I have an Alter Personality. Do I have DID?

In my last post, I discussed my experience with dissociated personalities, parts, or alters.

My parts have become a part of my identity and directly impact the inner self experience that I have every day.

So, does this mean I’ve been diagnosed with DID (Dissociative Identity Disorder)?

What is Dissociative Identity Disorder?

Per the DSM-5-TR, “dissociative identity disorder is the presence of two or more distinct personality states or an experience of possession.” The diagnostic criteria also includes recurrent gaps in recalling every day life events, trouble recalling important personal information, symptoms that cause significant distress or impairment, and the disturbance is not related to a broadly accepted cultural/religious practice and is not attributable to substance misuse or another medical condition.

In simpler words, Dissociative Identity Disorder presents as two or more distinct personality states.

Typically, with DID, these alters or dissociated personalities are VERY distinct and have their own identities that include their own names, their own life history, different personality traits, different ways of speaking, different ages, etc. Additionally, alters can even have physical differences, like needing eye glasses or other assistive devices when the “host” does not. (Host is the term used for the individual person experiencing DID.)

So, do I personally have DID?

I have never been diagnosed with DID.

What I do have is another dissociative disorder called Other Specified Dissociative Disorder. This disorder was previously named DDNOS in prior editions of the DSM which was a catch-all category for all dissociative disorders that didn’t fit the criteria of another dissociative diagnosis. This disorder has a less clear definition and is split into 4 different categories of presentation. One of those presentations, OSDD-1 is what I have. This version of the disorder is less severe than DID although many of the symptoms and experiences can be similar or the same. (Note: There is some continued debate as to whether OSDD-1 should be considered DID.)

Some of the dividing lines between DID and OSDD can be clear lack of switching between identities, no full barriers of amnesia between personality states, or not a clear structure/differentiation of personality states. This doesn’t mean that this is true for all cases of OSDD. The line is actually very gray when it comes to diagnosing those with DID and those with OSDD.

Clinically, DID should not be diagnosed until a physician has seen a clear presentation of an alter personality. However, it’s also common for alter personalities to only show for some patients during crisis, making this difficult to verify in a more clinical setting. Because of this, it is assumed there is a number of OSDD cases that could or should be diagnosed with DID.

Common questions about these disorders:

What is an alter?

Alters are a dissociated self state that can take executive control over the mind and body. An alter sees itself as its own separate entity or being from the rest of the parts; they do not see themselves as being one part of a whole person. Like I mentioned before, alters typically have their own complete identities - their own names, their own life history, their own memories, different personality traits, and they can even have their own disabilities or disorders separate from the rest of the system or person.

One thing to note about alters is that not everyone experiences alters or parts as completely different people from themselves. Some people, like me, experience parts and alters as different versions and ages of themselves. This can make it difficult for others around them to identity with them actually having a disorder.

In my experience, the hardest part of managing an alter personality is that these parts have their own opinions, ideas, thoughts, and behaviors that can be drastically different from what I consider my own. This becomes confusing and can cause personal issues or issues with others when the alter personality has executive function and makes choices or decisions that are not aligned with what I feel I would have wanted or would have done.

Previous to beginning to work with these different parts in therapy, I often felt like these alters were intrusive, controlling, and harmful to my overall health and well-being. I felt like experiences were being forced on me that I did not want and I struggled to identify with the alters as being an extensive of myself. To note, it can be common, especially in the beginning, for alters to feel resistance towards each other and towards treatment.

How do you know which alter or personality is really “you”?

The awareness of having alter or different dissociated parts can be extremely distressing at first.

One of the main things I first struggled with was knowing or understanding who I REALLY was and who was another part. I had little awareness of my other parts because I simply dissociated into them and became who they were, so understanding or knowing these other parts was not something I had much experience with. I was blocked off from their experiences and emotions when I was “me.”

To know your true self is to know yourself when you’re not dissociated.

Understanding and knowing when that is can sometimes feel difficult when you have no awareness of an alter fronting (when an alter takes over executive control) or when an alter is influencing your behavior. Some people experience amnesia and complete loss of time and memory when this happens. For a significant portion of time, my parts were able to front without me knowing or having any awareness of the experience. Every once in awhile, I would experience their experience with them fronting, but during these times I didn’t have any awareness of being another part. I thought I was just being me.

The key is learning to become aware of your alters, beginning to work with them in therapy, and beginning to learn about their experiences and emotions. As difficult as it can be to see parts or alters as an extensive of yourself, in reality, they are another part of you and your experiences. Alters or parts won’t just go away so beginning to work with them is one of the first steps you can take to begin feeling more integrated and more understanding of these different parts of yourself.

With most, these fragmented parts of the personality will likely never fully integrate into one personality, however, through a lot of work and patience, our parts can begin to work together and function as one cohesive body and mind.

Do you know when you’re going to switch into an alter?

So this answer can vary from person to person.

Switching is the term used when an alter personality takes over executive control.

Personally, at first, I could never tell when I was going to switch and couldn’t even tell when I had switched. But over time, as I’ve made a connection and opened up conversation with my parts, I’ve been able to have some small indications of when I’m going to switch or small tell-tale signs of when an alter or part is influencing my thoughts and behaviors.

Some people have no idea when a switch is going to happen, some state they feel dizzy or light-headed when an alter is beginning to try to take over. The process and experience can look different for everyone.

What causes DID or OSDD-1?

The main cause of both DID and OSDD-1 is believed to be severe trauma - emotional, physical, or sexual abuse experienced over a long period of time, typically experienced in childhood, but it can also develop with severe trauma from things like combat or war.

In childhood, as our personalities begin to develop, there are many aspects of different personality traits that eventually come together to form one core personality. During trauma, this personality sometimes does not have the chance to integrate and the different emerging personalities and traits can become alters in DID or OSDD-1. As they experience abuse, these children will typically use dissociation to to help mentally survive their trauma or neglect be taking on whatever personality state they think will protect them in the moment. Dissociation then becomes a primary coping mechanism and with the personality failing to integrate, it sometimes goes on to become a dissociative disorder once the child becomes an adult.

What are some symptoms of DID and OSDD-1?

• Memory loss, including inability to remember large parts of ones childhood

• Levels of functioning which seem to differ, being capable in some instances and nearly disabled in others

• Feeling detached or disconnected from ones body or environment or out of body experiences

• Delusions, your perceptions of yourself and others may be distorted or unreal

• Depression or anxiety

• Confusion and uncertainty about identity

• Doing things you normally wouldn’t do, reckless behavior like speeding or stealing

• Personal preferences may suddenly shift back and forth

• Self harm and suicidal thoughts

What is the treatment for DID and OSDD-1?

Treatment for both disorders is typically psychotherapy.

Types of therapy like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) have shown good results. The goal with therapy in both DID and OSDD-1 is not to get rid of the alter personalities but rather help the individual learn how manage the extra personality states so they work together and become a cohesive stable self together.

Medications like antidepressants can also be helpful in treating symptoms like depression and anxiety.

My personal favorite and what has probably helped me the most has been hypnosis. Hypnosis has given me a safe place for my therapist to interact with my parts and has given me a safe place to feel calm and opened up to new ideas and thoughts. It has been a life transforming experience for me and I would encourage anyone who struggles with other parts of themselves to give it a try!

Are there any other disorders that have alters or parts?

DID and OSDD are the only disorders that have alters or parts. This does not mean other people do not have the same experiences. Trauma is not a black and white thing and there’s a lot of gray area that leaves room for others to have the same experiences and not be diagnosed.

Some common disorders or illnesses that could mimic or have experiences that are similar to alters or parts are Schizophrenia, Bipolar Disorder, Borderline Personality Disorder, C-PTSD or PTSD, and many others.

With all of that being said, this journey has been a lonely journey. I do not know anyone else who has a DID or OSDD diagnosis and my experience and information is limited to myself and the information I’ve come across.

If you have experience with DID or OSDD, I would love to hear your stories or experiences in the comments below!