9 things 'Moon Knight' gets right and wrong about dissociative identity disorder, according to a mental health expert

"Moon Knight" is based on the Marvel comic character of the same name. In the comics, Marc Spector is a mercenary who becomes an avatar, or supernatural servant, for the Ancient Egyptian moon god Khonshu.

However, one of the things that make the character stand out is his struggle with mental health illnesses, especially his dissociative identity disorder.

The Diagnostic and Statistical Manual of Mental Disorders describes DID as a psychiatric disorder in which a person shows at least two fractured identities or personality states that can manifest through the person's behavior.

In the comics and the show, Marc has three main alters, or personality states. The series portrays some symptoms of the disorder, however, Anthony Smith, a licensed mental health counselor with 17 years of experience diagnosing mental health conditions in the Massachusetts court system, told Insider that the show is not accurate for all people with DID.

Smith also said that certain moments such as blackout scenes are a "visual effect" for viewers who do not have the disorder.

In the first episode of the TV series, the audience follows one of the alters, Steven (Oscar Isaac), who is unaware that he has DID.

He admits to his friend, a street performer, that he believes that his unexplainable movement is due to sleepwalking, and thus he has multiple locks on his door and a handcuff on his leg during the night in an effort to stop himself from ending up somewhere randomly.

Smith told Insider that coming to in unexplained circumstances "doesn't sound too far-fetched."

"People with DID really don't know they have DID until it's pointed out," Smith explained. "They often don't notice their alters, and often times nor do others, as they're rather subtle, not some 'Jekyl and Hyde' major switches."

He added: "What usually is the most troubling, and what brings people for evaluation, is they notice they're missing blocks of time that are too many/too long to be accounted for by normal forgetfulness. They may 'come to' in places that surprise them, or are doing things that they don't recall getting into, good or bad."

In episode one, Steven has a conversation with a co-worker who claims he planned to take her out on a date to a steakhouse. The problem is that Steven is a vegan and doesn't remember asking her out. This forgetfulness occurs multiple times throughout the series.

Smith said that people with DID often experience amnesia.

Smith told Insider: "That's because they subconsciously disassociate when triggered, causing them to temporarily lose awareness of your thoughts, actions, and surroundings."

In episode one, during a fight scene, Steven is surrounded by villains. Suddenly, the music in the scene playing starts to stutter and the lights start flickering. When the flickering stops, we see Steven again surrounded by the villains lying on the floor. It is implied that Steven switched to another alter, who defended them from the villains.

Smith told Insider that he believes this was "more of a visual effect to have the viewer along for the transition."

He added: "People aren't necessarily aware of switching, hence the frequent amnesia and surprises at one's location/activity. Because they can't remember, it may colloquially be referred to as a 'blackout.'"

At the end of episode one, we are introduced to Steven's alter, Marc. The series continues to focus on these two alters and they communicate through reflections.

Smith said that some people with DID do have "alters with fully-formed identities," but this is not always the case.

"Sometimes, it can be difficult to tell if a person with the disorder enters an altered state of consciousness because their mannerism changes are subtle," he said.

Later in the series, both Steven and Marc are able to somewhat control switching between alters. For example, at the end of episode one, Steven relinquishes control to Marc because he is in danger. Smith told Insider that this doesn't always happen with people with DID.

"Unlike popular media portrayals suggest, people with DID don't always have conscious control over their fractured identities, or alters," he said.

In the series, Marc and Steven also learn to unite very quickly in order to save the day, which isn't very realistic.

"Usually, it takes many years of consistent therapy for someone to learn how to unite their alters to work together, as part of their core self," said Smith.

In episode five, the audience discovers that Steven's name, Steven Grant, and his British accent, come from an adventure movie character Marc liked as a child.

In episode two, there are also implications that Steven had adopted the hobbies of Marc's wife, Layla. They share multiple interests, such as a love for the same French poet and learning about Egyptian hieroglyphics.

Smith told Insider that this part of the story seems more like "interesting character development."

"In DID, the alters are internally-generated, based on what the psyche feels is required for protection, and, as far as is known, developed early on, though some might not reveal themselves for some time," Smith said. "They have nothing to do with mirroring outside individuals, especially met in adulthood, which seems more like a conscious mimicry effort."

There is a heart-breaking moment in episode five when Steven, who believes he has a good relationship with his mother, discovers that in reality, his mom had abused Marc which led to their disorder.

Smith told Insider that people with DID can also be unaware of abuse in their childhood.

"Indeed, sufferers are often not aware of their abuse history. If so, they're usually not in tune with just how torturous it was," he said.

Smith also said alters come about to "protect" a person "from the horrors of the past."

In the final episode, when Steven and Marc take on the villain, they are able to switch seamlessly between each other, often in the same conversation.

Smith said that this might be the way the series decided to show different identities being "integrated" into one, meaning the identities that "split off from the core person have been re-absorbed because they're no longer required for protection or whatever function they served post-trauma."

"I'm inclined to believe the portrayal of seamlessly switching, as if they're a happily-married tag team of sorts, is a visibly-tangible way for a director to show that the different identities are integrated, or accept each other and there is now optimal function," Smith told Insider.

He added: "Integration indeed occurs, whether that's alters being co-aware and understanding one another and thus interacting more amicably/adaptively, or perhaps dissolving away into the core (Marc) as whatever conflict they evolved to defend against has been resolved."

Throughout the series, it is implied there is a third alter that comes out when Marc and Steven are in danger. His identity is revealed in the post-credits scene as Marc's third alter from the comics, Jake Lockley.

The character is not fully developed in the limited series, making the series seem like it is leaning into the "violent alter" trope. Past movies, like "Split," have created stigma against people with DID by portraying the idea that they have a dangerous alter waiting to come out and hurt people.

Smith told Insider that this is not accurate and is a product of Hollywood.

"Sure, some people have 'enforcers' or more volatile identities that can manifest when feeling vulnerable, and they could possibly be aggressive," he said. "But I've yet to hear of any non-fictional alters spontaneously turning into Jason from 'Halloween.'"

"Moon Knight" is streaming on Disney+ now.