COMPARISON: Dissociative Identity Disorder

[BPDFamily.com]

Does anyone know the difference?

[almostknowhoiam]

Does anyone know the difference?

[NewLifeforHGG]

Split personality is a highly dissociative disorder where the entire personality changes to another personality. It is like several people inhabiting one body.

Borderline is a one fractured personality.

[Skip]

When asking differential questions about multiple personality disorders, it is important to understand why you are asking the question and how you intend to use the information. Without this perspective and focus, the data may be overwhelming, confusing and misleading.  For example... .

~ if your child is not responding to therapy, it makes sense to look more carefully into the possibility that the wrong illness was diagnosed or whether there are comorbid (multiple) personality disorders at play. Bipolar and Major Depressive Disorder, for example, are far more responsive to pharmaceutical therapy than Borderline Personality or Aspergers Syndrome.

~ If you are trying to get along better with your wife, it's not as important to precisely analyze the comorbidity as it is to recognize and fully understand the problem behaviors and how to constructively deal with them.  

~ If you are recovering from a failed relationship, the important thing is often to understand which behaviors were pathologic/developmental (mental illness) and which were just the normal run of the mill problems common to failing/failed relationships - there is often a bias to assign too much to the "pathology" and not enough to common relationship problems, or the issues we created by our own behaviors.

It's important to know that the distinctions are not all that neat and tidy. In a 2008 study, comorbidity of BPD with another personality disorder was very high at 74% (77% for men, 72% for women).  In the study, the comorbidity of BPD with mood disorders was also very high at 75% as was anxiety disorders at 74%. This is one reason why there is controversy around the DSM classifications of Personality Disorders - there is so much overlap it is confusing even to professionals - personality disorders are real, but they are not easily or neatly defined.

More info

In a small 2003 study by Drs. Vedat Sar, and Turgut Kundakci (MD), two hundred and forty (240) consecutive patients who presented to a university outpatient psychiatry unit were screened. Twenty-five (25; 10.4%) of the participants tested positive for BPD and 33 participants (13.8%) tested positive for dissociative disorder in the final evaluation. Sixteen participants or 64.0% with BPD also tested positive for a dissociative disorder (i.e., dissociative amnesia, dissociative identity disorder, dissociative fugue, depersonalization disorder). The findings demonstrate that a significant part of psychiatric outpatients who fit the criteria of BPD have a DSM-IV dissociative disorder on Axis I. The presence of dissociative symptoms as a part of BPD could lead to overlooking the possibility of a co-occurring dissociative disorder.

Source: The Axis-I Dissociative Disorder Comorbidity of Borderline Personality Disorder Among Psychiatric Outpatients

Some helpful hints for sorting through this.

• General and Specific There are definitions for "personality disorder" as a category and then there are definitions for the subcategories (i.e., borderline, narcissistic, antisocial, etc.).  Start with the broader definition first.  Keep in mind that to be a personality disorder, symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder - - the history of symptoms can be traced back to adolescence or at least early adulthood - - the symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life. Symptoms are seen in at least two of the following areas: thoughts (ways of looking at the world, thinking about self or others, and interacting), emotions (appropriateness, intensity, and range of emotional functioning), interpersonal functioning (relationships and interpersonal skills), or impulse control

• Spectrum Disorders  An extremely important aspect of understanding mental disorders is understanding that there is a spectrum of severity. A spectrum is comprised of relatively "severe" mental disorders as well as relatively "mild and nonclinical deficits".  Some people with BPD traits cannot work, are hospitalized or incarcerated, and even kill themselves.  On the other hand, some fall below the threshold for clinical diagnosis and are simply very immature and self centered and difficult in intimate relationships.

• Comorbidity Borderline patients often present for evaluation or treatment with one or more comorbid axis I disorders (e.g.,depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, anorexia nervosa, bulimia nervosa). It is not unusual for symptoms of these other disorders to mask the underlying borderline psychopathology, impeding accurate diagnosis and making treatment planning difficult. In some cases, it isn’t until treatment for other disorders fails that BPD is diagnosed.  Complicating this, additional axis I disorders may also develop over time.  Because of the frequency with which these clinically difficult situations occur, a substantial amount of research concerning the axis I comorbidity of borderline personality disorder has been conducted. A lot is based on small sample sizes so the numbers vary.  Be careful to look at the sample in any study -- comorbidity rates can differ significantly depending on whether the study population is treatment seeking individuals or random individuals in the community.  Also be aware that comorbidity rates  are generally lower in less severe cases of borderline personality disorder.

• Multi-axial Diagnosis  In the DSM-IV-TR system, technically, an individual should be diagnosed on all five different domains, or "axes." The clinician looks across a large number of afflictions and tries to find the best fit.  Using a single axis approach, which we often do as laymen, can be misleading -- looking at 1 or 2 metal illness and saying "that's it" -- if you look at 20 of these things, you may find yourself saying "thats it" a lot.     A note in the DSM-IV-TR states that appropriate use of the diagnostic criteria is said to require extensive clinical training, and its contents “cannot simply be applied in a cookbook fashion”.

• Don't become an Amateur Psychologist or Neurosurgeon  While awareness is a very good thing, if one suspects a mental disorder in the family it is best to see a mental health professional for an informed opinion and for some direction - even more so if you are emotionally distressed yourself and not at the top of your game. 

I hope this helps keep it in perspective.  

Skippy



DIFFERENCES|COMORBIDITY: Overview of Comorbidity

Additional discussions... .

Personality Disorders

Borderline and Paranoid Personality Disorder

Borderline and Schzoid/Schizotypal Personality Disorder

Borderline and Antisocial Personality Disorder

Borderline and Histrionic Personality Disorder

Borderline and Narcissistic Personality Disorder

Borderline and Avoidant Personality Disorder

Borderline and Dependent Personality Disorder

Borderline and Obsessive Compulsive Personality Disorder

Borderline and Depressive Personality Disorder

Borderline and Passive Aggressive Personality Disorder

Borderline and Sadistic Personality Disorder

Borderline and Self Defeating Personality Disorder

Other

Borderline PD and Alcohol Dependence

Borderline PD and Aspergers

Borderline PD and Attention Deficit Hyperactivity Disorder

Borderline PD and BiPolar Disorder

Borderline PD and Dissociative Identity Disorder

Borderline PD and P.T.S.D.

Borderline PD and Reactive Attachment Disorder (RAD)

[peacebaby]

Here's my take... .Horrible childhood abuse tends to create mental illness, especially with family histories of drug/alcohol addiction or mental illness. Sometimes kids make it through basically sane. But most do not, and most when they are enduring the abuse, must dissociate to survive it. I think there are a lot of variables involved, and this early dissociation can continue to be used as a coping mechanism and potentially morph into DID (dissociative identity disorder) or BPD. Or other mental illnesses.

My dBPDso has the Jekyll and Hyde thing - most of the time she's sweet and child-like, thoughtful and generous and accepting and loving. And then when she dissociates so badly that she has a full psychotic break, her face literally gets darker, her eyes deeper and scary, and her voice changes, the way she speaks is different. The nice, self-effacing person is replaced by an abusive b_tch. I know it's her, it's not a different personality--it's part of her personality that only wakes up when the working part of her brain is triggered in particular ways and stops working right.

My partner remembers everything that happens during these times. She says it's like a dream where she's watching herself from above, unable to control herself, unable to really feel that it's her doing the things she's doing.

Sometimes she fears that it is DID, most of the time she says she knows it's not. (She knows what's going on. She has all 9 diagnostic criteria of BPD, plus PTSD, PMDD, and panic attacks. But not the symptoms of DID.

Like DID, though, BPD is often developed during childhood abuse as protection. The horrors are too great for the little mind to cope with, and cause it to split, to separate the awful things into compartments in a way that allows a part of the mind to remain sane--as opposed to someone who becomes full-time psychotic. So in that way, the diseases have similarities--DID creates different personalities to handle various and/or triggering things, while BPD creates different behaviors to handle triggering situations and emotions. Point is, there's a vulnerable person that's protected by a tougher personality (DID) or an a$$hole persona (BPD).

I don't know a ton about DID, and I base my opinions on BPD on my readings and my experiences with my partner.  BPD has lots of other criteria, the DID-like aspects are only a part of this disorder, and I imagine that DID has lots of stuff BPD doesn't have, like there are a bunch of different personalities that handle different situations and they all have different names--note the name of the disease was changed from "personality" to "identity" implying that those with DID do have these separate identities with different conciousnesses and experiences.

And again, this is my theory for those who got these diseases as a partial result of childhood abuse. I know that they can develop without the abuse, but I don't know how that works.

Peacebaby

[GaGrl]

My husband's ex-wife would dissociate to violence or near-violence but swear later that she did not do it, say it, or remember it.  This included telling him that if he ever left her, she would burn down the house with the children in it.

[JoannaK]

Just for the record, here's the intro to DID from Wikipedia:

Dissociative Identity Disorder, as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), is a psychiatric diagnosis that describes a condition in which a single person displays multiple distinct identities or personalities, each with its own pattern of perceiving and interacting with the environment.[1] The diagnosis requires that at least two personalities routinely take control of the individual's behavior with an associated memory loss that goes beyond normal forgetfulness; in addition, symptoms cannot be due to substance abuse or medical condition. Earlier versions of the DSM named the condition multiple personality disorder (MPD) and the term is still used by the ICD-10. There is controversy around the existence, possible causes, appearance across cultures, and epidemiology of the condition

www.en.wikipedia.org/wiki/Dissociative_identity_disorder

[Bitdawg]

I truely beleive there is a connection between the BPD and MPD. Prior to leaving a 20 year relationship with a BPD, the last year and a half I keep a journal of all her chaotic and bizarre moments, which I recorded her behaviours, anger outbursts, rages, ect... .I journaled and audio recorded these occurances for court proceedings, per my lawyer, because children were involved.  In a nine month period, I recorded 56 pages of arguements and 40 hours of audio.  Referring to Hurricanes, these arguements were Category 4 and 5 range.  My BPD wife, after a cool down period and when asked, did not remember one single incident.  When asked in court about these arguements, she stated se could not remember, when certain arguements and the issues of those arguements were brought up, she stated they did not happen.

The strange and awe inspiring part of the arguements I still have trouble with, is she looked directly over the top of my head while raging frantically, her face white as a ghost, not bulging red like one would think and her eyes were glassed over.   

[cult]

I do believe there is similarity between DID and any of the other dissociative disorders, including BPD and even severe depression. The difference is that in someone with full blown DID, the dissociation is much more severe and dramatic. Whereas someone with BPD has the classic "Jekyll and Hyde" dynamic, someone with DID is literally harboring different people within themselves. Each of the dissociated parts has a different name, different abilities (including being able to speak languages the other alters cannot), and different relationships with the outside world of which the other "alters" are usually totally ignorant. Someone with DID might be named Jane on her birth certificate, but at work she is known as Mary because that is the alter who got the job. She might lose the job because Denise, a three year old alter, comes on the scene one day and bursts into tears in the middle of an important meeting. Typically, in someone with DID there is one core alter who has all the dirt about all the others. Getting this alter to participate fully in therapy is usually required to achieve any sort of effective treatment.

Though there is some debate as to whether or not DID had its glory day as the "mental illness du jour" in the mid eighties and is nowhere near as prevalent as once was thought. Recent revelations that the two most famous media portrayals of DID, "Sybil" and "The Minds of Billy Milligan," were both fabricated didn't help on the credibility front either.

BTW, it is commonly believed that people who end up having DID suffer the worst kind of ritualistic abuse, such as Satanic cults, etc. It takes a LOT of very intense, very evil and prolonged abuse to produce DID, from what I understand.

Cult

[letitgo]

I did a research paper for first yr college english course on MPD in mid 90's.  It was very difficult to find info on the subject.  Cult, the info you just provided on MPD is how I understood the mental illness.  The one thing that has always stuck in my mind about the dissociation and going into other personalities are the headaches they get as they are about to go into another personality.  Therapist in fact go by the headache before change in personality as an indication that they may be MPD.  My exBPD had headaches (migraines) frequently.

I'm definitely with you Bitdawg!

[moscowpurple]

Hi,

I am a new member but have been involved with someone who has BPD and DID. 

My experience and understanding is that the two conditions are often comorbid or co-exist. 

My BPD person experienced terrible childhood abuse and still dissociates to this day when under any kind of stress.  I think it makes the experience for the non even harder because not only do you get the classic BPD push pull, etc but also the fragmentation of DID.

[SOOOdone]

I am taught that it is a matter of degree. A multiple personality doesn't usually remember one from the other as they transition.

A split is where the two "personalities" are concious of each other at once. Therefore they can say two opposing statements and mean both. (I hate you don't leave me)

[GENERAL ANNOUNCEMENT]

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[notmyproblem]

My stbxbph has been dx with both BPD and DID, the explanations I have read here on this thread are pretty accurate.  I have avoided talking about his DID problems on this site so that it wouldn't get confusing and I am actually glad that someone brought it up.

On a personal level dealing with someone with both is so difficult that I actually envy some of the stories I have read on this site.  My stbxbph is currently in a personality that can't remember any of the bad things that he has done and can not understand why I won't work it out with him and thinks that I have not allowed him to see his daughter over the last 4 years (even though I took her to see him on 3 separate occasions), when in reality he hasn't made any effort to see her and when he has made an arrangement to come see her he always changed his mind (personality), he also doesn't understand why she (D) doesn't want anything to do with him.

It seems to be an age thing for him, each personality has an age that is anywhere from 3 to 50, and different people and circumstances bring out different personalities, so his friends know one person and his work another and his family knows the rest, either of the two people he is when he is at work or with his friends, I could live with, but at home aarrrggghhhhh!

I can tell which personality he is in by how he talks, what vocabulary he uses, his writing changes, his memories change and more so than just changing something to be better than it actually was, he doesn't even remember that something happened, I have had to break up with him numerous times.  It has taken me 4 years to get to the legally separated stage, because every time I get him to realize that we are not getting back together, he switches personality and starts talking to me as though everything is fine.

He has to keep everything very simple, He has to write everything down to keep track of what he is supposed to be doing and when he does forget to do something or loses something it is always my fault (more so than just with the BPD), and he really is convinced that it was me, because he can not remember having anything to do with it.

Wow, this is just too much right now, to talk about, as I wasn't prepared to discuss the DID, if you all are interested in knowing more, I will be happy to share... .but not tonight.

[colonel]

My friend is diagnosed as DID and BPD as well. I agree with notmyproblem's comments about the age thing. My friend has about 5 personalities, each at a different age - supoosedly they are ages when traumas happened, major or minor, and the person couldn't cope so split off into another personality. The worst part is the person I knew so well is the one that never comes out anymore and she's forgotten about. That persona was the one I fell in love with and then spiralled out of control as what I now know as BPD. She described it as there being too much pain and darkness so she put her to sleep for a very long time. She says that persona is locked away some where way down deep inside her and may never come back because it hurts too much. my friend has changed her name and doesn't remember things that happened before, right down to interests and core values. The original used to be a passionate reader, confident and a great leader - she was training to be a teacher and would have been darn good at it. When everything happened she gave up on that goal, I once made a comment saying it's a shame she would have been good at it and she replied with no x would have been good at it, she's alseep now, y has no interest in anything like that. the other personalities are  also used to split things off from herself that she doesn't  like. She has one character who is sick with bullimia and anorexia, one that represents her sexuality who she doesn't like, one that represents her anger etc. It makes it hard because when she behaves in BPD ways she either doesn't remember them because it was a different persona or separtes herself from responsibility, saying it's not my fault i needed to cut you made character y come out. Or you made character z feel threatened and about to be abandoned so she lashed out at you with intense anger to protect the main persona. How i didn't end up in a mental hospital myself from dealing with it I don't know. Having both is incredibly difficult.

[FloatOn]

Dissociative identity disorder (DID), also known as multiple personality disorder, is "a psychiatric diagnosis that describes a condition in which a single person displays multiple distinct identities or personalities (known as alter egos or alters), each with its own pattern of perceiving and interacting with the environment."  According to wikipedia's page on BPD, it is suggested that if a patient meets all 9 diagnostic criteria for BPD, they be tested for DID.

This is pure speculation on my part, but it seems like BPD and DID may be related through the same mechanisms of brain function. I think DID is a more severe form of BPD. Here is how I'm thinking of it: those with BPD have a split "emotional memory" of other people who are close to them. They are unable to integrate the positive and negative emotions about a loved one, so they are either "all good" or "all bad" depending on whatever they are triggered towards at the time. They may dissociate often, and they also unconsciously mirror their new partner in the early stages of a relationship taking on what seems to be a whole new personality.

I believe that DID simply takes this process a step further, and those with DID are unable to integrate ANY aspects of their memory and their different personalities. Their multiple personalities have completely different attitudes, beliefs, and perceptions. And they often have associated memory loss such that they can't remember things when the other personality takes control.

My experience with those who seem to have BPD is that they can take on vastly different personalities, depending on who they are around and what mood they are in. And SOMETIMES they don't even remember the details of what happened when they were triggered -- they are either denying it, distorting events, or are outright delusional about what happened. In general, they do have a memory of events but the one thing they seem to lack is the emotional memory of people or events. I know from my experience I feel like those with BPD can become "completely different people" when they are stressed out and triggered. It's like you don't even know what happened to the person you knew. It seems like nearly everyone else on these boards feels the same way at some time in their relationship with someone with BPD.

So what do you guys think: is it possible DID is a more severe form of BPD? Such that the patient with DID doesn't have the ability to integrate any, or nearly any, aspect of their personality or memory, while the person with BPD cannot integrate their positive/negative perceptions of themself and others and can't integrate their emotional memory? Basically, BPDs can't integrate emotional perception, while DIDs can't integrate any perception (hence the complete split in personalities) of themself/others.

[TroubledNYC]

Actually, my T would agree with this assesment as she has told me that that BPD and DID are on what T's call a 'continum' of the psycholgoical state of mind and that DID is much further down the line from the personality disorders like BPD or NPD.

[karmickiss]

Hi All,

  I have been a member for quite some time, but haven't been here or posted in a long time. OK... so I have/had several people with BPD in my life... .my late partner, was the only one who actually really made progress(with treating BPD, he was willing, as tough as it was for him, and made progress), we had individual AND couples therapy... .but I'm digressing. This board helped me out so much in the past, so I want to at least add in what I know.

  I have DID... and yes, there are some commonalities... like dissociation continuum... and the depression, anxiety, self destructive at times... etc. goes along with DID(and BPD, but varies person to person in severity) ... but not in the same way... .the personality splits, but for different reasons... DID develops in early childhood years from chronic, sustained abuse too traumatic to deal with, parts are made to hold the memory away from consciousness... .a coping skill to continue carrying on at the time, keeping one more sane than not. It becomes dysfunctional in adulthood, when the danger is no longer persent, and for many other reasons... .

  There are differences in both BPD and DID depending on the individual... but I can say illicting pity or admiration is not a part of who I am... I do have a stronger sense of self... and there are varying levels of perception. DID people can be super high functional for a long time, and spend an average of 7 years in the mental health system until the read diagnosis is found. It often might at first look like BPD, or bi-poloar... .but honestly, the bare bones of it... .they are really different things... .totally. I have been healing and in treatment for myself a long time... I do have co-consciousness unless it's a certian kind of situation, or a certain altar out... .but this is worked on in therapy... .any one of my neighbors would be shocked to find out I had DID if I were to tell... I can say that! LOL. The system I have has been made to "blend in", and mostly we want to hide, not be the focus of attention.

   Basically... there can be personalities that might have a leaning towards several BPD components(separate personalities can have their own separate mental health issues, along with other things), but at least none of mine fit that bill truly and totally... .and actually... .the ones I'm aware of are not BPD. There's the whole manipulations, and... .OK... .maybe it's easier to concentrate first what seems similar, this is a topic close to my heart... .b/c if I had been treated all along as BPD... I would not be well or as well as I am right now... .so... there's dissociation... .DID is more extreme in that... but the reasons for are usually different. Seeming like a different person, I can only speak personally, and with the BPD's in my life, it's really exposing what their fears and distortions look like, up close and personal. These things are always lurking in there but often controlled or hidden, like a "slip" into true feelings... instead of triggering into an altar personality that was formed a long time ago, and has their own distinct history, ones I don't know all of, often... but we've learned how to work together,... and that is our integration... .OK... this is a lot at once, sorry. The other things... .depression, well, that is not uncommon for severly abused peoples and in BPD's... but even though I'm having more than one "personality state"... .I have a stronger "sense of self"... than most BPD's I've met. Anxiety... .usually with me related to PTSD... .Often there are diagnosis's that have many things in common... .but are fundamentally different. I think the strongest common denominator would be dissociation... and that varys person to person in either dx as well. I can have altars that fear being abandoned, usually child altars, but for totally different reasons... and abandonment as a fear is not near number one... at least not for me... one of my abusers is BPD... .so I have parts that learned how to relate with her... .but we/I still dont "get it"... or am continually surprised and hurt by certain BPD behaviors to this day... even though I intellectually know it's there, and try to brace myself for it, it's always shocking to me the lines of thought and black and white thinking, to name a few... .Then with working through therapy with me and my late partner(we were together a decade) who was BPD... even though I have a splintered self(though much more managable these days)... there were separate and distinct bottom lines for both of us. The therapist that did the couples counseling, was pointing out always things about BPD for him and DID for me... .and how we played into each other to unhealthy extremes... .like he loved to BLAME... .nothing was ever truly his fault, taking responsibility... .etc... .and I loved to TAKE BLAME... even blame that was not mine to take, so our fundamental problems and how we related to people and each other were very different. Most of me takes on too much blame, so differnt parts, but same person... .with me... .even though we are several... .the same underlying personality... that is a damaged person that takes on too much, instead of the other way around... .making us a perfect target for BPD's... .or at least it used to... .we can spot things and about face now better than ever before. I loved my partner, and we "made it"... but I don't think I'd ever willingly get into that situation again... the amount of work... etc... .I have enough with just me(s)... .LOL... .

WHEW! Enough from me for now... .just a topic I feel a lot about... so I got sucked in... .Wishing all of you the best today! Sincerely, karmickiss

[JoannaK]

Thanks for the personal explanation, karmickiss!

We do have a Workshop on Dissociation and Dysphoria which may be of interest:

https://bpdfamily.com/message_board/index.php?topic=68392.0;all

[karmickiss]

Hi All,

  Thanks, JoannaK! This is interesting. Oh the tangled web! I am endlessly fascinated with dissociation, as in how it's experienced in BPD... .even after all this time, reading, counseling... .with people with BPD and with myself with DID... .Very interesting how it's the same... .dissociation... but there are also differences in it(at least if I'm reading right, and if I understood the people that had Dx'd BPD and were willing to share about their dissociation symptoms)... in ways I'm still putting my finger on. It's been a while... .I am still friendly with the young man who was my biggest problem area last time I was here.

  It's been tough, just b/c my late partner really made strides... and we had some "gift time" together, where things were finally more peaceful, loving and honest than I'd ever have imagined. But, that was the exception... .there's my mom... and then like I said, this young man, who has been my friend(and we had a fling, long time ago) but I had to put some boundaries into place. The thing is, the male figure in my kids lives. They really miss their step dad still... of course... .and this friend of mine... they just didn't want to lose all contact... .and I didn't want to "take away" another person they are familiar with... .So... .also out of love, we stay at a certain connectedness. The neat thing about my friend, vs. my mom, is that he is aware of his BPD to a surprising degree. He is unable at this time to go to counseling with it... he has the official diagnosis... .but... .

   OK, don't want to run away with the thread... .but I felt it was time to come back around here for a good refresher course... .as I'm still needing to set and maintain boundaries... .the kids notice it too... but don't really know why... or about the dx... .and I just found myself needing to "check myself", so that I can keep a happy balance... it can be easy for me to fall back into accepting unacceptable behavior.My boys do know about my DID... and that's interesting, but they take it in such stride, and are not "exposed" to this in a negative way... .nor do I put too much emphasis on it besides answering anything they might have to ask from time to time. Kids in general are so much more accepting, and they understand so much more than they are sometimes given credit for. This was ironically a great thread for me to jump back in with. Again,thanks for the info link! Sincerely, karmickiss

[jTrue426]

Has anyone encountered splitting so severe that they suspected DID? Is there a thread or info along these lines?