Teenagers with dissociative identity disorder (DID) experience intense shifts in their self-identity. They may feel as though different parts of their identity are in control at other times. This can be very distressing and make it hard for young people to take care of themselves.
There isn’t a lot of data about the prevalence of DID among children and adolescents. However, some evidence suggests that dissociative tendencies may be even more common among young people than among adults. Around 1% to 1.5% of adults experience dissociative identity disorder.
Sadly, self-harm and suicidality are common among young people with DID, especially if they are not receiving mental health support. That‘s why it’s so essential for young people to access reliable diagnoses and effective treatment.
What Is Dissociative Identity Disorder?
Dissociative identity disorder is a type of dissociative disorder. Teenagers may be diagnosed with dissociative disorders if they have regular experiences of dissociation that are distressing and affect their daily life. Sometimes teenagers may have dissociative experiences that are symptoms of a different mental health disorder. In this case, they may not receive a dissociative disorder diagnosis.
Adolescents with dissociative identity disorder may experience:
- Several identity states that have different ways of thinking and relating to the world
- Identity states that present as different ages or genders
- A ‘main’ part of their identity that feels most like them. They may refer to it as their ‘host’ identity.
- Identity states that have memories and experiences that contradict each other
- A sense of lack of control over when different identity states take over
- Amnesia (lack of memory) about their inner and outer experiences when another part of their identity was in control
Sometimes, teenagers with DID may feel like they have several completely different personalities. However, in reality, they are experiencing various aspects of the same personality. Some young people may conceptualise their identity states as parts, and all these parts together as a system.
How Common is Dissociative Identity Disorder Among Adolescents?
There are still limited studies about the prevalence of DID among children or adolescents, or dissociative disorders in general. In two notable studies, around 2 to 5% of adolescents experienced pathological dissociative symptoms. However, only some of these would meet the diagnostic criteria for DID.
A study among 116 young people between 11 and 17 years of age at an outpatient clinic found that 45.2% had a dissociative disorder. 16.4% had dissociative identity disorder specifically. Of course, DID is likely to be much more common among adolescents in an outpatient clinic than in the general population.
Dissociative disorders usually begin in childhood, in response to ongoing childhood trauma. Despite this, fewer than 8% of diagnoses of the disorders are among those aged 12 to 18. Adolescents with dissociative disorders are often misdiagnosed because their non-dissociative symptoms overlap with other disorders that are common among adolescents. Sometimes, dissociative symptoms are almost entirely masked by different traits and behaviours.
While with an accurate diagnosis, treatment for dissociative disorders can be very effective, missed diagnoses often prevent any meaningful recovery. This means that providing reliable and precise diagnosis processes for adolescents is important.
Why Do Some Young People Develop DID?
Dissociative identity disorder and other dissociative disorders develop in response to childhood experiences of ongoing trauma. Dissociation can be a way that our bodies cope with trauma in the moment that it’s happening. But it can also be a way that individuals cope with trauma over time, mainly if they never process traumatic experiences or find other ways to deal with stress.
This can lead to long-term dissociation that persists even after the traumatic experience has ended.
Why Do People Dissociate In Response to Trauma?
There are several different ways that children and adults can respond to threatening situations. Experts often conceptualise them as fight, flight, fawn and freeze responses.
- Fight responses involve fighting back against the threat
- Flight responses involve escaping from danger
Sometimes a person may be unable to fight back or escape. This happens to young children and individuals who are unable to leave the situation they’re in. They may then experience a freeze or fawn response.
- Freeze responses make the body immobile, feel paralysed, or unable to move
- Fawn responses involve trying to please or ‘win over’ the source of the threat
Freeze responses are the kind of trauma response that is most connected to dissociative experiences.
How Do Dissociative Identity Experiences Develop After Childhood Trauma
Sometimes, traumatic events can be too scary, distressing, or intense for our minds to process all at once, especially for children. Instead, a child might separate different parts of their experience so that their thoughts, actions, memories, and sensations all feel separate. They may suppress certain parts of their memories so that they can’t access them alongside other memories.
While this may help children to cope with their experiences, it can make it hard to develop a clear identity during the rest of their childhood, adolescence, and adulthood. Sometimes, this disruption to self-identity and memory may cause young people to build experiences of separate senses of self or identity states. This may be especially likely when children experience isolation or alienation following abuse, making it harder for them to process their experiences and construct a coherent narrative.
Not everyone who experiences childhood trauma develops DID or another dissociative disorder. Research suggests that certain biological vulnerabilities and traits may make some people more likely than others to develop DID in response to childhood trauma.
DID and Normative Dissociation in Teens
It’s essential to distinguish dissociative identity disorder and normative (non-pathological) dissociation. Normative dissociation describes experiences like fantasy, daydreaming, and absorption in specific tasks that are an ordinary part of life. These experiences are widespread among young people.
However, normative dissociation is very different from the severe identity disturbance and emotional turmoil associated with DID. And recognising these differences is fundamental to accessing the proper support. Without professional help, dissociative identity disorder can cause severe distress and harm, including self-harm and suicide attempts.
Dissociative Identity Disorder and Co-Occurring Disorders
Co-occurring disorders are very common among young people with dissociative identity disorder. One study found that 82% of people with DID had at least one other co-morbid disorder in their lifetime. Another study found that 93.9% of adolescents with dissociative disorders had an additional co-occurring disorder.
Evidence suggests that the most common disorders co-occurring alongside DID are major depressive disorder and post-traumatic stress disorder. Other common co-occurring disorders include separation anxiety disorder, attention-deficit hyperactivity disorder, and oppositional defiant disorder.
Treating Dissociative Identity Disorder
Dissociative identity disorder is very distressing for young people and can make it hard to stay well. However, with proper diagnosis and treatment, many adolescents can make a full recovery. This means that the separate parts of their identity can become a single sense of self.
Sometimes, adolescents don’t stop having dissociative symptoms entirely. But with treatment, they can have more control over their identity.
Treatment and recovery can take some time, so it’s essential for young people and families to be patient and easy on themselves. Most young people benefit from multiple treatment approaches.
These might include:
- Talking therapy helps process traumatic events and understand the causes of dissociation. Therapy can also teach coping mechanisms and skills to navigate relationships and emotions.
- Eye movement desensitisation and reprocessing (EMDR) helps people process traumatic events. EMDR should be adapted for dissociative disorders by focusing on specific memories for shorter periods.
- Medication such as antidepressants or antipsychotics
The Wave Clinic: Specialist Recovery Programs for Young People and Families
The Wave Clinic provides specialised mental health support for young people and their families. Our programs take a whole-person approach to mental healthcare, combining exceptional clinical care with education and enriching experiences. We’re experts in complex trauma, addressing past experiences with sensitivity and care.
If you’d like to find out more about our programs, contact us today.
