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The Effects of Substance Abuse on Dissociative Identity Disorder

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    “For a variety of reasons there has been little dialogue among the disciplines that study patients with trauma and those that study and treat substance abuse. Little systematic investigation exists on the treatment of DID in general, and substance abuse in DID in particular” (1). Dissociative Identity Disorder is defined in Essentials of Abnormal Psychology as “a disorder in which as many as 100 personalities or fragments of personalities coexist within one body and mind” (Durand & Barlow, pg. 88).

    More commonly known as “multiple personality disorder,” the Diagnostic and Statistical Manual, also known as The DSM-IV, changed the name to Dissociative Identity Disorder, or DID, for various reasons. One main reason being that a patients personality is the sum of identities, which may have split off in the past due to individual or multiple traumatic events. Patients believe they have multiple personalities which take on a life of their own within themselves.

    Professionals sometimes use the term “alters” to reference the multiple personalities associated with DID, and use the term “host” in reference to the patient. “How many personalities live inside one body is relatively unimportant. This change also corrects the notion that multiple people somehow live inside one body” (Durand & Barlow, pg. 189). Dissociative Identity Disorder is also defined as a disturbance in the normally integrative functions of memory, identity, and consciousness.

    Mental illness can be brought on due to many different factors, as well as at any age, from childhood to adulthood. Factors included in causing mental illnesses are having a biological relative with a mental illness, stressful life situations, experiences in the womb, and the glue holding this entire paper together, childhood abuse and neglect as well as traumatic experiences. Dissociative Identity Disorder mainly stems from repeated early childhood abuse, mostly sexual and occasionally physical.

    In Sybil, a made for television film that tells the true story of a woman suffering from DID, a few facts have been left out and a few names have been switched, but the movie does reference her childhood and for the most part sums up how being sexually abused by her mother more or less resulted in Dissociative Identity Disorder. Doctors and psychologists believe that DID originates in childhood because the child’s brain isn’t fully developed yet, resulting in the child’s ability to “escape” easily. If the escape blunts the physical and emotional pain just for a minute, chances are you’ll escape again” (Durand & Barlow, pg. 192).

    Childhood abuse seems to be the number one cause of Dissociative Identity Disorder, but there are few cases in which the disorder is brought on at a later point in life mainly due to a very traumatic event. Essentials of Abnormal Psychology offers the example of a young woman who witnessed both of her parents die in an explosion in a war-torn minefield. “In a heart-wrenching response, she tried to piece the bodies back together, bit by bit” (Durand & Barlow, pg. 92). Essentials of Abnormal Psychology also dives into the 1986 study Putnam conducted, in which Putnam and his colleagues studied 100 separate cases of dissociative identity disorder and found that a majority of cases did stem from abuse, often times as cruel as what Sybil had to endure. “Such observations have led to wide-ranging agreement that DID is rooted in a natural tendency to escape or ‘dissociate’ from the unremitting negative affect associated with severe abuse (Kluft, 1984, 1991)” (Durand & Barlow, pg. 192).

    Dissociative Identity Disorder appears to be portrayed in the media as stigmatized by a number of hysterical symptoms. Symptoms of DID include a lapse in memory, finding yourself in places but not remembering how you got there, finding items but not remembering how they were acquired, hearing voices in their head, and not recognizing their own reflections. It’s been said that DID patients feel as if they are watching themselves in a movie, which possibly relates to why derealization is a common symptom, because their views on the world can be distorted and unreal.

    The DSM-IV diagnostic criteria includes “the presence of two or more distinct identities or personality states, each with it’s own pattern of perceiving and thinking about the environment and self, and recurrent transitions in which the alter takes control of the person’s behavior. ” When an alter takes over, this is called “switching. ” For example, Mary has dissociative identity disorder and has Alice, Christina and Judy for alters.

    If Mary is faced with a stressful situation in which she has a negative reaction, she might quickly “switch” into Christina, since Christina will feel like she can handle the situation calmly and maturely. Since there’s little research on the correlation between alcohol/substance abuse and Dissociative Identity Disorder, it was necessary to pull from the research what connections exist with substance abuse concerning other mental illnesses. The statistics of substance abuse with a mental illness are shockingly high.

    For having little research to rely on, this just shocks me. “One in five adults in the United States—nearly 50 million people—experienced mental illness in the past year, according to Reuters. Adults with any mental illness in the past year were more than three times as likely to have met the criteria for substance dependence or abuse compared with those without mental illness (20 percent versus 6. 1 percent). People with serious mental illness in the past year had a rate of substance dependence or abuse of 25. 2 percent.

    Mental illness was more common among women, and among people ages 18 to 25, the Substance Abuse and Mental Health Services Administration noted in a news release. ” Research for statistics of DID specifically show the rate of diagnosed patients is . 01% to 1% of the general population. It’s been said that 7% of the population might have an undiagnosed dissociative disorder. Clinically, DID has been recognized for centuries. “It is the most severe and chronic manifestation of the dissociative disorders that cause multiple personalities.

    The dissociative aspect is thought to be a coping mechanism — the person literally dissociates himself from a situation or experience that’s too violent, traumatic, or painful to assimilate with his conscious self. ” I believe dissociative identity disorder has a relation to schizophrenia in the sense that both of these illnesses classify hearing voices in one’s head as a symptom, both are hard to juggle with the real world, and both require a great deal of time and patience to overcome. Maybe DID is schizophrenia’s ousin or something, I don’t know. The National Institue on Alcohol Abuse and Alcoholism, or The NIAAA, reports that patients with Alcohol Use Disorder (AUD) and schizophrenia say they use alcohol to “alleviate the symptoms and general dysphoria of mental illness, poverty, limited opportunities, and boredom; they also report that substance use facilitates the development of an identity and a social network (Dixon et al. 1990)” It’s been reported that patients have also admitted to using other drugs.

    Some choosing one over the other, and some mixing both — drugs and alcohol, that is. “It is now generally agreed that as much as 50 percent of the mentally ill population also has a substance abuse problem. The incidence of abuse is greater among males and those in the age bracket of 18 to 44. People with mental illnesses may abuse drugs covertly without their families knowing it. The drug commonly used is alcohol, followed by marijuana and cocaine.

    Prescription drugs such as tranquilizers and sleeping medicines may also be abused” Even though there’s no direct relation (except my own personal beliefs, based on research) between DID and schizophrenia, further research also pits dissociative identity disorder against post traumatic stress disorder. “In clinical studies, most patients with dissociative identity disorder have also been found to meet the DSM-IV-TR criteria for posttraumatic stress disorder (PTSD)”; “Post traumatic stress disorder is a dissociative [identity] disorder, a chronic condition created by reliving traumatic experiences that involve horrific memories.

    In this condition, the sufferer’s psyche is fragmented resulting in strange or inappropriate behaviors. ” Given the enormous number of mentally ill with substance abuse issues, treatment becomes a problem. Having a substance abuse issue on top of mental illness is a very big problem for mental health professionals, mainly because they need to be able to differentiate the behaviors between the mental illness and the substance abuse. For this reason, mental health professionals have a difficult time diagnosing and/or treating their patients. Often only one of the two problems is identified. If both are recognized, the individual may be bounced back and forth between services for mental illness and those for substance abuse, or they may be refused treatment by each of them” As previously stated the symptoms of DID include a lapse in memory, finding yourself in places but not remembering how you got there, finding items but not remembering how they were acquired, hearing voices in your head, and not recognizing your own reflection.

    People might think that the memory loss associated with Dissociative Identity Disorder is rather alcoholism. It’s more common to hear “I was so drunk, I woke up on the roof and don’t remember getting there” than it is to hear “I have Dissociative Identity Disorder, so I woke up on the roof and don’t remember getting there. ” Alcoholics already occasionally find themselves in strange places or find strange items without remembering how they originally got them, and Dissociative Identity Disorder does mirror this behavior.

    Opposed to causing this memory loss by drinking heavily, DID patients unfortunately experience it naturally. Showtime once aired a series titled The United States of Tara in which a woman balanced family life while diagnosed with DID. One episode featured Tara (while as an alter) confronting a man with a gun. It was insinuated that she woke up the next morning in her front lawn but without any recollection of the transportation she took to get there. Tara also had a speeding ticket in her back pocket.

    It is very concerning that the memory lapse symptom of a diagnosed DID patient would be exacerbated by having a substance/alcohol abuse problem. Alcohol use doesn’t result in the direct “death” of brain cells, but it does damage dendrites which can result in communication problems between neurons. As Dissociative Identity Disorder patients struggle to communicate with the world, a drinking problem worsens not only the illness, but also the possibility of treatment. The side effects of stimulant drug abuse wouldn’t be any better than the side effects of alcohol.

    The side effects from any substance abuse wouldn’t make any disorder “better. ” Many people already have mental health issues prior to using crystal meth, yet many people who abuse drugs in general have started using due to some sort of mental health disorder. Some have discovered crystal meth relieves their symptoms. “Maybe they feel less depressed or less anxious while they are high, for example. There are two aspects to consider when talking about crystal’s impact – the symptoms of mental health problems and the root causes of these problems” (9).

    When taken, stimulants improve the nervous system’s response and leaves the person active and alert. In some cases stimulants are used for treatment when the patient suffers from severe depression, but obviously only in recommended doses and under a prescription. In other cases, stimulants aren’t even considered mainly due to the severity of the patient’s case. “Marijuana is one of the few illegal substances with little negative effect that has high medicinal value.

    Doctors are quick to prescribe mind-altering, dangerous, highly addictive, opiate painkillers. An alternative option needs to become available for those suffering with emotional and physical disabilities, and who are unable to take other medications” (10). Marijuana can not cause dissociative identity disorder but it has been reported that heavy use can cause schizophrenia. It’s not an official fact that schizophrenia is in direct relation with DID, just my personal belief that they could be considered two sides of the same coin in a way.

    However, I found this to be very interesting: “108 inpatients admitted to a dissociative disorders unit completed the Positive and Negative Syndrome Scale, developed to differentiate schizophrenia subtypes. Scores were compared with norms for 240 clinically diagnosed schizophrenic patients. Positive symptom (particularly anxiety and depression) scores and general psychopathology scores were more severe in the dissociative identity group than in the norms for schizophrenia, while negative symptoms were more severe in schizophrenia.

    Consequently, emphasis on positive symptoms may result in false-positive diagnoses of schizophrenia and false-negative diagnoses of dissociative identity disorder” (11). It would seem that marijuana could work wonders for dissociative identity disorder patients. The calming, euphoric sensation one feels while under the influence and marijuana’s direct affection on the hippocampus could alter the host’s mind and help control their mental system. Psychotherapy is the first choice of treatment for patients suffering from ny type of dissociative disorder. As reported earlier, some doctors have used certain stimulants as medicines but further research shows that the use of medication is not recommended. Even though everybody experiences mild dissociation, there’s really no gender barrier to who can specifically suffer from DID. Latest research shows that men with dissociative disorders are most likely to be treated for other mental illnesses, drug/alcohol abuse, or be incarcerated.

    Of the four dissociative disorders, dissociative identity disorder is unfortunately one of the most underestimated illnesses. Mental health professionals still, to this day, argue and debate about whether or not it’s a “real” disease. “Most people experience mild dissociation on a regular basis, like when they daydream. However, what makes this common experience different from a dissociative disorder is the severity and length of the dissociation” (12). This is a topic that obviously needs further research, but I hope this paper sheds a little more light on the issue.

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    The Effects of Substance Abuse on Dissociative Identity Disorder. (2016, Oct 14). Retrieved from

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