Robert Louis Stevenson's "Strange Case of Dr. Jekyll and Mr Hyde" frightened and fascinated a vast number of readers with the science-fiction prospect of one person exhibiting radically different personalities. What readers may not have realized is that this problem is not merely a fantasy. Dissociative Identity Disorder is a very real disorder. While it is somewhat rare, its unusual symptoms can take over the lives of those diagnosed with it.
According to an article written by Psychiatric Medicine Prof. Lawrence Merkel, DID is defined by the presence of two or more distinct personalities inhabiting the same person, in which each personality dominates over the others at different times. Every personality is defined by very different, specific characteristics.
"There is a lot of argument about what DID is and what it isn't," said licensed professional counselor Lenny Carter, who works in the University's Counseling and Psychological Services office. "Basically, it's the term used to describe two or more distinct personalities residing in the same person," he said. "There is some sort of switching that takes place between the personalities, when one personality takes control and then the other."
Carter explained that the different identities may talk to the sufferer, and the sufferer may respond. These personalities seem to be different from the sufferer's core personality.
"For example, one personality may have diabetes and another might be able to drive a truck really well," Carter said.
The source of this complicated disorder is not innate or drug or alcohol abuse, but rather the direct result of a horrific experience, such as years of child abuse.
"A consistently strong connection has been shown between DID and child abuse, especially if [the abuse is] severe, extreme, and sadistic," Merkel wrote in his study.
According to Carter, DID is a way a sufferer can attempt to dissociate himself from this experience, resembling something similar to an out-of-body experience.
In addition to child abuse, Merkel noted other leading causes of DID are sexual abuse -- particularly incest -- physical abuse and witnessing a violent death.
Researchers have not quite determined whether DID is hereditary, but believe it is most likely unrelated to family genetics.
"The disorder is sometimes common in first-degree relatives," Carter said. "We don't really know therefore if it is hereditary, or if this means that the disorder results from the same level of horror in the same household. We can't really tell."
Recent research, however, has given doctors some important insights into the disorder, including the correlation between the disorder and gender. DID is reported much more often in females than in males, Carter said.
"Perhaps this is due to the notion that females tend to suffer from a greater deal of sexual abuse than men," he added. "On average, women sufferers possess 15 different personalities, while men average approximately 8."
Another important characteristic of DID is memory loss -- the sufferer often has difficulty remembering what he did while influenced by other personalities.
"With the disorder comes a certain memory loss, an inability to remember," Carter said. "For example, if a person goes shopping, then looks in the back seat a little bit later and sees shopping bags, he/she may not remember going shopping."
Merkel noted that other characteristics of DID include "depression, mood swings, suicidality, insomnia, sexual dysfunction, conversion symptoms, fatigue, panic and depersonalization."
As a result of DID's many symptoms, many people find difficulty in differentiating the disorder from others.
"The general population doesn't understand the disorder at all; they generally refer it with something like schizophrenia," Carter said.
According to psychcentral.com, which describes itself as "an independent mental health social network created and run by mental health professionals," both schizophrenia and DID are chronic, serious mental health concerns; however, they are very different. Schizophrenia sufferers see or hear things that do not exist and seem to believe things that are not true; they do not have multiple or distinct personalities. DID sufferers do not seem to report delusions; they only hear and talk to voices that are within the identities.
DID is also commonly mistaken for bipolar disorder. According to psychcentral.com, bipolar disorder is defined by altering moods of mania and/or depression that seem to last for several weeks or even months. Bipolar disorder affects about two million Americans in any given year.
When diagnosing DID, Carter explained that a doctor generally asks a series of questions to determine whether a person suffers from DID.
"The diagnosis of DID tends to be rather difficult," Carter said. "The average period of time between the first symptom and the next is approximately six to seven years. Then again, this is different for every person; it can be as little as two years or as many as 12 years."
Some people, after diagnosis, see improvement with medication, while others do not. According to Carter, it can take years of psychotherapy to be re-integrated into one personality.
According to Merkel, DID is not very common; he noted that less than two percent of psychiatric patients suffer from the disorder.
"The disorder is not often seen full-blown at the University clinic, but sometimes in a much milder form," Carter said. "I personally haven't seen many cases, probably about three in the past 24 years of my practice."
Carter added that while information about the disorder is still sparse, researchers have begun to delve further into the disorder? in the hopes of shedding more light on the issue to help those with DID cope more efficiently.
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