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 2023, September 25 from https://www.healthyplace.com/blogs/dissociativeliving/2016/09/suicide-risk-in-dissociative-identity-disorder
Author: Crystalie Matulewicz
Hello, we're a bodily 30-year-old autistic system of over a dozen alters. We're battling a lot of daily suicidal ideations & our most suicidal alter is consistently front-stuck so we can't just pull them to the back for everyone's safety. How would you recommend we 'feel' for a therapist that genuinely works with DID, not just IFS & 'can they come forward?' non-system-friendly bs? What kind of training or credentials should we look for? What kind of fielding questions should we ask?
im khyana, im a 12 year old girl who has been abused at home, neglected, bullied, raped, excluded and gone through heaps of foster care houses. i suffer from DID, every day i tear myself apart for never being able to be normal. every time i think about my future i have a different thought about what i wish to do and who i wish to be. i hate how every single day im different, and this also stops me from being able to have relationships with people because i have too many different personalities so i never get accepted as one person. i dont get bullied much anymore because recently my frustration got teh best of me and i dragged a a classmate down the stairs, a whole class saw and everyone was scared of me because of how much damage i did to her, but instead they backstab me and fear me, some personalities want to be feared and respected, but sometiems i dont, so this is very annoying for me. i feel as though im heaps and heaps of different people, so i cant even asnwer serveys abotu myself or anything cause i always get in trouble about 'lieing' about myself. i really just want to be normal, and recently ive tried to commit suicide multiple times. i keep thinking of running away and living in complete solitude or hiding myself from the world because all the stress has started making me a dangerous person, but i really dont want to. my mother doesnt want to get me a therapist or anything cause she thinks its a waste of time and money, just liek going to the docters. im not sure what to do at this point, so i really need help. ive never really vented before or asked for help that often, its rare that i even hint to people that im stressed, so this was really hard for me to write and i will probebly get scared and delete this in a couple of days, knowing me. but please, if anyone knows how to help me, im all ears.
Thank you so much for reaching out with your comment—this takes courage. I am so sorry to hear that you have experienced so much pain and suffering. Help and resources are available to you, though. I recommend looking at our list of confidential mental health hotline numbers. You can find the list here: https://www.healthyplace.com/other-info/resources/mental-health-hotline-numbers-and-refer…. I know it can be difficult, but please continue reaching out.
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if you don't mind me asking, how old were you when you realized you had multiple personalities?
Hi may name is Amanda I have DiD I'm 38 I'm struggling verry bad I'm still going threw abuse and it a eavry day battle I'm having problems finding someone that knose what I'm going threw not just a therapist 😭 while sumone talck to me
Hi Angela. I am suffering a lot too. Homeless, waiting to see a new therapist to tell her what I’m dealing with. I do t see her for another week and it sucks because no one will listen to me. I recently acknowledged my alters and it helped to give strength to the stronger protective one, but now they ALL want control. Not sure how to communicate with you?
My reply is concerning the suicidal comments; I am diagnosed with DID & BIPOLAR DISORDER. I tried to commit suicide in the year 2000 and spent 2 days in intensive care. Since then somehow my system founded an alter ironically named Angelica. Angelica calls my therapist or tells someone who can help about the suicidal desires, or plans. She has no other functions except in saving our life! She don't care what any of us say, she just does her job. I like her very much & she knows what all of us is thinking. We are blessed to have her in our system.
What athena had to say gives me strength i dont have parents im 18 homeless and i was diagnosed with DID 8 months ago
Thank you for writing this. It is helpful in understanding why my fight against suicidal thoughts and actions has been so difficult. Now that I have a diagnosis of OSDD things make so much more sense.
I have DID and childhood trauma. I gave up trying to live a 'normal' life and opted for the happiest life I could, long ago. I'm now 60. The odds are against me as people with mental illnesses tend to be more suicidal as they get older. but I have no intention of living up to the odds. Hang in there. You don't have to live up to social norms. Just stay alive.
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.
I didn’t know people are more suicidal as they get older! My grand daughter was raped just over a year ago And my best friend died in September I thought I was handling things well I am so tired and so are the others
Recently Diagnosed and Terrified
Sorry, I hit post comment before I actually said anything. For years, I was diagnosed with Bipolar Disorder, BPD, severe PTSD, crippling anxiety and panic attacks. The worst was laying on my couch with no energy to do anything. Sometimes, it was hard just having the strength to use the bathroom. I've always had extreme anger issues stemming from years of sexual abuse by 2 cousins from the age of 5 to 8.I would instantly get so pissed off, I wouldn't remember anything I said, did, destroyed, bruises and cuts on my body. It's like I lost periods of time I couldn't recall. I called it blind rage. These episodes happen when I was being abused and traumatized. In some way, it was like my body was split in two, and the angry part of me became my protector so I wouldn't have to remember. I have flashbacks as well. What I didn't realize was my protector was the other part of me. As I write this, my alter is speaking for me due to the trauma. It probably doesn't make sense, I know. None of my life has seemed to make sense.
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.
I read an article recently about the “little known underside of grieving.” I t addressed mild depersonalization, fears of going outside, etc.. I left a comment that it all sounded like a fairly good day for those with CPTSD.
I wish that doctors could help you more with your medication when you feel this way. Last week I was having suicidal thoughts and have been really sick for the past 3 years. (I started my medications in 1987), I wanted to try Adderall cause I read it was good for drug resistant depression, my doctor was offened and is trying to get rid of me by being mean (just like some of my past jobs). I did not want to try another failed attempt at a psychotropic med., even though I was and she would have let me go on Lamcial, I could not bear knowing that I could die by trying this medication, when I was try trying to help myself. I have not tried another med. in the past 10 years cause I get really sick and then it gets worse with most med's.
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.