Dissociative identity disorder is sometimes confused for schizophrenia, but the two are very different, albeit equally severe mental health disorders. To understand dissociative identity disorder in teens, what it looks like in teenagers, and how to treat it, we need to understand dissociation and why it happens.
Dissociative identity disorder, or DID, used to be called “multiple personality” disorder. While fragmented personas and “alters” are still a common element in cases of DID, it’s important to emphasize that our understanding of DID is not centered around the idea of multiple people in one body, but a fragmented psyche, usually as the result of a traumatic event.
What Is Dissociative Identity Disorder?
The central characteristic of dissociative identity disorder is dissociation, usually in response to a traumatic event. Dissociation is characterized as a separation or distancing between a person and their perspective on reality. In one example of dissociation, a person might “check out” in moments of stress, appearing nonresponsive or different somehow. When they’re “back,” they might have no recollection of dissociating and might even experience holes in their memory. In cases of dissociative identity disorder, a person’s dissociation extends to the degree that they become someone else for a while.
Dissociative Identity Disorder vs Psychosis
It is not necessarily the same as psychosis, where a person’s perception of reality is altered significantly through delusions or hallucinations; however, the outside similarities between the two – in the sense that people who dissociate and people who experience psychosis are not entirely present – is what often leads people to conflate conditions like schizophrenia or post-traumatic stress disorder with split personalities or dissociative disorders.
As a result, mental health professionals believe that dissociative personality disorder is currently underdiagnosed and may be mistaken for another similar mental health condition. Currently, about 1 percent of the general population experiences dissociative identity disorder, with rates being significantly higher in clinical settings.
Dissociation as a Defensive Mechanism
In a way, dissociation can be understood as a defensive mechanism after a significantly traumatic event. People who dissociate do so to protect themselves from the reality of their situation and their circumstances. However, these dissociative symptoms can last for a long time and continue to impact a person’s mind even long after the original danger has passed. This is the prime characteristic of trauma – like mental scarring, trauma means reacting, unknowingly and unwittingly, as though the past is recurring or as though what happened is always imminent.
Not everyone dissociates after trauma – dissociation is just one of the ways in which the mind might react to something horrifying or impactful.
Signs and Symptoms of Dissociative Identity Disorder in Teens
Recognizing dissociation in our loved ones is important because treatments for dissociative identity disorder are effective but take time and patience to work. Helping someone heal from their trauma, cope in healthier ways, and develop a consistent and unified personality can help them avoid the negative consequences of dissociative identity disorder, including memory loss, social anxiety, depressive thoughts, and mood swings.
Teens with dissociative identity disorder don’t behave like stereotypes from movies. There is a spectrum of symptoms involved in cases of DID, and not every case is alike. While representations of DID in media have improved in recent years, it’s important to differentiate reality from fiction. Some common signs of dissociative identity disorder in teens include:
1. Separate and Distinct Personalities
The defining symptom of dissociative identity disorder is the presence of two or more distinctly different personality states. In many cases, people develop multiple different personalities, upwards of five. Each one of these personalities, or alters, will have its own distinct age, name, gender, memories, and behavior.
Switching from one alter to another may occur randomly, although the switch usually happens in response to a stressor, whether it’s a traumatic trigger or some other mental stimulation, including drug use. Alters usually do not share memories and may not always be aware of each other. This means that teens with dissociative identity disorder suffer from memory gaps and frequent bouts of amnesia.
2. Memory Issues and Amnesia
In addition to changing personalities, accompanying memory problems are another common aspect of dissociative identity disorder. Teens affected by DID are not acting out as other people – their mind compartmentalizes moments in time, experiencing them as different individuals and not always letting these experiences interact with each other.
If we think of dissociation as a protective mechanism, we can imagine it like a series of filters – swapping one filter for another, sometimes in response to a person’s surroundings, so the “right” filter captures the experience, rather than having one filter experience everything at once.
As a result of these swaps, however, teens with dissociative identity disorder might not have a coherent understanding of their day-to-day.
3. Intrusive or Unwanted Thoughts
Intrusive or unwanted thoughts are, to a degree, normal. We all experience a fleeting moment of thinking about something we did not want to think about or were surprised to think about. However, some mental health conditions can exacerbate the frequency and severity of these thoughts to the point that they almost feel compulsive.
Dissociative identity disorder can suffer from unwanted thoughts, usually in the form of recurring memories or flashbacks, sudden traumatic remembrances, or unwanted shifts in thinking, such as an outburst of anger or sadness.
4. Social Anxiety
Dissociative identity disorder can be a very socially disabling condition. It is difficult for people to manage friendships and relationships while struggling with DID, and poor experiences can further feed a growing sense of social anxiety as a result of these symptoms.
These anxious thoughts can trigger and worsen traumatic stressors and make the mind more sensitive to such stressors. Some personalities within a teen may be more confident than others, but social anxiety is still a common symptom.
5. Depressive Symptoms
Depressive symptoms, including symptoms of self-harm and suicidal ideation/suicidal attempts, are also unfortunately common in cases of DID. Furthermore, reports that as many as 70 percent of patients in treatment for DID attempt suicide at one point or another, meaning the unknown statistic may be even higher.
6. Substance Use
Dissociative identity disorder correlates strongly with substance use, at times as a form of self-medication or just for recreational purposes.
Sadly, drug use can further amplify the effects and symptoms of DID, as well as suicidal ideation, depressive thinking, and anxiety.
Treating Dissociative Identity Disorder in Teens
Patients with dissociative identity disorder may require outpatient or inpatient residential treatment to see long-term success. In addition to their dissociative and trauma-related symptoms, teen patients with DID may struggle with suicidal thoughts, drug use, and anxiety.
A holistic treatment plan addressing multiple symptoms and co-occurring disorders is often necessary. To that end, a teen with DID may undergo trauma-specific individual and group therapy, in addition to taking medication to help reduce their symptoms.
An inpatient or outpatient facility can help provide structure in a teen’s treatment and give them the medical and psychiatric attention they need, while providing a safe or comfortable home environment, or allowing them to continue going to school and home between treatments.
For more information about dissociative identity disorder in teens, reach out to Visions Treatment Centers.