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Stigma and Misconceptions

Antipsychotic medications for dissociative identity disorder (DID) are sometimes used although DID is not treated with psychiatric medications like other mental illnesses are. However, there are medications that can help alleviate the symptoms that tend to go along with DID. These symptoms include difficulty sleeping, panic, anxiety, depression, and mood instability, among others. Antipsychotic medications are one type of medication commonly prescribed to people with DID, but they carry a huge stigma. Does taking an antipsychotic medication when you have DID mean that you are psychotic?
Life with dissociative identity disorder (DID) is most likely different than you've imagined. Perhaps you've heard the horror stories or seen the movies portraying us as killers, psychopaths, crazies, or dangers to society. Perhaps if you have been diagnosed with dissociative identity disorder, you might have compared your experiences with DID to that of others, wondering if your symptoms are "right" or if you're "normal." People are curious about the disorder because of the common misconceptions about DID. What is real and what is concocted? What is a day in the life of someone with dissociative identity disorder truly like?
There are hundreds of articles describing what dissociative identity disorder (DID) is, but there aren't many articles describing what DID is not. With all of the misconceptions and stigma out there about DID, it is just as important to write about what DID is not as it is to write about what DID is. Let us clear the air about DID.
Dissociative identity disorder (DID) and other dissociative disorders go hand-in-hand with signs and symptoms of dissociation. You can find these signs of dissociation included in many lists, and in books like the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). But symptoms of dissociation aren't always so black and white. The reality of dissociation goes beyond the obvious signs and symptoms of dissociation that you read about.  So what is dissociation really like?
Dissociative identity disorder (DID) remains a largely misunderstood diagnosis, and one of the things people need to understand is that dissociative identity disorder doesn't make you violent. Previously known as multiple personality disorder, or MPD, DID has been the topic of several television shows, books, and Hollywood films -- including the new movie Split, set to be released later this month. These portrayals, however, are not always accurate. Characters with DID are often portrayed as violent and dangerous, but that is not the reality. Dissociative identity disorder doesn't make you violent.
I am living with dissociative identity disorder and I can't just "get over it." Would you tell someone with diabetes to "just get over it?" Dissociative identity disorder (DID) and other mental illnesses are illnesses. They all have causes, treatments, and greatly affect the individuals that have them. Mental illness is not a choice. It cannot be switched off and on at will. No one can wake up and decide they aren't going to be mentally ill that day. So why do some people expect those with mental illnesses like DID to just get over it?
Embracing the individuality of alters in dissociative identity disorder (DID) is often misunderstood by people without DID. One assumption is that alters are voices a person with DID hears in his or her head; this leads people to confuse DID with schizophrenia. Another assumption is that alters are imaginary friends made up in one's mind, yet unlike imaginary friends, alters are not consciously created. Lastly, many people believe that alters are different mood states or aspects of a person's personality. This isn't accurate, either (Mental Illness Myths And The Damage They Cause). The reality is that alters are individual persons existing within and sharing one body. Embracing the individuality of alters is key to DID treatment and recovery.
Over the years I've heard many people advise dropping the word 'disorder' from dissociative identity disorder, citing A) dissociation as a normal response to trauma, and B) honoring subjective experiences as the primary reasons that it’s not helpful. But the degree to which something is normal really has nothing to do with whether or not it’s a disorder. Disorders are referred to as disorders not because they're abnormal, but because they actively, regularly, and severely disrupt people's lives to such an extent that their ability to function is notably, even dangerously, compromised. And labeling a particular set of psychiatric symptoms with a particular psychiatric diagnosis is no more a call to ignore individual experience than it is to use labels like diabetes, hyperthyroidism, or influenza.
All of the misconceptions about Dissociative Identity Disorder bother me because they create barriers to diagnosis, treatment, and support. But there’s one myth that bothers me for more personal and, up until today, private reasons. And that’s the assumption that child abuse causes Dissociative Identity Disorder.
Reader Deanna asked if anyone has ever experienced remission from Dissociative Identity Disorder. If we’re defining remission as a period of diminished, unobtrusive dissociative symptoms – “normal” dissociation, in other words – then I’d wager there are people who have experienced exactly that. But they have worked hard to achieve that degree of integration and awareness. It didn’t happen spontaneously, which is what I suspect most of us with Dissociative Identity Disorder mean when we bring up this idea of remission. And I also suspect it isn’t really integration we’re talking about, but the apparent disappearance of other personality states. I’m guessing plenty of people experience this latter scenario too; but remission it is not.
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