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Dissociative Identity Disorder and Addiction

February 27, 2012

Dissociative Identity Disorder (DID) is commonly known or referred to as multiple personality disorder. When we think of DID, we generally think of extreme cases (Sybil comes to mind). However, as with any disease or illness, there is a spectrum, from the mild to the severe.

In the general public, it is estimated that up to 3% of the population is suffering from DID. In the substance abuse, eating disorder, and OCD population, it is believed that up to 5% of the population suffers from DID.

Symptoms of DID
The symptoms of DID include the following:
Current memory loss of everyday events
Disruption of identity characterized by two or more distinct personality states
Distortion or loss of subjective time
Flashbacks of abuse/trauma
Frequent panic/anxiety attacks
Identity confusion
Mood swings
Multiple mannerisms, attitudes and beliefs
Pseudo-seizures or other conversion symptoms
Psychotic-like symptoms such as hearing voices and other Schneiderian first-rank symptoms
Self-alteration (feeling as if one’s body belongs to someone else)
Somatic symptoms that vary across identities
Sudden anger without a justified cause
Spontaneous trance states
Suicidal and para-suicidal behaviors (such as self injury)
Unexplainable phobias

Often, it is believed that DID develops from PTSD or other traumas. This is not proven, however, but in clinical experience, they often go together. Whether or not the trauma causes the DID is up for debate.


It is believed that DID is under diagnosed due to several reasons. Most clinicians have been taught that DID is very rare and presents dramatically. The reality is that the signs are generally subtle and can seem to come and go. There is generally a “window of diagnosability” that is easily missed. A typical DID patient shows a variety of symptoms that mix dissociative and PTSD symptoms that generally also come along with non trauma-related symptoms (depression, panic attacks, substance abuse, etc). The non trauma symptoms are more familiar and present more consistently than the DID symptoms, often leading to misdiagnosis.

Practitioners also often use the same standard diagnostic interview tools that often do not include questions about dissociation, PTSD symptoms,or a history of psychological trauma. DID patients rarely volunteer information about their symptoms, so if a practitioner does not specifically screen for these symptoms, the diagnosis will not be made. Even if a patient volunteers information that would suggest DID, practitioners are not trained to recognize the symptoms and may tend to misdiagnose the patient according to other more common symptoms.

Getting Help

If you think you may have DID along with your substance abuse problem, it’s important that you choose a treatment program that is well versed in diagnosing and treating both. As always, being honest and up front about what is going on in your life will help you to get the best treatment.

At Serenity Acres, our counselors and therapists are trained to screen for DID as well as other co-occurring disorders. We can then provide the most individualized and specialized treatment possible. If you have questions or would like more information, please call 800-335-7440

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