often have a profound impact on the development of identity because they can affect attachment and violate boundaries.2
The creation of “alters” is rooted in this disruption of identity because a child dissociates from deep emotional pain and struggles to create a consistent sense of self. In this way, alters serve as a protective mechanism against the overwhelm of traumatic experiences.1
DID used to be known as “multiple personality disorder” until 1994. Yet, dissociative identity disorder is a much more appropriate name for the condition because it describes its mechanism more accurately. In other words, it expresses how it arises from severe dissociation that disrupts the formation of a whole and intact sense of self. Furthermore, DID is not a personality disorder as implied by multiple personality disorder, which we’ll explore later in this article.1
Signs and Symptoms of Dissociative Identity Disorder
As mentioned, people with dissociative identity disorder typically experience two or more alters, amnesia, and feelings of dissociation. The following information explores the symptoms of dissociative identity disorder in more detail.
Alters:
Also referred to as alternate identities or personalities, alters are independent and autonomous identities within the same person. They may have independent ways of speaking and expressing themselves, different names, and even unique memories.1
It’s common for alters to have their own histories and personalities, with one dominant identity in control most of the time.2 Different alters may also deny the existence of other identities or be in open conflict with each other.8 Signs someone is switching between alters include eye rolling, trance-like behavior, and changes in posture.1
Amnesia:
People with DID typically also experience amnesia or gaps in their memory. This loss of memory could be related to traumatic events, but also to daily activities.1 For example, some people may realize they’re in a certain location and not remember how they got there, or come across a new item they can’t remember buying.7 Plus, distinct alters often do not have access to each other’s memories, which can result in amnesia around periods of time when another alter was in control.
Dissociation:
Feelings of dissociation are another sign of DID. These can be split into two categories: depersonalization (DP) and derealization (DR):
Feelings of DP revolve around the self; people may not recognize their reflection in mirrors or feel like observers of their own thoughts and behaviors. Feelings of DR are outwardly focused; people describe feeling as though the world is dreamlike or that familiar locations feel strange.9
Aside from these symptoms, people with DID may also be more likely to have a disorganized attachment style.2 This is because this style is often rooted in trauma and fear. Signs of disorganized attachment include a preoccupation with rejection, needing reassurance and closeness, but also a fear of intimacy in close relationships.10
Getting a Diagnosis for Dissociative Identity Disorder
About 1.5% of the global population is diagnosed with DID, but the diagnostic process can take a long time as DID is sometimes confused with other diagnoses. Namely, borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD).1 We’ll explore these other conditions later in this article.
For now, let’s discuss the process of getting diagnosed with DID.
If you think you have DID, mention your concerns to your primary care provider. You can ask them to refer you to a psychiatrist or psychologist for a full assessment. At this appointment, you may be asked about any substance use that could explain your condition.1
Once referred to a mental health professional, they’ll use a set of criteria from the Diagnostic and Statistical Manual (DSM-5) for diagnosing dissociative identity disorder. These criteria outline that someone has to have the following to achieve a diagnosis:1
At least two or more distinct personalities, with each personality varying in behavior, memory, perception of the outside world, and sense of consciousness- Amnesia and gaps in memory of both daily events and traumatic experiences
- An absence of substances that could explain symptoms
- Struggles with daily activities and relationships as a result of symptoms
To determine whether you meet these criteria, the clinician is likely to ask you straightforward questions like, “Have you ever felt there are two or more distinct personality states within yourself?” Or, “Have you experienced an inability to recall important personal information or traumatic events?”6
The clinician may also gather information about your personal history to gain an understanding of the trauma that might have caused your symptoms. You won’t need to go into detail or discuss anything you’re not ready for at this stage, but they may simply ask if there is trauma in your past.6
Dissociative Identity Disorder Evaluation Tools
To gain a deeper understanding of your condition and determine which dissociation signs you experience, clinicians may use a questionnaire to evaluate your symptoms and their severity. For example, they might use one of the following:1
Dissociation Questionnaire: 63 questions that measure identity confusion and fragmentation, amnesia, and the loss of control that someone’s condition causes- Dissociative Experiences Scale: A self-report questionnaire with 28 items measuring the impact of amnesia, depersonalization, and derealization
- Difficulties in Emotional Regulation Scale (DERS): 36 subjective questions about emotional responses and regulation, impulsivity, and handling of goal-directed tasks
These DID evaluation tools can give mental health professionals a better understanding of how your condition impacts your life, which can then inform your treatment. For example, the Dissociative Experiences Scale asks questions like:
“Some people have the experience of driving or riding in a car or bus or subway and suddenly realizing that they don’t remember what has happened during all or part of the trip. Select the number to show what percentage of the time this happens to you. (0% Never, 100% Always)”7
After you’ve answered 28 questions in this format, clinicians may ask you to describe any experiences you’ve had for which you’ve scored 20% or more. This can help give them a more accurate view of how your symptoms are affecting your life.7
Next, we’ll explore other trauma-related conditions that can sometimes be confused with each other in the search for a DID diagnosis.
Signs of Other Trauma-Related Conditions
Recognizing dissociative identity disorder can be difficult because many people with DID have symptoms that resemble those of borderline personality disorder (BPD). BPD is another trauma-related condition marked by mood swings and instability in relationships.3
Other symptoms of BPD include a fear of abandonment, chronic feelings of emptiness, instability in self-image, and difficulty with emotional regulation.11
Studies show that 64-72% of people who meet the DSM-5’s criteria for BPD also meet the criteria for DID. This doesn’t mean that these people truly have both conditions; it’s often just that their symptoms can look very similar.3 Plus, some experts suggest DID and BPD could exist on a spectrum, though this issue is still being debated.2
Mental wellness evaluations may also observe symptoms of post-traumatic stress disorder (PTSD), which is another trauma-related condition. In fact, many researchers agree that DID is an extreme form of PTSD, as it shares many characteristics (aside from the existence of alters) and is caused by trauma.2
PTSD can cause a wide range of symptoms, but it’s characterized by intrusive memories or nightmares, heightened vigilance, and avoiding things that remind someone of a traumatic event.12
Dissociation and trauma connect these three conditions because dissociation acts as a protective mechanism to shield the brain from the overwhelm of traumatic experiences.4 Trauma can also cause other dissociative conditions, such as dissociative amnesia or depersonalization/derealization (DPDR), but these do not involve the existence of alternate personalities.13
While the DSM-5 lists ten personality disorders, DID is not one of these. Even though dissociation and trauma are shared by those with BPD, people with BPD don’t experience a fragmentation of their identities in response to trauma. It is this key symptom that distinguishes DID from other trauma-related conditions.5
Mission Connection: Get Support for DID Today
While trauma-related disorder symptoms can share a lot of similarities, there are clear-cut criteria for diagnosing DID. Once you’ve got a DID diagnosis, appropriate treatment can begin. Therapy for DID symptoms is a careful and long-term process that focuses on processing and integrating trauma. Once integrated, alters become no longer necessary, and people can finally heal and see a reduction in their symptoms.3
At Mission Connection, our licensed professionals are focused on providing personalized mental health treatment, with your unique needs and goals at the center of our work. With trauma-focused, compassionate, and evidence-based support, coping with DID can become much easier. Get in touch today to learn more about how we can support you in your recovery.
References
- Mitra, P., & Jain, A. (2023, May 16). Dissociative identity disorder. PubMed; 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
- 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
- ScienceDaily. (2016, December 9). Can you unconsciously forget an experience? https://www.sciencedaily.com/releases/2016/12/161209081154.htm
- Saxena, M., Tote, S., & Sapkale, B. (2023). Multiple personality disorder or dissociative identity disorder: Etiology, diagnosis, and management. Cureus, 15(11). https://doi.org/10.7759/cureus.49057
- Ross, C. A. (2015). When to suspect and how to diagnose dissociative identity disorder. Journal of EMDR Practice and Research, 9(2), 114–120. https://doi.org/10.1891/1933-3196.9.2.114
- Dissociative Experiences Scale – II. (2024). Trauma Dissociation. https://traumadissociation.com/des
- Psychology Today UK. (2021, September 21). Dissociative identity disorder (multiple personality disorder). https://www.psychologytoday.com/gb/conditions/dissociative-identity-disorder-multiple-personality-disorder
- 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/
- Beeney, J. E., Wright, A. G. C., Stepp, S. D., Hallquist, M. N., Lazarus, S. A., Beeney, J. R. S., Scott, L. N., & Pilkonis, P. A. (2017). Disorganized attachment and personality functioning in adults: A latent class analysis. Personality Disorders: Theory, Research, and Treatment, 8(3), 206–216. https://doi.org/10.1037/per0000184
- Chapman, J., Jamil, R. T., & Fleisher, C. (2024). Borderline personality disorder. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/
- Mann, S. K., Marwaha, R., & Torrico, T. J. (2024). Posttraumatic stress disorder (PTSD). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/
- National Alliance on Mental Illness. (2024). Dissociative disorders | NAMI. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders/