Dissociative Identity Disorder (DID)

As with many mental health conditions, DID doesn’t have a singular definition or a rigid diagnosis. There are three main types of DID, each with their specific set of symptoms.

Depersonalisation-Derealisation Disorder
Depersonalisation-derealisation disorder occurs when you are persistently and repeatedly having the feeling that you’re observing yourself from outside of your body. The experience of this condition can be quite disturbing and make you feel as though you’re living in a dream world.

The feeling of depersonalisation and derealisation can be experienced by many people at various point in life. We’ve all had points at which we ‘zone out,’ where things become a bit of a blur and we’re on “autopilot”. But when these feelings continue to occur – never fully abating – they interfere with your ability to function. This is when you would be considered to have depersonalisation-derealisation disorder.

Symptoms
Symptoms of depersonalisation include:

• Feeling as though you’re observing yourself from an outside perspective. You feel detached from your thoughts, feelings, and physical body. e.g. You may feel at points as though you’re floating above yourself.
• You feel almost mechanical in nature and that you’re not fully in control of your body.
• There’s a sense that your limbs are distorted, enlarged or shrunken and that your head is wrapped in cotton wool.
• You can feel dissociated from your memories and that there is no emotion attached to them.

Symptoms of derealisation include:

• You may feel alienated from your surroundings. Your life may appear to be ethereal, almost like you’re in a movie or a dream.
• You may feel emotionally disconnected from those who’re closest to you, such as your friend and family.
• Your surroundings may appear distorted blurry, colourless, two dimensional or artificial. Conversely, you may have a heightened sense of awareness about your surroundings.
• You may experience distortions in your perception of time, such as event recall. Recent events may also feel like distant memories.
• You may experience distortions in the distance between objects.

Dissociative Amnesia
Dissociate amnesia (DA) is a specific form of amnesia that inhibits your ability to remember important information about your life, including things such as your name, your family and friends, as well as both your own and other people’s personal history. It occurs most often as a response to a traumatic event or excessive stress. As with many other types of mental health conditions, there are subsets that exist within the overarching condition. There are three different types of DA:

• Localised: This type is where you cannot remember event relating to a specific time in your life.
• Generalised: This type entails a complete loss of memory the extends to things such as your identity and personal history.
• Fugue: When you experience dissociate fugue, you forget most or all of your personal information. This can cause you to travel to places quite randomly. In more serious cases, you may take on a whole new identity.
• Dissociative Identity Disorder
  DID is characterised by the presence of two or more distinct personalities within an individual. It used to go by the name of multiple personality disorder until it was changed very recently in the DSM-5. As with the other dissociative disorders discussed here, the main tenet is of dissociation from reality and an inability to regulate cognitive functions.
  Symptoms
  If you’re suffering from DID, you’ll experience the presence of two or more distinct personalities known as ‘alters.’ These personalities will take control of the main functioning of your actions by exerting their own sense of morality, emotional intelligence, attitude, likes and dislikes. Your behaviour will be completely under the control of a given alter during these episodes and as such, you’ll experience a loss of memory regarding the events surrounding your behaviour during this time. Each alter will have a specific set of traits, personal history and way of relating to the world.Other symptoms may include:

• An inability to recall childhood memories and your personal history.
• Feelings of intense detachment or disconnection from the world.
• Flashbacks or the sudden return of memories that had been suppressed or forgotten.
• Hallucinations
• A distinct lack of awareness about recent events in your life.
• Experiencing the loss of time.
• Having recurrent thoughts of suicide or self-harm.

DID can be a challenging and distressing experience for those impacted, particularly without proper understanding and support. Our professional team is here to offer guidance and access to effective treatment options.

Seeking the assistance of a therapist can be a courageous decision. Our knowledgeable and experienced therapists employ a personalized approach to help patients, including those with DID, manage their condition. Therapy should be viewed as an empowering and growth-enhancing step, not a sign of weakness.

For DID patients, we offer a customized treatment plan, combining various therapeutic approaches to meet individual needs. This may include medication and personalized therapy sessions to alleviate symptoms and improve coping strategies.

All treatment begins with a comprehensive assessment by our accredited therapists to gain a deeper understanding of your experiences and goals. Based on this information, we collaborate with you to develop and implement a treatment plan that is tailored to meet your specific needs and aspirations.

1. Clinical assessment and diagnosis for the purpose of treatment (no report) (£340) – this can be conducted by one of our psychologists from a 2 hour assessment. At the end of the session, the psychologist will detail whether the practitioner strongly suspects you have DID. Please note this is not an official diagnosis.
2. Clinical assessment and diagnosis for the purpose of treatment (1-2 page report) (£510) -– as this assessment is not using the SCID-D (Option 3), it would not result in an official diagnosis and could not be used to apply for funded treatment from the NHS. However, the report would detail treatment recommendations and whether a DID diagnosis is likely.
3. Structured Clinical Interview for Dissociative Disorders (SCID-D) official diagnosis and report (£1190) – this is the official diagnostic tool for DID. If you are linked with any services that support an application for funded treatment (ICB funding), the SCID-D would help in this case.

The SSCID-D is a diagnostic tool used to assess the presence and severity of dissociative disorders, including DID. The interview is designed to be administered by a psychologist and typically takes between 3 to 4 hours to complete.

The SCID-D consists of several sections, each focused on a specific aspect of dissociative symptoms. The interview begins with a general assessment of dissociative symptoms, including amnesia, depersonalization, derealization, and identity confusion. The psychologist will ask you about specific instances of dissociative symptoms, such as gaps in memory, feeling detached from oneself or the environment, and experiencing multiple identities or personalities.

The next section of the SCID-D assesses for the presence of DID. The psychologist will ask about your history of dissociation and identity confusion, as well as any current symptoms of DID, such as feeling like your body is not your own or experiencing multiple identities or personalities. The psychologist will also ask about your experiences of trauma, as DID is often associated with a history of severe abuse or neglect. The final section of the SCID-D assesses for the presence of other dissociative disorders, such as dissociative amnesia and dissociative fugue. The psychologist will ask about specific symptoms, such as gaps in memory or periods of time that cannot be accounted for.

Note: the SCID-D is not a diagnostic tool for other mental disorders, such as schizophrenia or borderline personality disorder, which may have dissociative symptoms. It also does not include assessment of other psychiatric or medical conditions that may have dissociative symptoms as a feature.

If you would like to talk to someone about a DID assessment, both online or in Ireland, please get in touch with the Private Therapy Clinic on Whatsapp message at: 7511116565 email, chat bot or book online to arrange an appointment.

Steinberg, M., & Hall, P. (1997). The SCID-D diagnostic interview and treatment planning in dissociative disorders. Bulletin of the Menninger Clinic, 61(1), 108–120.