February 8, 2019, BrightQuest Treatment Centers

It can be difficult to understand how dissociative identity disorder affects daily life. However, by learning more about it, you can begin to imagine the challenges. Living with DID is not only stressful for the person at the center of it—it is also stressful for the family. Find out how you can be helpful now by showing receptive support and by helping your loved one get life-changing clinical care as soon as possible. What is it really like living with multiple identities or alters? Tristan says, “It frustrates me when people try to tell me my alters aren’t real. Even if they’re just trying to make me feel better, I end up feeling more alone and misunderstood. My alters are me. How could they not be real?” It’s difficult to understand for someone on the outside. But the more we know about how dissociative identity disorder affects daily life, the better we can support someone who suffers with it. Treatment goes a long way to helping a person integrate the distinct parts of themselves, develop supportive resources, and practice coping skills that really work. But over the long term, they are going to be discovering how the benefits of treatment really weave into daily life. And having understanding family members and friends will be critical in this continuing recovery journey.

Understand How Dissociative Identity Disorder Affects Daily Life

For people like Tristan who cope with dissociative identity disorder every day, their reality of selfhood is different from what the rest of us typically experience. At different points throughout the day or the week or the month, they see, feel, understand, and interact with the world through more than one identity. In a way, their “alters” take turns living their life. The various identities usually have unique names, personalities, voices, interests, genders, even ways of dressing. At some point in their past, an experience was too intense, overwhelming, or painful, and their mind adapted by withdrawing and compartmentalizing certain sensitive parts of itself. It dissociated. It was intended as a way to protect the whole person, but this coping mechanism basically ruptured a complete consciousness so that they understand themselves as being a system of various individuals. And the mind is not in a position to reintegrate these different identities without help. Some people with DID are aware that they have this disorder and that the various versions of themselves take turns living different moments and stretches of their days. Other people are not aware of the wider perspective and live out their days confused and destabilized by this disintegration. One very important truth is that these alternate personalities are all critical aspects of the original individual. When a person is able to gain a clearer perspective and some helpful coping skills, their alters may work together as a cooperative system. One personality might be best at interpersonal skills, another at organizational skills, and another at leadership, for example. So, they can manage life situations by compartmentalizing certain responsibilities. But it isn’t always the case that a person’s system of alters is awake and prepared enough to cooperate. If the individual isn’t even aware that they are living with this disorder, it can be extremely destabilizing to endure a rollercoaster of personalities and thoughts and behaviors. The unpredictable patterns and inability to cope can severely upset relationships, school and job opportunities, and basic life responsibilities. And an individual’s sense of self is far from grounded in this distressing scenario. They may be at risk of other problems and disorders, too, as they struggle through their days.

What Can You Do to Help Someone with Dissociative Identity Disorder?

People with dissociative identity disorders likely already feel isolated and alone in their suffering. One of the first things you can do is to help them feel supported and understood. Even if you can’t quite know what they are going through, you can be patient and receptive to the range of their experiences. When this person is living through the lens of an alternate personality that is unfamiliar to you, remember that this is still your loved one, and help them to feel accepted and supported regardless. While your ongoing support is indispensable, you will not be able to help them through recovery on your own. This is a disorder that requires knowledgeable clinical attention and proven treatment options for lasting recovery. It is very possible with comprehensive treatment for someone to learn to integrate their alternate identities and significantly mitigate their dissociative symptoms. Not only was there an initial traumatic episode that provoked their severe dissociation, but there has also been trauma and pain resulting from the distressing symptoms that followed. Only an experienced therapist can help guide this individual to a harmonious sense of self and healthy coping strategies. The realities of dissociative identity disorder are understandably stressful for the family as well as for the person at the center of it. Early treatment is the best assurance for a successful recovery. Residential treatment, in particular, allows an individual to be immersed in healing practices and perspective. It will take time to develop therapeutic alliances, healthier coping skills, and a productive relationship with their stored trauma. All of these important layers of treatment can pave the way to reintegrating the self. A residential treatment center can inspire harmony among the selves within a single person, as well as among the individuals within their family community. And you can be an integral part of that journey. If you’re concerned about a loved one and believe they may need residential care, we can help. BrightQuest offers long-term treatment for people struggling with complex mental health illnesses and co-occurring disorders. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.

Dissociative identity disorder can control many aspects of a person’s life. However, treatment can reduce symptoms of the condition. A person’s life before treatment can vastly differ from their life after treatment.

Dissociative identity disorder is a mental health condition characterized by the presence of one or more alternate personalities. According to the National Alliance on Mental Illness, 2 percent of people experience dissociative disorders like dissociative identity disorder. People with dissociative identity disorder often feel helpless to the condition. However, receiving an early diagnosis and undergoing proper treatment for dissociative disorder can help an individual cope with symptoms of the disorder.

Dissociative Identity Disorder: Before Diagnosis

A report by the American Psychiatric Association told the story of Sandra, a veteran with a dissociative identity disorder. While in the military, Sandra was hospitalized for poor memory and sudden behavioral changes. She was eventually diagnosed with a dissociative identity disorder. Before her diagnosis, Sandra experienced a difficult childhood. Her parents divorced when she was 6 years old. Her mother became involved with a man who sexually abused Sandra when she was 11. She also dealt with memory problems after the abuse. During her hospitalization, Sandra underwent hypnosis. While hypnotized, medical professionals discovered that Sandra had an alternate personality who called herself Mary. The voice said that she often punished Sandra by physically abusing her. In the past, Mary would command Sandra to harm herself. In one instance, the alternate personality ordered Sandra to intentionally cut her leg. Sandra gave an alternative story about how she received the injury, but the medical professionals found inconsistencies in Sandra’s explanation.

Symptoms of DID

Dissociative identity disorder symptoms include headaches, amnesia, a distorted perception of time and memory problems. Individuals with the disorder may also fail to remember personal information and traumatic events. Other symptoms associated with dissociative identity disorder include:

• Anxiety
• Panic disorder
• Sleeping disorders
• Depression
• Thoughts of suicide

Like Sandra, many other people with the disorder have alternate personalities. The personalities associated with dissociative identity disorder might take on names, characteristics and mannerisms. The symptoms of dissociative identity disorder can have personal and professional effects. People with the disorder often struggle to maintain relationships. They also tend to have problems completing everyday tasks.

Effects of Dissociative Identity Disorder

In 2016, a study published in the journal Lancet Psychiatry examined the long-term effects of personality disorders. It was the first study to outline the long-term implications of conditions like dissociative identity disorder. Led by researchers at the University of Bristol, the study analyzed health and social outcomes among 1,500 people with a personality disorder 11 years after diagnosis. Researchers linked conditions like dissociative identity disorder with:

• Anxiety
• Depression
• Relationship problems

Some people with dissociative identity disorder engage in substance abuse. They might turn to drugs or alcohol to numb their psychological distress. While individuals who use these substances can experience temporary relief, using drugs or alcohol over time can lead to addiction.

Coping With Dissociative Identity Disorder

Treatment can improve a person’s ability to cope with a dissociative identity disorder. Treatment for dissociative identity disorder can involve antipsychotic and antianxiety medications, family therapy, clinical hypnosis and psychotherapy approaches like cognitive behavioral therapy. Aftercare is important for people with dissociative disorders. Therapy is a common aftercare treatment for people with dissociative identity disorder and other mental health conditions. Creative therapies allow people to express their thoughts, feelings and experiences through activities that involve art or music. According to the Cleveland Clinic, individuals recovering from dissociative disorders should consider mindfulness techniques. For example, meditation practices can help people continue to cope with symptoms of the disorder. Mindfulness activities can reduce stress and produce a sense of calm.

Life With Dissociative Identity Disorder After Treatment

After her diagnosis, Sandra sought treatment for her dissociative identity disorder. Psychotherapy was one aspect of her treatment plan. Through psychotherapy, she learned to view her symptoms as poorly integrated parts of her overall self. She also learned ways to manage her alternate personality. People in dissociative identity disorder recovery can still experience symptoms of the condition after treatment. However, treatment can help them learn ways to better control their distressing thoughts and alternate personalities. After treatment, people can participate in aftercare programs. These resources include individual therapy, support group meetings and physical activities like jogging or yoga. Aftercare resources can help reduce stress in people with a dissociative identity disorder.

Can Someone With Dissociative Identity Disorder Live a Normal Life?

Living a normal life after experiencing a mental health condition, like dissociative identity disorder, is possible. People who learn ways to healthily cope with dissociative disorders can increase their chances of living what they consider to be a normal life. Although recovering from dissociative identity disorder is not easy, many people with the condition can still spend time with loved ones. They can also keep working and lead an otherwise fulfilling life. Treatment helped Sandra to learn ways to restructure her memories and even disrupt negative thinking patterns related to her past abuse. She was also prescribed antidepressant medications to treat her depressive thoughts. If you’re living with a mental health disorder, like dissociative identity disorder, and deal with substance abuse problems, contact The Recovery Village. An admissions representative can offer you helpful resources for better managing your substance use and mental health disorders. Editor – Thomas Christiansen With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more Medical Disclaimer The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers. As a survivor with both lived and professional experience of dissociative identity disorder, DID, there are a few things I wish people understood. Life with DID is hard, very hard. When you are managing life with multiple parts, there can be competing needs among those parts. What to wear, who to spend time with, career choices, and identifying which parts are responsible for which aspects of daily living (getting ready, taking care of grocery shopping, going to work). One part may pay the bills while another part may have no awareness that a bill is even due, especially early in the recovery process. Living with DID can be exhausting and while DID systems should never be compared, there are some aspects of daily life where we can all relate. The journey through healing can be cumbersome, expensive, and frustrating. And while there are some beautiful aspects to recovery, I wish I could shout: ”You just don’t get it, life with DID can be so hard!” But how can anyone understand dissociative identity disorder if they don’t live with it and the only thing they have been led to believe is that people who suffer are crazy, inept, or unintelligent—all of which is far from the truth. Many individuals living with DID are bright, capable, and talented. Imagine managing life with several parts of yourself that feel and can act like completely separate entities. Visiting the dentist, doctor, or gynecologist can feel like trauma is happening all over again. Daily hygiene practices can pose problems, as some parts of the self may have the skill to take care of the body while other parts do not. Body image, body dysmorphia, physical fitness, struggles with weight and food, the list goes on. A person with dissociative identities may shower three times a day to wash off old trauma and shame, and they may not realize they are doing this until they had a moment to reflect. Sometimes if a survivor experiences a trigger they may switch into a younger part and find themselves curled up with a stuffed animal, this can be a jarring and embarrassing experience. One hopes that friends never witness this level of vulnerability. What would they do? What would they say? A common theme that can replay in the mind of a survivor: If they know this truth, what will happen, will they leave? The threat of abandonment is never far behind. Those of us who live with DID are also not here for other people’s entertainment, we have survived unimaginable trauma and our responses to stress and triggers need more understanding and compassion. Having a safe place to talk openly about life with DID and its realities is crucial to everyone’s well-being. It is one of the biggest reasons I have come out; I want to help others. I spent far too many years feeling alone, scared, and embarrassed; I don’t want others to feel that way. Flashbacks, night terrors, disrupted sleep, body memories, overwhelming panic, the urge to self-harm, suicidal ideation, and relationship struggles are common when living with DID. Although it can be manageable and there is hope on the path to recovery, it’s important for people to understand that this condition is no joke. Not only is the trauma that led to its development excruciatingly painful but living with DID requires empathy and compassion for self. Patience is also key. There is no fast-tracking to heal the trauma. I wish people took the condition more seriously. I wish people educated and trained themselves to better help survivors. I wish clinicians could admit to their clients when they don’t know something. Those with DID are often more educated than their providers, and while we should be the expert on ourselves, it would be helpful if providers were more informed, not just through a textbook or Hollywood tropes, but through the voices of lived experience. I have learned the most from people living with DID. We need survivors to know they are not alone. I get it, I see you. It’s really hard, keep healing, it does get better. On dark days, there is someone else in the world who knows how hard it is for you. Never give up and remember to ask for help. You and your DID system are worth it. Dissociative identity disorder (DID) is a highly dysfunctional, long term disabling and pervasive mental illness. It’s exhausting, time consuming and frustrating, but I have developed techniques and strategies to help me exist on a daily basis. While DID has affected my ability to work and socialise, my strategies help me get the most out of each day. I hope they can be of use to you or a loved one living with DID.

End the blame and the shame

It’s important to tell yourself that this illness is not your fault. Your past is not your fault and traumas endured are absolutely not your fault. The blame lies purely with the perpetrator. Please remember that! Moving through unwarranted blame has been long and difficult, but therapy helped. Similarly, shame destroys self-worth and tells you that you are not deserving of help or acceptance. Shame is corrosive and humiliating, it keeps us silent, and silence in treatment prevents recovery.Learning to move through shame takes time, patience and a sensitive therapist. People with DID can experience internal intense shame from themselves and their voices, resulting in unrelenting internal dialogue of blame and self-hate. Shame can also come externally from the outside world (family, friends, other people) in the form of disbelief, isolation and stigma.

‘Shame is a soul-eating emotion.’ Carl Jung

Build your knowledge

Reading up on DID was confusing and confronting. My search for answers and solutions to my anguish lead me to countless books and internet resources. What I found is that, like most mental illnesses, DID isn’t necessarily ticking all the boxes and that my DID, like just about any illness, is extremely personal and varied. Many people living with DID will be on a spectrum – low to high or 0-10 scale. Accept that you can be anywhere on the spectrum and that’s completely okay. It was important to understand how this illness affects me, and not be worried that my experience isn’t textbook. Reading countless books probably gave me more anxiety than anything else. But it did allow me to weed out the things that weren’t relevant to my experience and I found material that helped. So, read up, but only work on things relevant to you.

Find calm and relaxation

My internal world is chaotic. So it’s imperative to ensure calm and order in my external world. My home, my life, my relationship and my family.De-cluttering my day to day life has proved highly beneficial. I accept I’m going to have bad days, but having calming techniques like music, knitting, self-safe talk (we’re okay and safe) and grounding techniques are helpful. Feeling like I am losing control is daunting and alarming, so distractions such as, TV, time with pets and hobbies work for me. Overwhelming mental clutter is tormenting and unhelpful. Voices, when confused, scared or stressed, can be critical and frightened.

Start planning and organising

I learnt to plan because it became necessary for basic functioning. With unpredictable amnesia, I can spend minutes to hours of unaccounted time on any given day. Forgetting things that I have done, like taking medication, can be very detrimental. Some things I do include:

• Writing down medicines when I take them
• Setting the timer when in the kitchen
• Organising email/mobile reminders for bills
• Writing appointments down in a diary
• Drawing up a daily/weekly plan.

My daily plan is an A4 sheet of activities. I print this template, and as I work through things I tick the corresponding box. I can insert one-off events relating to treatment, hobbies, study, relaxation and distractions.

Develop emergency strategies

Having a routine for stressful times is also helpful. I listen to music when I am stressed, or watch TV shows or movies to distract me from confronting chatter in my head. Some strategies include ringing my partner or close friend when feeling particularly vulnerable, afraid or tense. A comforting talk may be all that is needed. Times of crisis – like feeling suicidal or self-harming – require a more structured plan of safe interventions. I have a 1, 2, 3 approach I try when things get tough.

1. Self-soothing or grounding techniques to keep me present and feeling safe
2. Pain or anxiety medication as recommended
3. Contacting my therapist if it’s getting out of control.

Some episodes of self-harm have required medical treatment and it’s important that those I turn to are non-judgmental and understanding. A negative condemnatory reaction may mean I avoid treatment in the future.

Form a support network

A support network of family, close friends and treatment providers is crucial. People to talk to, have an understanding therapeutic relationship with and build trust with. It’s important to ask for help, and accept help when it is offered because you do not need to do this alone. I personally find a treatment team who talk to each other is ideal – doctor talks to psychologist and they both consult with psychiatrist.

Communicate

Internal communication with my Voices is vitally important. This is a continual work in progress and I may never know the full extent of my system. Think of my DID system like a group of people in a building. Some people you see regularly. You know them by name and have a chat as you pass in the corridor. Whereas others you didn’t even know were in the building! To understand why a particular voice is there, first you have to identify that voice, get to know them and what they are linked to. This may take years or decades, because the fundamental basics of DID are secrecy and protection. ‘Don’t tell’ because that is the safest option. I have no doubt that shame manifests itself in this as well. Some of my Voices were created during extremely traumatic events and just locating them is challenging let alone opening up communication channels, because their purpose of existence is to keep the traumas from me, to hold those horrific memories so that I can live in the outside world. Allowing me to experience that past defeats their purpose, but for many DID sufferers working with these voices and understanding the distressing memories they hold is necessary for recovery. If you are feeling alone, in crisis, or in need of support call the SANE Help Centre on 1800 187 263. Or Lifeline on 13 11 14. I have Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. DID is an extremely complex psychological disorder characterized by the presence of two or more distinct identities that repeatedly take control over my behavior. I like to refer to these identities as my “parts.” I think the hardest obstacle I have to overcome in my day-to-day life is constantly being pulled in different directions with every decision. It can be very chaotic for me. It’s like having a committee inside my head letting me know how they would handle things if they were “fronting,” or in control. In some ways, my biggest challenge is also one of my greatest strengths—the ability to see everything from multiple perspectives. One of my favorite descriptions of dissociation is by Bessel van der Kolk: “Dissociation is simultaneously knowing and not knowing.” There are so many things I know and do not know because of my DID. That simple awareness has helped me put different interventions in place to guide me through the challenges of my symptoms and manage the shame that is so heavily associated with DID. Here are some of the interventions that have worked for me.

Use Timers

Having DID can be very disorienting and makes it difficult to maintain daily structures. Even if I don’t have a busy day, I sometimes set my timer to go off each hour that I’m awake. This is in case one of my parts comes out unannounced and throws me off what I had planned to do. The timer will prompt me to get back on track. The timer also helps me to keep my schedule on course and to be on time for meetings or appointments.

Write Sticky Notes

One of the symptoms of DID is hearing voices inside your head; speaking to one another, arguing and commenting on your day-to-day tasks. This can get overwhelmingly loud. One way my parts can express themselves to me is through writing sticky notes. You’d be surprised at how many notes I’ve found stashed throughout my apartment from my parts. It can be a creative way to communicate with each other or remind one another of upcoming events or meetings. And most importantly, to get all the voices onto paper rather than just in my head.

Listen to Binaural Beats

If things get too loud inside of my head, I get a screaming headache which affects every single other aspect of my functioning. I searched and searched for anything that would help me during these times and was unbelievably elated when I found binaural beats. For me, they work every single time. Binaural beats provoke our brain to go into a specific brainwave (delta, theta, alpha, beta or gamma) by simply playing tones into each ear with headphones.

Seek Knowledge

I have found that if there is anything that will send me into a downward spiral—it’s shame. For me, shame comes in many forms: a yucky stomachache; a sideways, downward glance in a social situation; a refusal to excel in life for fear of not being good enough; or feeling uncomfortable in my own body. Mental illness brings its own laundry list of shame to the table, and I have found comfort in turning to science and facts. I recommend three books* that helped me in ways that probably saved my life.
1. Waking the Tiger by Peter Levine
2.The Body Keeps the Score by Bessel van der Kolk
3. Intensive Psychotherapy for Persistent Dissociative Processes: The Fear of Feeling Real by Richard A. Chefetz

Practice Self-Compassion

Having compassion for your own experience is no different than having compassion for your best friend going through a turbulent divorce. Instead of criticizing yourself for your shortcomings, why not confront those failings with kindness and understanding? We may have been fed a script that says we need to be perfect growing up—but now, as an adult, we need to embrace imperfection. For me, self-compassion is giving myself an extra 15 minutes to indulge in social media on a particularly difficult day because I know my brain needs to zone out when things become overwhelming. Sticking with self-compassion is allowing myself to enjoy those 15 minutes of mindlessness rather than being self-critical.

Keep a “Denial Book”

When I was first diagnosed with DID, I combatted daily feelings of denial. And back then my denial manifested as suicidality. Once I realized that, I knew I needed an intervention put in place. I went through all of my old journals and therapy documents and organized them in a binder. My “Denial Book” helps me when I begin to deny my diagnosis or the abuse I experienced in childhood. I have artwork, letters from doctors and therapists stating my diagnosis, testing results, journal entries from my teen years that scream DID, and journal entries from my childhood that prove I was abused. I even printed off the Dissociative Experiences Scale, completed it and put it in the back of the book. In my experience, sharing a mind and body with several unique identities due to severe, ongoing trauma in childhood almost certainly ensures a chaotic life. However, I’ve found that we have the power to safely guide ourselves through life by implementing interventions throughout the day and by redirecting ourselves away from shame and focusing on small accomplishments. These tips are best implemented under the guidance of a knowledgeable and dedicated therapist to help you along the way. Mental illness does not have to hold us back from reaching our goals and experiencing the life we’ve dreamt about since childhood. I believe in you. You are worth it. You are worthy of self-love and self-compassion. We all are. Jane is the mother of two exuberantly bright little boys, a lover of science and the brain, an author and mental health advocate, and a forever student. Jane, self-proclaimed Human Information Sponge, stars in A&E’s Many Sides of Jane which premieres January 22, 2019. She hopes to bring about social change by educating the public on the science behind childhood abuse and its effects on the growing brain, and by normalizing her stigmatized disorder—Dissociative Identity Disorder. Note: Jane’s story is being featured in a six-week series, “The Many Sides of Jane,” on A&E starting on January 22. Check out NAMI’s discussion guide. *The recommended readings are solely from Jane and have not been reviewed by NAMI. We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices. Check out our Submission Guidelines for more information.

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