Key Takeaways
- Disassociative identity disorder (DID) is a complex mental health condition that typically develops as a coping mechanism in response to severe and prolonged trauma. Someone with DID has two or more distinct identities, and the condition frequently co-occurs with depression.
- We don’t yet fully understand why so many people with DID also experience depression. However, because trauma is a shared risk factor, having a significant trauma history may make a person more vulnerable to DID and depression.
- Living with both DID and depression can worsen symptoms of both conditions. However, with the right combination of therapy, self-care, and, in some cases, medication, people with DID and depression can improve their stability and quality of life.
Dissociative identity disorder (DID) — formerly known as multiple personality disorder — is a rare mental health condition, affecting about 1.5% of the population. Depression, on the other hand, is a more common concern and is believed to affect approximately 5% of adults across the world. These two psychiatric conditions, while distinct, often go hand in hand. Research shows that the majority of people with DID also have severe depression.
We’re yet to understand the link between DID and depression. However, it appears that trauma may play a significant role in the onset of both conditions. Co-occurring depression and DID can worsen symptoms of both conditions and may increase the risk of suicidality*. So if you or someone you care about is exhibiting signs of these conditions, don’t hesitate to seek professional help.
*A note on safety: If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. Their counselors will provide confidential support and resources to help keep you safe.
What’s it like to have both DID and MDD?
DID and depression (also known as major depressive disorder or MDD) are two different mental health conditions with their own features. Some of the most common symptoms include:
DID symptoms
- Having two or more identities or “alters” with their own patterns of thinking, feeling, and behaving
- Memory loss
- Sense of detachment from people and/or the environment (dissociation)
- Hallucinations or flashbacks
- Loss of time and awareness
Depression (MDD) symptoms
- Social isolation and withdrawal
- Chronically low mood
- Feelings of hopelessness or worthlessness
- Trouble paying attention
- Loss of interest in activities you used to enjoy
In addition to these distinct features, DID and MDD also have some overlapping symptoms. For example, if you have both conditions, you may be more at risk for intense, rapid mood swings and suicidality.* Living with co-occurring DID and MDD is sometimes referred to as “dissociative depression.” In this situation, symptoms tend to manifest earlier and are often more severe. The outlook for dissociative depression is typically worse than stand-alone depression and can be resistant to medication.
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Can depression cause dissociation?
Dissociation is associated with several different mental health conditions, including depression. While experts are still working to understand the link between these experiences, it appears that trauma may play a role.
Pathological dissociation is seen as a trauma response because it provides temporary relief when a person can’t physically escape a harmful situation. Because trauma is a known risk factor for both dissociation and depression, it may be one of the reasons why DID and MDD co-occur so frequently. However, it’s worth noting that many people experience depression without ever dissociating, and the relationship between these conditions remains unclear.
How serious is dissociative depression?
Dissociative depression is a serious and potentially life-threatening mental health concern. People with this condition often experience more severe symptoms and poorer outcomes than people with other forms of depression.
Left untreated, dissociative depression can also increase a person’s risk for post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), antisocial personality disorder (APD), and other conditions.
Treating dissociative identity and depressive disorders together
If a person has co-occurring DID and MDD, they’ll typically require integrated care that addresses both concerns at the same time. While this combination of symptoms can be difficult to treat, the following approaches can be used to help people living with DID and depression.
- Therapy: Talk therapies like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) can be used to address symptoms of depressive and dissociative disorders. These types of therapy can help a person understand how past traumas might be affecting their lives in the present, interrupt unhelpful thought and behavior patterns, learn new coping skills, and form a cohesive identity.
- Medication: Currently, there are no medications approved for stand-alone DID. However, there are medications that can help alleviate symptoms of other mental health concerns like depression and anxiety. If you’re curious about medication, you can always talk to your provider about whether it’s the right option for you.
- Self-care: Although it’s not a replacement for therapy or medication, prioritizing self-care can help keep your mind and body strong throughout your recovery. This can include getting adequate sleep, eating a balanced diet, keeping your stress level under control, and making time for movement you enjoy.
Find care with Rula
DID and MDD are two different mental health concerns that can frequently co-occur. And while experts are still working to understand the link between these conditions, it might be tied to trauma. People living with co-occurring DID and MDD often have more intense symptoms. So they usually require comprehensive care that acknowledges the complexity of their experiences and addresses the symptoms of both conditions. With the right support, people with DID and MDD can find more stability and integrate their identities.
If you or someone you care about needs support for co-occurring DID and MDD, or any other mental health condition, we want to welcome you to Rula. With our streamlined therapist-matching program, you can find an in-network provider who’s right for you in just a few clicks. No matter the issue you’re facing, with Rula, the care you need is easier to access than ever before. You can select the therapist or psychiatrist of your choice today and make your first live video appointment for as soon as tomorrow.
About the author
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
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