Piecing the Puzzle Together: Addressing the Overlaps Between DID and Psychosis

Dissociative Identity Disorder can make your life feel like it’s made of fractured moments, each lived through a psyche with different thoughts, memories, and emotions. Given the overlaps between symptoms of this disorder and psychosis, misdiagnosis is common, preventing many from getting the treatment they need. By unearthing the roots of Dissociative Identity Disorder, we can promote proper diagnosis and help those suffering from it put the pieces of their psyche back together and resolve the true roots of their illness.

Take a moment to ask yourself who you are—what makes you you. You’ll probably begin to think about the most prominent experiences in your life that have shaped you into the person that you are today, the people you love, your best and worst times, your job, your hobbies. Now imagine asking that question—and answering it differently, every single time you do.

Dissociate Identity Disorder (DID) (formerly known as multiple personality disorder) is a mental disorder characterized by the dissociation of the psyche into two or more identities. For most of us, it’s hard enough having just one sense of self, but for many who live with DID, navigating between many is a complicated reality. Because the identities that appear in those with DID are often misinterpreted as psychotic episodes or alternating moods, it can be hard for those who struggle with DID to get mental health care that really meets their needs. That’s why it’s critical to have a well-rounded, experienced treatment team that can spot the difference between the symptoms of Psychotic Disorder and the fractured psyche that characterizes DID.

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Overlaps Between DID and Psychosis


The similarities between DID and psychotic disorder are many. There’s considerable overlap in the symptoms of both:

  • disruptions in memory
  • hallucinations (or what can appear to be hallucinations)
  • delusions (or what can appear to be delusions)
  • confused ideas about the self
  • fluctuating moods
  • intense anxiety

Underlying the similarities between these disorders, however, are vastly differing causes. Let’s take memory as an example. Someone suffering from a psychotic episode might experience memory loss because of how the disorder affects the brain, while someone living with DID may move into one identity without having any recollection of what they’ve experienced in another.

As one woman with DID explains:

I convinced myself that the things that happened to me, that were completely baffling and unexplainable, happened to everyone. Didn’t everyone lose track of time, belongings, people? Didn’t everyone find things in their possession they couldn’t recall buying, or money spent they couldn’t recall spending? Didn’t everyone have such drastic extremes in desire and goals? Didn’t everyone regularly run into people whose names and faces couldn’t be placed?

In both experiences, there’s a kind of memory loss, but they’re caused by very different things. The symptoms merely present themselves similarly, and that’s where the difficulty in diagnosing lies. The problem, of course, is that misdiagnosis of DID as a Psychotic Disorder not only hides what they’re really struggling with—multiple personas—it prevents those who struggle with DID from exploring why they formed.

Unearthing the Roots of DID


One of the main commonalities among those with DID is childhood trauma. As a child, experiencing trauma with no physical escape can cause some people to retreat further and further into their minds. It’s a defense mechanism that allows them to dissociate from all of the memories and emotions attached to their trauma, essentially creating another sense of self that has not endured that pain. Over time, they come to rely on this defense mechanism for any situation that’s too emotionally or physically painful, and that catalyzes the development of several senses of self, each with its own unique consciousness separate from the others in terms of thought, emotion, and memory.

When those who live with DID are misdiagnosed with Psychotic Disorder, the trauma that underlies that dissociation often goes unaddressed. For psychoanalyst and writer Valerie Sinason, the differences are there, though subtle: the voices her clients with DID heard came “from inside and not outside,” manifested from their most repressed traumatic memories. Disordered thoughts were not consistent, surfacing only at certain times, and time and place distortions only manifested when her patients dissociated into other identities. Crucially, it was trauma that defined her clients, and distinguished them from those with Psychotic Disorder.

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Putting the Pieces Back Together


Dealing with the trauma that underlies DID can be a difficult, complicated endeavor, but it can be done, and it’s best approached in a residential treatment program. There, surrounded by a team of compassionate mental health professionals, people who struggle with DID can unpack that trauma slowly and with care.

At its core, DID is a coping mechanism, one that gives the people who live with it a means of dissociating from the suffering they’ve endured. Above all things, it’s a testament to the resilience of the human mind in the face of the most extreme trauma. “The disorder itself is an incredible survival technique,” writes DID survivor Olga Trujillo. “You should feel proud to have survived.”

Bridges to Recovery offers comprehensive residential treatment options for people struggling with dissociative identity disorder and other mental health challenges. Reach out to us today to learn more about how our trained staff of mental health professionals can help you or your loved one get at the root of their disorder and move forward into lasting recovery.

Lead Image Source: Unsplash User Jude Beck