Dual Diagnosis: Multiple Personality Disorder And Addiction
Dual diagnosis, or suffering from both a substance use and mental health disorder can complicate treatment. Inpatient rehab is likely the best course of treatment because a person will have access to around-the-clock medical care, therapy, medications, and a network of peer and professional support.
While each person is different, there is often a complex relationship between mental illness and drug addiction. It can be an incredible struggle when addiction and multiple personality disorders co-occur, as people attempt to manage conflicting personalities, memory gaps, chemical dependency, and significant distress in daily living.
What Is Multiple Personality Disorder?
Multiple personality disorder is the previous name for what’s now called Dissociative Identity Disorder (DID). This disorder is characterized by alternating between at least two distinct identities or personalities. The person may hear multiple voices in their heads, all of them vying or competing for control. Sometimes these identities have unique characteristics, mannerisms, voices, or names.
In many cases, personality shifts are involuntary and unwanted, causing deep distress. Those suffering from DID may feel like observers of their own lives. They can feel like their speech, actions, and bodies are different and not their own. For example, some personality shifts may resemble a small child, the opposite gender, or muscular body types.
Personal preferences, like what people like to eat or do for fun, may suddenly shift one way, and then shift back. This back and forth of attitudes and preferences can cause memory problems and various troubles in daily life.
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Risk Factors Of Dissociative Identity Disorder (DID)
DID often develops as a result of experiencing childhood trauma. At a young age, the person may have been exposed to emotional, sexual, or physical abuse over long periods of time. DID can also result from post-traumatic stress disorder (PTSD) from combat, natural disasters, or other situations of crisis.
Those with DID also have an increased risk of suicide. More than 70% of people with DID have attempted to commit suicide. Because of the likelihood of past childhood trauma and the ongoing difficulties in daily life, some people turn to drugs or alcohol to self-medicate or escape the stresses of living with multiple personalities.
The Link Between Dissociative Identity Disorder And Drug Addiction
There are few studies that examine the link between DID and substance abuse. However, some research has suggested that people with severe cases of DID believe substances like alcohol and cocaine can help them manage their psychological symptoms and problems. But, it still remains unclear if people with DID use substances as a conscious choice to self-medicate, or as an unconscious psychological defense that arises in response to overwhelming external factors.
What is clear, however, is that co-occurring mental illness and substance use is a common problem. According to a 2014 National Survey on Drug Use and Health, almost 8 million people suffered from dual diagnosis (co-occurring disorders).
Symptoms Of Dual Diagnosis
While the general symptoms of dual diagnosis tend to be wide-ranging, a person suffering from DID and addiction will likely have unique symptoms related to each condition.
Symptoms of DID include:
- anxiety, depression, or suicidal thoughts
- emotional numbness
- lack of self-identity
- memory loss of specific times and events
- out-of-body-experiences (like watching yourself in a movie)
- problems with daily functioning
- two or more distinct personalities
On top of the symptoms of DID, a person may also show various symptoms of addiction. Symptoms of drug addiction include:
- abrupt changes in behavior
- developing tolerance and withdrawal symptoms
- engaging in risky behaviors
- lack of control over substance use
- using drugs in dangerous situations
- withdrawing from family or friends
Both risk factors and symptoms may overlap for people with DID and addiction. Because symptoms vary and some people are reluctant to admit their struggles, treating and diagnosing co-occurring disorders can be complex.
The Difficulties Of Dual Diagnosis Treatment
To properly diagnose DID and addiction, a doctor must review symptoms and personal history. If the person is unwilling to share their symptoms or denies distinct personality shifts, diagnosis can be difficult. Compared to men, women are more likely to be diagnosed with DID, as men tend to deny their symptoms. It’s not uncommon for people to minimize the effect and influence of their symptoms on daily life.
Also, symptoms can be blurred between DID and addiction. If a person isn’t forthcoming about their struggles with dissociation, then a doctor may only address their problems with addiction. Or, a doctor may fail to address any substance abuse problems, and only focus on treating DID. Complications can arise because treating one condition, and no other may worsen each disorder.
Treatment for Dissociative Identity Disorder And Drug Addiction
Treating both DID and addiction requires an integrated approach. This means a person can receive treatment for both substance abuse and mental illness, which may involve a collaboration of healthcare professionals. Other treatments that are effective for treating dual diagnosis include:
- behavioral therapy or psychotherapy
- inpatient rehab
- medically supervised detox programs
- support groups
Behavioral therapies like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can be effective for addressing both DID and addiction. Medications are used to treat symptoms and may include antidepressants or addiction medications to address dependence on opioids or alcohol.
Inpatient rehab is likely the most effective option for someone suffering from DID and addiction. At an inpatient rehab, a person can receive 24-hour medical care and supervision, participate in a supportive community, engage in therapy, and have access to medications and other health services capable of addressing both conditions at the same.Article Sources
American Psychiatric Association - https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders
National Alliance on Mental Illness - https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis
National Alliance on Mental Illness - https://www.nami.org/learn-more/mental-health-conditions/dissociative-disorders
U.S. National Library of Medicine - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341607/