MPD RULES

Dissociative Identity Disorder (Formerly called Multiple Personality Disorder)

Definition
Dissociative Identity Disorder is the existence within a person of two or more distinct personalities or personality states, each of which may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. At least two of these identities or personality states recurrently take control of the person's behavior. It is also essential to the diagnosis that the person be unable to recall important personal information to an extent that cannot be explained by ordinary forgetfulness. The different personalities are sometimes called "alters".

Cause
Dissociative Identity Disorder is thought to result from severe and prolonged emotional trauma, physical abuse or sexual abuse during childhood.

Course
The course is variable and often prolonged. This disorder almost always begins in childhood, although it may not become apparent to others or to the patient until a later age. The disorder may be less troublesome past the late forties, but may reemerge during episodes of stress or trauma or with substance abuse. This disorder is far more common in women than in men. The degree of impairment ranges from mild to severe, and complications may include suicide attempts, self-mutilation, violence, or substance abuse. There has been no systematic study of long-term outcome in this disorder.

Treatment
Treatment of Dissociative Identity Disorder often consists of individual therapy, structure (scheduling one's time so that there are no long periods of unplanned time), medications for specific mood or anxiety symptoms, education about the illness, social skills training, learning more effective communication and coping skills, and group support. Inpatient or day hospitalization may be necessary when symptoms make the person a danger to self or others.

Self-Management
Ways to recover and stay well include: Know your triggers for dissociation, e.g. environmental stimuli (e.g. noises, specific people or situations, certain places), emotional stimuli (e.g. conflict, overstimulation, anger). Learn coping techniques to deal with your triggers such as relaxation exercises, focusing, reality testing, mindfulness, distress tolerance, self-hypnosis, and/or emotional regulation. Find a therapist experienced in dissociative disorders and work collaboratively with that person. Use specific management techniques for different alters to ensure safety. Sleep adequately. Avoid fatigue. Eat a well balanced diet. Avoid alcohol and drugs. Exercise regularly and vigorously. Structure your time. Make a daily written schedule for yourself.

Dealing with Relapse
Relapse is most likely to occur in situations that trigger an emotional connection to the childhood abuse or trauma. Examples include contact with the childhood abuser, having one's own child reach the age at which the patient was abused, resumption of sexual activity, or involvement in an abusive relationship. If you notice symptoms returning, call your therapist and reduce stress as much as possible for the time being.