Think about the different selves you embody— at work, with friends, and at home. For someone living with Dissociative Identity Disorder (DID), these shifts aren’t just quirks. DID is a recognised diagnosis in the DSM-5-TR (the standard reference used by mental-health professionals to define and diagnose mental disorders): a person experiences two or more distinct identity states, often called alters, each with its unique way of thinking, feeling, and behaving. Along with these shifts, people with DID often have significant gaps in memory, gaps that go far beyond normal forgetfulness because the different identity states may hold different memories.

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Dr Sandeep Vohra, psychiatrist and founder of NWNT, puts it simply: “DID usually develops as a survival strategy to severe, repeated trauma, especially in early childhood, when a young mind has limited coping tools.” Research over the last decade backs him up. A 2023 review in Developmental Cognitive Neuroscience linked chronic childhood maltreatment with changes in the brain’s connectivity that mirror dissociative symptoms. In other words, the mind learns to separate unbearable experiences into different “rooms” so the child can keep functioning.

How Common Is It?

DID is often called rare, but surveys estimate it affects about 1–1.5 per cent of people over a lifetime, roughly the same as obsessive-compulsive disorder. “People with DID often bounce between professionals for years before someone recognises what’s actually going on,” says Dr Vohra. That delay happens because the symptoms can look like depression, anxiety, or schizophrenia.

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Busting the Biggest Myths

Why does DID get such a bad rap? Movies and TV often show people with DID as violent, unpredictable or manipulative. In reality, research shows they’re far more likely to harm themselves than others. Another myth is that DID is “made up” or implanted by therapists.

Confusion with schizophrenia is also widespread. Schizophrenia involves primary psychosis, while DID is rooted in dissociation and identity fragmentation. Reality testing between identity states is often preserved, one of the clues psychiatrists use to tell them apart. And those dramatic on-screen “switches”? In real life, transitions between identity states can be subtle, changes in tone, posture, or mood that outsiders may barely notice.

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Early Roots and Other Theories

Most cases trace back to chronic, repeated interpersonal trauma, physical, sexual or severe emotional abuse, during the first years of life, often before age six. A 2023 paper in Psychological Medicine described how neuroimaging studies consistently find altered brain connectivity linked to early maltreatment and dissociation. Genetics and temperament may shape vulnerability, but early trauma remains the main driver.

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Alternative theories, such as sociocultural or “suggestibility” models, exist, and social media can sometimes influence self-reporting. Still, the prevailing evidence underscores DID as a complex trauma-related disorder requiring trauma-informed care. “Whatever the pathway, what we see in clinic is overwhelmingly a trauma-linked disorder that needs patience, not scepticism,” says Dr Vohra.

The Everyday Struggle

Imagine trying to keep a job when parts of your workday vanish from memory, or when colleagues think you’re “acting differently” from one day to the next. People with DID often face functional problems across work, relationships and self-identity. Comorbid conditions, like post-traumatic stress, depression or self-harm, raise suicide risk and complicate treatment planning.

Relationships can strain under misunderstandings. Partners or family may misinterpret dissociative episodes as deception or unpredictability. Parenting and sexual roles can become especially complex, requiring careful boundaries and psychoeducation. Stigma in workplaces makes disclosure risky, leading to economic insecurity and isolation. “These aren’t people trying to be difficult,” Dr Vohra notes. “They’re trying to survive a condition most of us can barely imagine.”

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Getting the Diagnosis Right

There’s no single test for DID. Psychiatrists rely on the DSM-5-TR core features, identity disruption and recurrent amnesia, plus longitudinal assessment and collateral history. They use tools like the SCID-D and the Multidimensional Inventory of Dissociation (MID) to measure dissociation.

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A key clue is phenomenology. DID’s voice-hearing is usually internal and tied to identity states, with reality testing intact between states, unlike schizophrenia’s external, command-type voices. Dissociation in borderline personality disorder tends to be briefer and less accompanied by robust amnesia. Neurological screening rules out conditions like temporal lobe epilepsy. “Getting the diagnosis right matters enormously,” says Dr Vohra, “because the wrong label can delay effective care for years.”

Treatment: A Marathon, Not a Sprint

There’s no single pill or quick fix for Dissociative Identity Disorder. The approach that works best, Dr. Sandeep Vohra explains, is what clinicians call phase-oriented psychotherapy. In plain language, that means starting with safety and stability, then carefully working through traumatic memories, and only later moving toward integration of identity states.

“Think of it as building a foundation before you add more floors,” says Dr. Vohra. “If you try to go straight to the trauma without stabilising the person first, you risk overwhelming them.” This is why good treatment begins with grounding techniques, skills for managing distress, and setting up a predictable routine.

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Medications can help with related symptoms, such as depression, anxiety, or sleep disturbance, but they don’t “cure” the dissociation itself. “Medicines can calm the storm,” Dr. Vohra notes, “but therapy is what teaches you how to sail.”

How Loved Ones Can Help

Living with DID is already isolating; facing disbelief at home can make it unbearable. Dr. Sandeep Vohra says the first thing families can do is suspend their scepticism. “DID is a trauma response, not a performance,” he tells me. “When people feel believed, they stabilise faster.”

Instead of confronting an “alter” or demanding explanations, keep your tone steady and language simple. Offer small, practical support: lift-share to therapy appointments, send a text reminder for medication, help keep a predictable daily routine. These seemingly mundane acts create safety.

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Dr. Vohra also urges families to take up psychoeducation or family sessions when the therapist offers them. “Once relatives understand what’s actually happening, blame turns into empathy,” he says. And he reminds caregivers to protect their own well-being: “You can’t pour from an empty cup. Support groups or a counsellor for yourself aren’t indulgences, they’re necessary.”

Why It Matters

A wrong diagnosis can trap someone in years of treatment that never quite fit. Dr. Vohra has seen many patients labelled with depression, borderline personality disorder or schizophrenia before anyone even considers dissociation. “By the time they reach us, they’re tired and distrustful,” he says.

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Yet when DID is recognised early and treated with a trauma-informed plan, the change can be dramatic. People move from crisis mode to finishing their degrees, holding steady jobs, or finally enjoying relationships. “We’re not trying to make someone ‘normal’ overnight,” Dr. Vohra adds. “We’re helping them build a life that feels safe and coherent.”

Dissociative Identity Disorder isn’t a plot twist. It’s a way the mind copes with overwhelming pain. Most people living with it are far more likely to be hurting than to be dangerous. With patient, evidence-based therapy and steady support, recovery is not only possible but common.

As Dr. Vohra puts it, “The mind is doing something extraordinary to survive the unimaginable. Our role, whether as clinicians, families or society, is to support that person until survival can give way to living.”

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