MULTIPLEPERSONALITYDISORDER

NAME:

SofiaSusanaZertuchePerez

ID:

1669685

DATE:

Thursday,17March2015

Introduction
There are several illness that affect our minds and can cause problems in our
dailylife,some of themare more dangerous than othersbutthere isnoreasontothink
that they are irreversible. Family of these patients are often scared,theydonotknow
what to do or how toreact.Through thepast years new researchand doctorsallover
the world had found treatmentsand even a total recoveryfor some ofthisillness.One
ofthemostcontroversialis theDIDorMPD(DissociativeIdentityDisorder)withnoclear
consensus regarding its diagnosis or treatment. But there is no reason to lose hope,
multiplepersonalitydisordercanbetreatindifferentways.
A mental illness regularly disrupts a person's thinking, feeling, mood, ability to
relate to others and function, but with early intervention and proper support and
treatment, outcomes can be improved [] 1 in 4 adults, nearly 60 million
Americans, experiences a mental healthconditionevery year.1 in17liveswitha
serious mental illness such as schizophrenia and bipolar disorder. Inadditionto
the person directly experiencing by a mental illness, family, friends and
communitiesarealsoaffected.(Nami.org).
According to theDMS5 theDissociativeIdentityDisorder(DID),formerlyknown
as Multiple Personality Disorder, is a condition in which a person has two or more
distinct identities or personalities, which mayalternatewithinthe individual'sconscious
awareness of this illness. The different personality states usuallyhave distinct names,
identities,temperament,andselfimage.

I.

BackgroundInformation
A. WhatisaMentalDisorder
The term Mental Illness, according to the DSM5, refers to a wide range of

mental health conditions/disorders that affect your mood, thinking and behavior. A
mental illness can make you miserableand can causeproblemsin your daily life,such
as at work or in relationships. In most cases, symptoms can be managed with a
combination of medications and psychotherapy. According to ICD10 and DSM5,
mentaldisordersincludeawiderangeofproblems,suchas:
AnxietyDisorders(panicdisorder,obsessivecompulsivedisorder,
posttraumaticstressdisorder,phobias)
BipolarDisorder
Depression
MoodDisorders
PersonalityDisorders
PsychoticDisorders(schizophrenia)
There are many causes for mental disorders. Your genes and family history
might play a role. Your lifeexperiences,suchasstressorachildhoodtrauma,mayalso
matter.Biological factors are alsosometimes partof the cause.Atraumaticbraininjury
can lead to a mental disorder.A mother's exposureto viruses or toxic chemicals while

pregnant might playapart.Otherfactorsmayincrease your risk,suchas use ofillegal

drugsorhavingaseriousmedicalconditionlikecancer.
B. PersonalityDisorders
Personality disorders are classified in three different groups or clusters
depending on the author. They all have four defining features: distorted thinking
patterns, problematic emotional responses, underregulated impulse control, and
interpersonal difficulties these four core features are common to all personality
disorders. (Sevencounties.org) We are going to refer to the groups with the term
cluster because most of the sources used in this research consider the term to be
more specific. Furthermore, the ten different personality disorders can begrouped into
three clusters based on descriptive similarities within each one of these. The clusters
are:Cluster A(the "odd, eccentric" cluster)ClusterB(the"dramatic,emotional,erratic"
cluster)andClusterC(the"anxious,fearful"cluster).
1. GroupA
Cluster A is called the odd, eccentric cluster. It includes Paranoid Personality
Disorder, Schizoid Personality Disorder, and Schizotypal Personality Disorders. A
person with a Cluster A personality disorder tends to have difficulty relating to others
and usually shows patterns of behaviour most people would regard as odd and
eccentric. The common feature of the personality disorders in this cluster are social
awkwardness.Thesedisordersaredominatedbydistortedthinking:

 ParanoidPersonalityDisorder:characterizedbyapatternofirrational
suspicionandmistrustofothers,interpretingmotivationsasmalevolent.
SchizoidPersonalityDisorder:lackofinterestanddetachmentfromsocial
relationships,apathy,andrestrictedemotionalexpression.
SchizotypalPersonalityDisorder:apatternofextremediscomfort
interactingsocially,anddistortedcognitionsandperceptions.
2. GroupB
Cluster B is called the dramatic, emotional, and erratic cluster. It includes
Borderline Personality Disorder, NarcissisticPersonality Disorder, HistrionicPersonality
Disorder, and Antisocial Personality Disorder. Someone with a Cluster B personality
disorderstrugglesto relate to others. As aresult,theyshowpatternsofbehaviour most
wouldregard as dramatic,erratic andthreatening ordisturbing.Disordersinthiscluster
shareproblemswithimpulsecontrolandemotionalregulation:
AntisocialPersonalityDisorder:apervasivepatternofdisregardforand
violationoftherightsofothers,lackofempathy,bloatedselfimage,
manipulativeandimpulsivebehavior.
BorderlinePersonalityDisorder:pervasivepatternofinstabilityin
relationships,selfimage,identity,behaviorandeffectsoftenleadingto
selfharmandimpulsivity.

 HistrionicPersonalityDisorder:pervasivepatternofattentionseeking
behaviorandexcessiveemotions.
NarcissisticPersonalityDisorder:apervasivepatternofgrandiosity,need
foradmiration,andalackofempathy.
3. GroupC
Cluster C is called the anxious, fearful cluster.

It includes the Avoidant,

Dependent,and ObsessiveCompulsive Personality Disorders. SomeonewithaCluster

C personality disorder fears personal relationships and showspatterns ofanxiousand
fearful behaviour around other people. These three personalitydisordersshareahigh
levelofanxiety:
AvoidantPersonalityDisorder:pervasivefeelingsofsocialinhibitionand
inadequacy,extremesensitivitytonegativeevaluation.
DependentPersonalityDisorder:pervasivepsychologicalneedtobe
caredforbyotherpeople.
ObsessiveCompulsivePersonalityDisorder:characterizedbyrigid
conformitytorules,perfectionism,andcontroltothepointofsatisfaction
andexclusionofleisurelyactivitiesandfriendships.

II.

MultiplePersonalityDisorder
A. WhatisaMPDorDID
Dissociative Identity Disorder (DID) known before as Multiple Personality

Disorder (MPD) is a mental disorder on the dissociative spectrum characterizedby at

leasttwodistinct and relatively enduringidentitiesor dissociated personality statesthat
alternately controlaperson'sbehavior,and isaccompanied bymemoryimpairmentfor
important information not explained by ordinary forgetfulness. DID is a disorder
characterized by identity fragmentation rather than a proliferation of separate
personalities. The disturbance is not due to the direct psychological effects of a
substance or of a general medical condition, yet as this once rarely reporteddisorder
hasbecomemorecommon,thediagnosishasbecomecontroversial.
Dissociation can be described as a temporary mental escape (similarto
selfhypnosis)fromthe fear andpainofthetrauma.Evenafterthetraumaislong
past, however, the leftover pattern of dissociation to escape stressfulsituations
continues. When dissociation is done repeatedlyas in the case of prolonged
abusethese dissociated mental states can take on separate identitiesof their
own.(Clevelandclinic.org)
B. Causes
The cause of DID is controversial,with debate occurring betweensupporters of
different hypotheses: that DID is a reaction to trauma that DID is produced

iatrogenically by inappropriate psychotherapeutic techniques that cause a patient to

enact the role of a patient with DID and newer hypotheses involving memory
processing that allows for the possibility that traumacausing dissociation can occur
after childhood in DID, asitdoesin PosttraumaticStress Disorder(PTSD). It hasbeen
suggested thatallthetraumabased and stressrelated disorderscanbe placedin one
category that wouldincludebothDID and PTSD. Disturbedand altered sleep has also
beensuggested as having a role in dissociative disorders in generalandspecificallyin
DID,alterationsinenvironmentsalsolargelyaffectingtheDIDpatient.
Research is needed to determine the prevalence of the disorder in those who
have never been in therapy, and the prevalence rates across cultures. The debates
over thecausesofDIDalsoextendtodisagreementsoverhowthedisorderisassessed
andtreated.
C. Symptoms
Often people livingwith DIDaredepressedorevensuicidalandselfmutilationis
common in this group. Approximately onethird of individuals affected complain of
auditory or visual hallucinations. This uncommon illness has reported more and more
cases around the world, we need to aware people of this and help identifying it. A
personwith DID mightrepeatedlymeetpeoplewhoseemtoknowhimorher,butwhom
he or she does not recognize. The personalalsomight finditems thathe orshedoes
notrememberbuying.(Clevelandclinic.org).

In addition to experiencing separate identities, individuals living with DID may

alsoexperiencemanyothersymptoms,someoftheseinclude:
Depression
SuicidalTendencies
AnxietyorPanicAttacks
AlcoholandDrugAbuse
Confusion
MemoryProblems
Delusions
Headaches
Flashbacks
EatingDisorders
PersonalityChange
SelectiveLossofMemory
Disorientation

III.

Treatments
A. Psychotherapy
This treatment can be used for patients with DID. Psychotherapy is a general

term for treating mental health problems by talking with a psychiatrist, psychologist or
other mental health provider. During psychotherapy,youlearnaboutyour conditionand
your moods, feelings, thoughts and behaviors. Psychotherapy helps you learn howto
take control ofyourlife andrespondto challenging situationswithhealthycopingskills.
Therearemany specific typesof psychotherapy, each withitsown approach.Thetype
of psychotherapy that is right for you depends on your individual situation.
Psychotherapy is also known as talk therapy, counseling, psychosocial therapy or,
simply,therapy,thesearesomecommontypesofpsychotherapy:
BehaviorTherapy
CognitiveTherapy
DialecticalBehaviorTherapy
InterpersonalTherapy
PsychodynamicTherapy
FamilyTherapy
GroupTherapy

B. ClinicalHypnosis
Hypnotherapy is a valuable therapy with which to release past trauma and
deconditionestablishedhabits. Even though our personalunconsciousonlyeverseeks
to promote our wellbeingitcanoften be the seatoffaulty learning fromourchildhood,
leading to low selfesteem,underachievement and sometimes worse.Oftenitattempts
to protect us by raising our fears and anxieties to phobic levels to keep us from a
particular activity or stimulus it sees as dangerous. Utilising hypnosis in therapy often
facilitates an unconscious relearning process. Hypnosis is a state of inner absorption,
concentrationandfocusedattention.Itislikeusingamagnifyingglasstofocustherays
of the sun and make themmore powerful. Similarly, when our minds are concentrated
and focused, we are able to use our minds more powerfully. (American Society of
ClinicalHypnosis)
Recentresearchsupportstheviewthathypnoticcommunicationandsuggestions
effectively changes aspects of the persons physiological and neurological functions.
Practitionersuseclinicalhypnosisin threemain ways. First, they encouragethe useof
imagination. Mental imagery isvery powerful,especially ina focusedstate ofattention.
The mind seems capable of using imagery, even if it is only symbolic, to assist us in
bringing about the thingswe are imagining. Inthisway wecanapplythis ideatocuring
people with DID, hypnosis can help clients access repressed memories, control
problematic behaviors, such as selfmutilation and eating disorders, and help fusethe
his/heralteregosduringtheintegrationprocess.

C. Medications
Asthemaincause isunknownandthat therearesometheoriesthatsay it isnot
abiologicalillness, somepsychiatristshad used severalmedicationsinordertocureor
controltheDIDofpatients.
One ofthemost commonare the antidepressantdrugs,theyincludeCitalopram,
Venlafaxine, Phenelzine, Fluoxetine, and Sertraline. These drugs help reduce
depression in some dissociative identity disorder patients. Antidepressants must be
taken only under expert guidance as some of them have several side effects. Any
change in the patients behavior due to the effect of medication must be monitored
consistently.
Other medication used by the doctors are the depressants. Depressants are
used to calm down certain dissociativeidentity disorder patients displaying violentand
manic behavior. These drugs temporarily diminish hyperactivity of the brain. Theyare
used to prevent seizures or respiratory disorders that can be associated with a
dissociative identity disorder. Examples of depressants include Carisoprodol, Atropine,
Benzodiazepines,andCyclobenzaprine.
As some patients show schizophrenia or psychotic behaviors, antipsychotic
medication is used in certain cases, these include Chlorpromazine, Aripiprazole,
Risperdal, Haldol, and Mellaril. They work as mood stabilizers as well, even if the

dissociativeidentity patient isnotdiagnosedwithpsychosis,thesedrugscanbeusedto

tranquilizeandstabilizethemood.
Like mentioned earlier some psychologistsbelieve that DIDis causedbystress
or traumas, soanxietymedicationisperfectforthiscases.Thesedrugsareusedforthe
treatment of dissociative identity patients who display excessive anxiety. Anxiety can
sometimes be an associated condition caused by dissociativeidentity problems.These
medications help reduce anxiety. Xanax, Librium, Valium, and Ativan are some
examples.
Whenthe subjectpresent anemotional decaydoctorsusestimulants.Theseare
used as dissociative identity disorder drugs when the patient displays severe
depression, or in cases where depression isa cause ofdissociative identity problems.
Stimulants improve the central nervous system's response and make the person alert,
wakeful, and active.Thismedication should onlybetakenin recommended doses and
on a physicians prescription. In addition, these medications are notsuitable forsome
dissociative identity disorder patients. Examples of stimulant drugs include Midafinil,
Methylphenidate,andDextroamphetamine.

Conclusion
There aremany ways totreatDID,these paperonly reviewed threeof the most
common and more efficientto treatthismentalissue.Thefirststepistoverifythatwhat
your condition is actually DID, forthisyou must goand consult an expert on this area.
Secondly hear different opinions from different doctors such as psychologists,
psychiatrists, etcetera. In order to be able to treat this successfully is necessary to
know all thedifferent treatments andwhichonesarethebestforyourcase.Ifsomeone
youknow presents thesesymptomsorhasalreadybeendiagnosedwithDID,heorshe
will need all your support. Even thought of the controversy around DID there is no
reasontobelievethattherearenotopportunitiestohaveanordinarylife.

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