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Glenn Yank, MD is a Psychiatrist located in Tennessee.


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Question:
Is it possible to be DID and not know it? How can you live with someone and not know that they are DID? Is there a list of symptoms to help one identify this condition? Anonymous

Answer:
The recognition of DID (dissociative identity disorder) is one of the most challenging tasks facing all who are involved with patients who have this disorder. This includes the patients themselves, their friends and family members, and the clinicians who treat them. In fact, DID is one of the most controversial diagnoses in Psychiatry, with well known authorities taking widely divergent positions on whether the disorder is under diagnosed or over diagnosed. It is important to recognize in this regard that DID is only one of the group of dissociative disorders, and that patients with DID represent only a fraction of all the patients with dissociative symptoms.

It is possible to have DID and not know it because the hallmark of DID is the existence of distinct identities or personality states, which means that there may be no continuity of memory between the personalities. Thus, a person (or in this case a personality) may have no memory at all of the episodes of dissociation or switching, other than a vague perception of losing time, “blackouts,” or gaps in the continuity of memory. Since there are many reasons for poor recall, and because awareness of the episodes of dissociation may be actively kept away from consciousness (as a defense against anxiety), a person may have only a vague sense of not remembering parts of a day. Or they may think they napped, or were asleep when an alter personality was active. Some patients may have the experience of “hearing” their alters, but may think this is normal, or part of another disease.

It is possible for others in the family or household not to know that a person has DID because each of the personalities may act in a perfectly normal way, and may go to considerable effort not to reveal that it is different from the primary personality. People are often quite reluctant to disclose that they “hear voices,” have periods of amnesia, or experience themselves as divided inside. If it is any consolation, on average more than 6 years pass before a DID patient’s first psychiatric contact and the diagnosis of DID being made, and such patients typically acquire three or more other diagnoses before DID is diagnosed. Similarly, family members and significant others may have an awareness that something is wrong or distressing to the patient, but attribute periods of different behavior to “mood swings,” “stress,” or the influence of alcohol or drugs. Psychiatrists may misdiagnose DID patients with Bipolar Disorder because of the changes in behavior and mood associated with switching. Also, DID patients may be misdiagnosed to have schizophrenia because of their experiences of hearing their alters commenting on them or arguing with each other, which somewhat resemble certain forms of hallucinations in schizophrenia.

For extensive lists of symptoms that help one identify DID and dissociative disorders, check out the DID resource right here on the Multiplicity, Abuse & Healing website!

http://www.m-a-h.net/library/did-general/index.htm

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Disclaimer: The information contained here is not intended nor implied to be a substitute for professional advice relative to your specific medical or mental health condition or question. ALWAYS seek the advice of your physician or other health provider for any questions you may have regarding your medical or mental health condition. Information provided here DOES NOT constitute a doctor-patient relationship between you and the column author.

© Copyright 2003-2005. All rights reserved. Contact: ShrinkTime Last edited: 04/05/03.