Understanding Dissociative Identity Disorder & Addiction
Dissociative identity disorder (DID), formerly known as multiple personality disorder, is a complex dissociative condition characterized by the presence of two or more distinct personality states (often described as "alters") that recurrently take control of behavior, accompanied by gaps in memory for everyday events, important personal information, and traumatic events. DID develops as a survival response to severe, prolonged childhood trauma -- typically beginning before age 6 -- when the developing brain compartmentalizes overwhelming experiences into separate identity states to maintain functioning.
The relationship between DID and substance use disorders is complex and clinically challenging. Substance use rates among individuals with DID are estimated at 50% to 75%, making it one of the highest rates of any psychiatric condition. Different alter states may have different relationships with substances: one alter may use alcohol to cope with emotional pain, another may use stimulants for energy, and another may be entirely abstinent. This internal inconsistency creates unique treatment challenges, as traditional addiction treatment approaches that assume a unified sense of self do not account for the reality of DID. Additionally, substance use may be used to manage the distressing experiences of switching between alter states, losing time, or confronting traumatic memories that surface unbidden.
At Trust SoCal, our trauma-specialized dual diagnosis program provides DID-informed addiction treatment that respects the complexity of the dissociative system while working toward internal cooperation around recovery goals.