Dissociative Identity Disorder (Multiple Personality Disorder)
What's the Difference Between Dissociative Identity Disorder and Schizophrenia?
Schizophrenia and dissociative identity disorder are often confused, but they are very different.
Schizophrenia is a severe mental illness involving chronic (or recurrent) psychosis, characterized mainly by hearing or seeing things that aren't real (hallucinations) and thinking or believing things with no basis in reality (delusions). People with schizophrenia do not have multiple personalities. Delusions are the most common psychotic symptom in schizophrenia; hallucinations, particularly hearing voices, are apparent in about half of people.
Suicide is a risk with both schizophrenia and dissociative identity disorder, although patients with multiple personalities have a history of suicide attempt more often than other psychiatric patients.
How Does Dissociation Change the Way a Person Experiences Life?
There are several main ways in which the psychological processes of dissociative identity disorder change the way a person experiences living, including the following:
Depersonalization. This is a sense of being detached from one's body and is often referred to as an "out-of-body" experience.
Derealization. This is the feeling that the world is not real or looking foggy or far away.
Amnesia. This is the failure to recall significant personal information that is so extensive it cannot be blamed on ordinary forgetfulness. There can also be micro-amnesias where the discussion engaged in is not remembered, or the content of a meaningful conversation is forgotten from one second to the next.
Identity confusion or identity alteration. Both of these involve a sense of confusion about who a person is. An example of identity confusion is when a person sometimes feels a thrill while engaged in an activity (such as reckless driving, DUI, alcohol or drug abuse) which at other times would be revolting. In addition to these apparent alterations, the person may experience distortions in time, place, and situation.
It is now acknowledged that these dissociated states are not fully-mature personalities, but rather they represent a disjointed sense of identity. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a host personality within the individual, who identifies with the person's real name. Ironically, the host personality is usually unaware of the presence of other personalities.
What Roles Do the Different Personalities Play?
The distinct personalities may serve diverse roles in helping the individual cope with life's dilemmas. For instance, there's an average of two to four personalities present when the patient is initially diagnosed. Then there's an average of 13 to 15 personalities that can become known over the course of treatment. While unusual, there have been instances of dissociative identity disorder with more than 100 personalities. Environmental triggers or life events cause a sudden shift from one alter or personality to another.