- Myths about DID paint it as a rare, untreatable condition that involves extreme personality changes.
- In reality, people with DID switch identities because they don't have a single unified identity.
When experiences like long-term abuse or neglect prove too traumatic to bear, some people cope with their distress by involuntarily escaping reality, or dissociating.
Dissociation is a mental process that involves disconnecting from your own thoughts, memories, feelings, and sense of personal identity. If you have dissociative identity disorder (DID), dissociation also involves switching between alternate identities or states of consciousness.
According to Shari Botwin, a licensed clinical social worker in private practice who has treated people with DID for over 26 years, this complex mental health condition is massively misunderstood, in large part due to inaccurate media portrayals.
Note: Until 1994, DID was known as multiple personality disorder. Botwin says the name change emphasizes the fact that people with DID don't switch personalities — rather, they lack a single unified identity.
Botwin says many of the misconceptions about DID tend to perpetuate the stigma around this condition. Below, she dispels some of the most common myths.
Myth #1: DID is rare
In reality, DID affects about 1.5% of the global population. This percentage may seem like a small portion of people, but to put that into perspective, that's more than four times the amount of people diagnosed with schizophrenia worldwide.
What's more, since DID often goes undiagnosed, or misdiagnosed as a personality disorder, the true prevalence of this condition may be even higher.
Botwin says DID may affect certain groups more often. For example, as many as 6% of highly traumatized people in inner city hospital settings have a DID diagnosis. Researchers believe this may relate to the fact that people in inner cities, especially people with marginalized identities, experience high rates of oppression and trauma.
Myth #2: Identity switching is the only symptom
People with DID have two or more distinct identities, known as "alternates" or "alters." Each alter usually has its own name and personal history, along with a unique personality, mannerisms, and preferences.
If you have DID, these alters can take over your thoughts, actions, and behavior at different times, and you may or may not have an awareness of these identities. Very often, you won't remember what happened while an alter was in control.
Movies and TV shows tend to dramatize switches between alternate identities. In reality, Botwin says these switches happen subtly enough that other people who don't know you well may not even recognize they're happening — especially when the alter doesn't have noticeably different speech patterns, mannerisms, or body language.
While alters remain the most well-known aspect of DID, Botwin says other equally common symptoms include:
- Amnesia, or gaps in memory
- Derealization, or feeling detached from yourself or your emotions
- An inability to cope with stress
- Depression
- Anxiety
- Suicidal thoughts or self-harm
Important: If you're having thoughts of suicide, help is available right now. You can get free, confidential support from compassionate crisis counselors by calling 988 to reach the Suicide and Crisis Lifeline or texting "HOME" to 741741 to reach the Crisis Text Line.
Myth #3: Dissociation is just another term for DID
Dissociation can also occur with other dissociative disorders, like:
- Dissociative amnesia: This dissociative disorder involves gaps in memory about personal information — such as things you've done, things that have happened to you, or even skills you've learned.
- Depersonalization-derealization disorder (DPDR): This dissociative disorder involves strong out-of-body experiences, where you may feel as if you're observing your thoughts, emotions, and actions from a distance.
But experiencing symptoms of dissociation doesn't mean you have DID — or any other dissociative disorder, for that matter. In fact, Botwin says she's worked with dozens of clients who developed a tendency to occasionally dissociate after experiencing abuse from family members or after witnessing abuse during childhood.
Dissociation can also happen with other mental health conditions, including:
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Borderline personality disorder (BPD)
- Schizophrenia
- Binge eating disorder
Some research also suggests dissociation can happen as a symptom of attention deficit hyperactivity disorder (ADHD). Also, people with epilepsy may experience dissociation during seizures.
Finally, you might also dissociate after using certain psychedelic drugs, including:
- PCP
- Ketamine
- The cough suppressant dextromethorphan (DXM), in amounts higher than directed on the label
Myth #4: People with DID are violent
Hollywood portrayals of DID often involve a dangerous or aggressive alter.
"This myth further contributes to the stigma around DID," Botwin says.
According to Botwin, no documented evidence supports a link between DID and increased criminal activity or violent behavior.
"In actuality, many clients with DID focus their anger inward with behaviors like cutting and disordered eating. Some clients report hearing voices from their alters that tell them things like, 'You're a bad person,' or 'You deserve to feel pain.' Trauma survivors with DID are at a much higher risk of harming themselves than harming others," Botwin says.
Note: Botwin expands on the impact of traumatic experiences in her book, Thriving After Trauma.
Myth #5: DID is a personality disorder
Because DID used to go by the name multiple personality disorder, Botwin says it's often misconstrued as a personality disorder. And it's true that DID and personality disorders do share a slight overlap in symptoms — for example, both may involve:
- An unstable sense of self
- Difficulties coping with distress
- Self-harm and suicidal ideation
Botwin also emphasizes that both personality disorders and DID can develop in response to traumatic experiences.
However, the Diagnostic and Statistical Manual of Mental Disorders classifies DID as a dissociative disorder, not a personality disorder, and the two conditions do involve many distinct symptoms.
People with personality disorders:
- Tend to have trouble regulating their emotions
- Typically start showing symptoms in their later teen years or early adulthood
- Usually remember and feel connected to their actions, regardless of their emotional states
Meanwhile, people with dissociative disorders like DID:
- Often lose touch with their identities and memories
- Usually start showing symptoms in childhood, between the ages of 5 and 10
- Typically experience amnesia when switching between alters
All that said, it is possible to have both a DID and a personality disorder diagnosis — and if you do, you may experience even more overlap between these sets of symptoms.
Myth #6: DID can't be treated
While there's no "cure" for DID, Botwin says the right treatment can help manage, even significantly reduce, symptoms.
Psychotherapy is the most common approach to treating DID. Through therapy, many of Botwin's clients have learned to:
- Work through traumatic memories associated with alternate identities
- Reach for alternative coping strategies for stress so they dissociate less
- Merge some of their separate identities, or at least find ways for them to coexist in harmony
For instance, one of Botwin's clients recognized that some of her younger alternate identities had been fueling her eating disorder. During their therapy sessions, she recalled childhood memories of feeling unheard, unseen, and unprotected. She eventually realized the alters contributed to her eating disorder in an effort to help get her parents to notice her.
A number of different types of therapy can help treat DID. Some of the most common methods include:
- Dialectical behavioral therapy (DBT): This approach teaches skills to help you regulate your emotions, stay grounded in the present, and self-soothe — all of which can help you cope with distress so you're less likely to dissociate.
- Cognitive behavioral therapy (CBT): This type of therapy can help you recognize and change negative thought patterns that may contribute to dissociation, which can then help reduce symptoms. For example, Botwin says CBT may allow you to shift negative beliefs about certain identities so you can gradually integrate them.
- Psychodynamic psychotherapy: Experts believe people with DID often dissociate as a way of "shutting off" and separating themselves from emotionally overwhelming experiences. Psychodynamic therapy emphasizes gaining a better understanding of unhelpful beliefs, thoughts, and feelings — so, for example, if you tend to avoid or suppress troubling emotions, your therapist can guide you in learning to accept and express them.
- Eye movement desensitization and reprocessing (EMDR): With this method, a therapist directs your eye movements in a specific way while you access traumatic memories and the alternate identities associated with them. The goal involves replacing negative beliefs around those triggering experiences with neutral or positive ones, so you no longer need to dissociate to avoid those memories.
- Schema therapy: This approach involves uncovering and understanding your "schemas," or unhelpful coping mechanisms you may have developed in response to childhood neglect or abuse.
Hypnosis may also have benefits — in fact, a 2022 study found that people with dissociative disorders often prove easier to hypnotize than others. Hypnosis may help you access alternate identities, encourage communication between them, and find ways to regulate the shifts between them.
Note: While your doctor may prescribe antidepressants or other medications to help relieve symptoms like depression and anxiety, medications can't directly prevent or treat dissociation.
Insider's takeaway
DID is a complex and widely misunderstood condition that most often stems from traumatic experiences in childhood. While it does involve shifting between multiple identities, other symptoms can include lapses in memory, depression, and feeling detached from yourself or the world around you.
Even though no specific cure for DID exists, Botwin emphasizes you do have options for managing and easing your symptoms. A variety of treatments like therapy, hypnosis, and medication can all make a difference.
"Many of my clients who have DID are also professionals, parents, and partners. People with DID can go on to live happy and fulfilling lives," Botwin says.