Suicide Risk in Dissociative Identity Disorder (DID)
Suicide risk in dissociative identity disorder (DID) is a significant concern (Facts About Suicide). People with DID have one of the highest risks for suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), more than 70% of outpatients with DID have attempted suicide, and multiple suicide attempts are common. What causes this increased suicide risk in DID, and can it be prevented?
Childhood Trauma and Abuse Increases the Risk of Suicide in DID
Numerous studies have been performed over the course of decades, and the results have shown an undeniable link between childhood trauma and suicide risk. Physical, emotional, and/or sexual abuse in childhood leads to a significantly increased risk of suicide in adolescence as well as adulthood. Since 90% of people with dissociative identity disorder (DID) have a history of childhood abuse and neglect, it makes sense that the suicide risk is so high; childhood abuse plays a significant role.
Complications in Assessing Suicide Risk in Dissociative Identity Disorder
Suicide in DID can become complicated when different alters are involved. Just because one part is suicidal, that does not mean that other parts in the system are also suicidal. It is possible that other parts may not even be aware of the suicidal feelings of another, especially when those parts are not co-conscious.
In some cases, the main person is not suicidal, but there are one or more alters that are. It's very possible for suicidal feelings and behaviors to occur without the host's knowledge or awareness. The dissociative amnesia can make it difficult not only for the person with DID, but for therapists and treatment teams as well. I have had several experiences where I went to the emergency room because part of me was suicidal, only to have a non-suicidal part come through when I was there, which left medical staff confused and dismissive of my needs.
Risk of Suicidal Alters in Dissociative Identity Disorder
Suicidal alters are not uncommon in DID systems. These alters can be any age, and yes, even child alters can be suicidal. Sometimes, an alter becomes can become suicidal because of a trigger; overwhelming flashbacks and memories can affect anyone, including alters.
In some instances, an alter can be consistently suicidal. This is dangerous, because these alters may not realize that the suicidal behaviors affect the entire system, or if they do, they do not care. Their focus is on destroying themselves, which, in turn, destroys the system. It is important to work with suicidal alters in order to keep the entire system safe and keep each other alive.
Dealing with Suicide Risk in Dissociative Identity Disorder (DID)
Managing suicidality in dissociative identity disorder is important, and the risk also involves alters--which can make things complicated. When another part is feeling suicidal, it's important to let that part be heard. Don't ignore the issue. Allow suicidal parts to express their needs. Ask other parts in the system for help. Bring any concerns you may have to your therapist, so he or she can help as well. If there is an imminent risk of in DID, find the closest emergency room to keep yourselves safe.
It can be helpful to have a psychiatric crisis plan in place in case suicidal thoughts come up. It can also be useful to have a paper describing the aspects of your mental health that you are comfortable disclosing. This can help hospital staff better understand your needs in case you are unable to explain them in the moment.
See our resources and hotlines page for more.
Matulewicz, C. (2016, September 14). Suicide Risk in Dissociative Identity Disorder (DID), HealthyPlace. Retrieved on 2019, August 18 from https://www.healthyplace.com/blogs/dissociativeliving/2016/09/suicide-risk-in-dissociative-identity-disorder
Author: Crystalie Matulewicz
I read your comment you live the happiest life posted 2 years ago. I was diagnosed with DID in my late 30's, I'm now 53 years old. I suffered abuse from my oldest brother from age 4 to 15, 16. My flashbacks get worse in detail as I age. Are your flashbacks worse as you've aged? I also try to live my happiest life as well. Focus on the good and a brighter future. Yet now these new flashbacks are harder to recover from. The thought and love for my husband and children keep me going.
Losing time is a scary thing. No. Terrifying. 2 horrible doctors ignored my cries for help because they didn't believe I was suicidal. I took my life 3 years ago. Two shots of adrenaline brought me back. I was so angry. I just wanted to be free from all the pain. It's a Hell I wouldn't wish on anyone. When I got out of hospital, they said I needed rehab. I said, 'Um no, because if you actually looked at my toxicology report, I took so many different things so I WOULD DIE! By the way, you're both fired!'
After 23 years of going through shrinks like rolls of 1 ply toilet paper, I finally found a doctor who actually LISTENED to me and treated me like a person instead of some broad who is crazy. I've seen her consistently for almost 3 years. I trust her completely. So, I told her I had something to tell her I've never said to anyone about: my alter, other, whatever. I was afraid if I told a doctor about it, I'd get locked away in a psych ward and never leave. Her eyes lit up and she said, 'Now, it makes sense. We finally have one of your illnesses diagnosed correctly.' I was relieved, but then, I realized it was a worse illness than the misdiagnoses for almost 30 years. Officially, I have mixed dissociative identity disorder, severe PTSD, anxiety and panic attacks, depression, social anxiety disorder, hypervigilance, etc. The cocktail I'm on now is helping, but I had nothing to help with my sudden debilitating panic attacks. Now, I'm taking Klonepin (sp?), Effexor XR, propranolol, amlodipine and trazodone. Just another day in the life of a pharmaceutical Guinea pig.
I don't have any support, only my best friend of 18 years. My mom tried to help me, but she'd say, 'Honey, I don't know how to help you. Nothing hurts me more than knowing you're sick, and I can't make it go away.' Unfortunately, I lost my mom to cancer almost 3 years ago. I will never get over her loss. I don't have much interaction with my siblings or my father (he beat me for years, never apologized, never will). They treat me different and insult me because I'm 'so effed in the head. Are you on meds?' I am tired of their crap, so I choose not to take the bait for more insults. There is no way I could tell them my real diagnosis; I'd be ostrasized permanently. I can't even tell my boyfriend because he wouldn't and doesn't have the comprehend something that heavy. I told my bestie, but only he and my doctor know. I am ashamed, humiliated and still raging in anger why and who I am. At my last session, I said to my doctor, 'It won't be lung cancer, booze or anything which will kill me. It's the stuff in my head that will kill me first.' I'm not suicidal. I just know that outcome is inevitable. Until then, I'm just trying to get through a day, week, month, year...
Sorry my story was so long.
Thank you for sharing your experience.
I did not know about Adderall for treatment-resistant depression. I do know that some doctors are now prescribing it because it helps with dissociation issues in some people.
I'm sorry your doctor reacted that way, and I'm sorry about your struggle with medications. You are not alone in that.