Depression and Dissociative Identity Disorder
It is common for people who have dissociative identity disorder to experience depression, in fact, it is safe to say that a majority of them do. Dissociative identity disorder (DID) is hard to live with, add on depression and you have a person who is in deep pain.
This article will focus on the diverse types of depression and how someone living with dissociative identity disorder can cope.
A Brief Description of Dissociative Identity Disorder
According to Psychiatry.org, “Dissociative identity disorder is associated with overwhelming experiences, traumatic events and/or abuse that occurred in childhood. Dissociative identity disorder was previously referred to as multiple personality disorder.
Symptoms of dissociative identity disorder include:
- The existence of two or more distinct identities. The distinct identities are accompanied by changes in behavior, memory, and thinking. The signs and symptoms may be observed by others or reported by the individual.
- Ongoing gaps in memory about everyday events, personal information, and/or past traumatic events.
The symptoms cause significant distress or problems in social, occupational or other areas of functioning.”
A Brief Description of Depression
Depression changes the lives of an estimated one in fifteen adults every year with one in six people experiencing depression sometime in their lifetimes. Depression can strike a person anytime during their life, but it often first appears during the late teens to mid-twenties with women more likely than men to experience it.
Depression is a common yet serious medical condition that can impact negatively the way people feel, think, and act. Depression causes feelings of deep nagging sadness and can be life-threatening if left untreated.
To be clear, everyone experiences some depression during their lifetime, however, when the condition becomes chronic (lasting two or more weeks) one must seek treatment.
The symptoms of depression vary greatly from person to person but may include any or all of the following:
- Feeling sad
- Loss of interest or pleasure in activities once enjoyed
- Weight loss or gain
- Appetite changes
- Trouble sleeping or sleeping too much
- Fatigue
- Increase in movement or slowed movements
- Feeling worthless or guilty
- Feelings of helplessness and hopelessness
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
If one has two or more of the symptoms listed above, seek medical attention at once.
Risk Factors for Depression
Depression is an equal opportunity disease that affects people of all demographic divides crossing cultural, political, and economic lines. However, several risk factors appear to play a role in the development of life-changing depression.
These risk factors include:
Biochemistry. Differences in people of the chemicals in the brain, including neurotransmitters, might contribute to the formation of depression
Genetics. Depression may occur in families with one having a 70% chance of developing depression if their lifetime if they have a close relative who has it.
Personality. People who are overwhelmed easily by stress, have low self-esteem or are more pessimistic appear to experience depression more than others.
Depression, the Brain, and DID
One factor that can play an enormous role in the formation of depression is the environment in which a person grew up. An environment of continual exposure to violence, neglect, abuse, or poverty makes many people more vulnerable to the formation of depression.
The main reason depression affects survivors is that maltreatment in childhood changes the fundamental structure and activity in the brain that can lead to depression later in life.
The brains of children who are severely maltreated or living in an environment full of fear and hopelessness do not get the chance to form correctly in vital regions such as the cerebral cortex (the thinking/reasoning part of the brain) or the hippocampus and amygdala (the fear response and memory consolidation parts of the brain.) (Pandya, et. al. 2012)
The neurotransmitters, the chemicals that allow for communication throughout the brain, are altered as well with adults who grew up in traumatizing homes having less production of serotonin and other “feel good” chemicals in their brains.
Clearly, since depression can be caused by childhood maltreatment that alters the structure and function of the brain, people living with the diagnosis of DID are highly susceptible to forming it.
The Treatment of Depression and Dissociative Identity Disorder Overlap
While there are no magic answers, the treatments for depression often intersect one another.
Medication. There are no magic pills for depression nor are there any medications that can treat dissociative identity disorder. However, medications that alter the chemistry of the brain may help. Antidepressants are the first line of defense as they change the brain’s chemistry, but they are not sedatives or uppers, they simply increase the neurotransmitters in the brain that make a person feel well and happy. They are not habit-forming and can be lifesavers.
The drawbacks to many antidepressants are that they may take two weeks or more to become effective and they can cause sleepiness and fatigue in the first weeks of treatment.
Psychotherapy. Many who have DID already know the value of psychotherapy to their healing. Psychotherapy is also used along with medication to treat the depression and anxiety that accompanies the treatment of dissociative identity disorder which can be long and arduous. Cognitive-behavioral therapy (CBT) may be an effective treatment for severe depression as the therapist will help their client learn to think differently. This is also extremely effective for the treatment of DID.
Electroconvulsive Therapy (ECT). ECT is a medical treatment used with patients who have severe depression that is not responding to other types of treatment. Although it can greatly ease the most troubling symptoms of depression, it should be noted that ECT will not cure or fix dissociative identity disorder. That takes time and dedication on the part of a good therapist and client.
Suicidal Ideation and Actions
Unfortunately, the symptom that both depression and dissociative identity disorder share is the formation of suicidal ideation or actions. While medications, psychotherapy, and ECT might help, here again, there are no magic pills or treatments.
The best way to defeat depression when it comes knocking at the door of a person living with the diagnosis of DID is to stay in close contact with their therapist and work through it by facing depression head-on.
One cannot go around, under, or over depression, the only way out of the darkness that is depression is to go through it. One must make up their mind that the people who harmed them as children will not win by causing them to take their own life.
Life is too precious to give it up to depression or dissociative identity disorder either one. Do not become a statistic. If you are facing the dark abyss of depression with or without a dissociative disorder, please, reach out for help.
The world needs you.
“Your problem is how you are going to spend this one odd and precious life you have been issued. Whether you’re going to spend it trying to look good and creating the illusion that you have power over people and circumstances, or whether you are going to taste it, enjoy it and find out the truth about who you are.” ~ Anne Lamott
“It dawns on you one day… how precious your life is and how not okay it is for anyone, ever, to cause you any amount of suffering, ever. Then the next time you step out the door you look at everyone and you’re thinking, “My life is precious, and you’re not allowed to hurt me.” ~ C. JoyBell C.
References
Pandya, M., Altinay, M., Malone, D. A., & Anand, A. (2012). Where in the brain is depression?. Current psychiatry reports, 14(6), 634-642.