This most serious of personality disorders was made popular by the Hindi flick `Karthik calling Karthik.’ Multiple personality disorder or MPD was recently coined Dissociative Identity Disorder (DID).
We have all experienced some degree of dissociation when engrossed watching a good movie or reading an un-putdownable book. However DID is a serious disorder where individuals do not know how to deal with their traumatic past and use dissociation as a coping mechanism. It is a mental process which causes a lack of connection in a person’s feelings, thoughts, actions or a sense of identity.
Causes of multiple personality disorder or dissociative identity disorder
Research indicates that a combination of biological and environmental factors cause DID. Experts agree that trauma in one’s past, for example in childhood (usually before nine years of age) can be an important factor in triggering this problem. The abuse could be physical, emotional or sexual in nature and is extreme or repetitive.
Environmental factors include living through a war, natural disasters like famines and earthquakes, torture, kidnapping or invasive medical procedures.
0.5-2% of the population is diagnosed with DID. Another 7% may have undiagnosed DID. The patients are most often female and it usually occurs in adolescence or young adulthood.
Symptoms and signs of multiple personality disorder
The person has at least two `alters’ which keep switching suddenly. When the person is diagnosed initially, two to four alters may be recognised but even a 100 alters have been recorded. On an average 12-15 alters are seen.
The trigger for the switching of personalities is an event or an environmental change. The person assumes the characteristics and trait of the personality that is the dominant one at that time. Hence the person’s behaviour is erratic and unpredictable. There is a feeling of another person talking to you or living inside your head. What is interesting is that the person has amnesia during the time when another personality takes over and has no recollection of that period or the events that happened when a different personality is dominant. Each personality or alter has its own age, sex and race and has a distinctive gait and manner of speaking.
Some important symptoms include:
- Mood swings
- Sleep problems like insomnia, sleepwalking and nightmares
- Alcohol and drug abuse
- Hallucinations like seeing or hearing something not actually there
- Suicidal tendencies
- Eating disorders
Diagnosis and treatment of multiple personality disorder
It takes an experienced psychiatrist to diagnose DID as it must be distinguished from schizophrenia and other dissociative states like dissociative amnesia, dissociative fugue and depersonalization disorder.
Treatment must be considered from the holistic perspective. Regular visits to a good psychiatrist with a family member or partner is essential. Psychotherapy is the primary treatment which includes hypnotherapy, counselling and talk therapy.
Hypnotherapy: Alternative medicine in the form of hypnotherapy is helpful if undertaken by a qualified person. Under hypnosis, the multiple personalities slowly reveal themselves and since persons in this state are highly receptive, the personalities can be integrated to form one single personality. However hypnotherapy requires several sessions to give good progress and the person needs to be co-operative to an extent.
Drug therapy: If mood swings or depressive behaviour is present, anti-depressants or other drugs are prescribed which must be taken on a regular basis.
Prevention of multiple personality disorder
If your child has been abused or you know of one who has, do not hesitate to take him to your physician who can then refer the child to appropriate healthcare professionals.
If you as a parent feel unable to cope with the demands of children and abuse them in a fit of anger, seek professional guidance to deal with the situation. There are many ways of delegating childcare from professional childcare centres to at home nannies. Talk to your partner and ask for his support. There is no excuse for neglecting a child or child abuse.
Complications that may arise
Persons with DID are at a risk for other psychiatric ailments like depression, sexual dysfunction, eating disorders, alcohol and drug abuse, suicide and self-mutilation.
Written by Dr Nisreen Nakhoda
Photograph via sxc.hu
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Multiple personality disorder – Causes and symptoms is a post from: mDhil