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Dissociative identity disorder is a psychological condition characterized by the presence of two or more distinctive personalities within an individual. It was earlier referred to as “multiple personality disorder”.
Patients with dissociative identity disorder suffer from mood swings, depression, suicidal ideations, panic attacks, and dissociation between their own thoughts. They often have little or no memory of their behavior during the episodes.
The prevalence of this condition is relatively low in general (approximately 2% of the population). Women are considered more susceptible to develop the symptoms compared to men, whereas the association of the condition with a particular race or ethnicity is not observed.
The exact etiology of dissociative identity disorder is not fully understood. However, the most commonly reported cause of developing this condition is trauma. Majority of the patients with dissociative identity disorder have suffered from extreme emotional, physical, or sexual abuse during the childhood. While some individuals cope with trauma reasonably well with the help of emotional support and rehabilitation in a healthy environment, it becomes little too much to handle for the few, especially when the abuse is repetitive.
Dissociation is a natural reflex mechanism that is helpful while trying to deal with trauma. However, repetition of traumatic events and resultant dissociation turns into the dissociative identity disorder.
Children who have been victims or witnesses of severely abusive behavior from their parents or other family members are prone to psychological abnormalities including dissociative identity disorder. Particularly, the children at a very tender age find it more difficult to cope with such behaviors. In some cases, the pattern of abuse (e.g. at night) makes them feel scared in the anticipation even when the things are normal. The impact is more profound when the abuser is someone very close (e.g. one or both the parents), and there is no other adult around to confide in. Sometimes, abusers also try to feed into the children that nothing happened, and threaten them if they speak about it to anyone. These things leave a serious impact on a child’s mental state.
Also, some of the children who are exiled from their families due to one or the other reason, or those living in foster homes are also reported to embrace dissociation, albeit unintentionally. Partial behavior toward one of the siblings in a household can also sow the seeds of dissociation in a child.
While the roots of the disorder could mainly lie in the childhood, the manifestations may occur at any age. The response to traumatic events may or may not be immediate. Compulsive overthinking and re-playing the traumatic events mentally over and over again are the other causes for aggravation of the condition.
Researchers have studied that individuals with a close family history of dissociative identity disorder are at a relatively higher risk compared to general population. This could possibly be due to common genetic triggers in biologically related individuals (e.g. siblings), or due to the exposure to similar circumstances in a family – the fact remains to be known.
Unexpected overwhelming experiences during a natural calamity or a war at any age can also trigger dissociative identity disorder. The memories of such incidents keep haunting the individuals even after years of nightmares.