The Long-Term Effects of the Formation of Dissociative Identity Disorder

People who have dissociative identity disorder have difficulty integrating their memories, their sense of identity and aspects of their consciousness into a continuous whole. They find many parts of their experience alien as if belonging to someone else. They cannot remember or make sense of parts of their past.

It is easy to dismiss the long-term effects of dissociative identity disorder (DID) as they tend to get lost in the shuffle of survivor mode for many living with the disorder. However, recognizing how the formation of DID can change one’s life long-term can help to mitigate the worst of the effects and how they can hold one back from the healing process.

There are some severe impacts that DID has on the person living with it, that are not named in the DSM-5. These include impacts on emotions, relationships, sexuality, social functioning, and physical problems.

This article will take each of these topics one at a time

Two of the Long-term Emotional Impacts of Dissociative Identity Disorder

The emotional impact of having dissociative identity disorder have tremendous power to alter the course of one’s life. Below are just two of these emotionally distressing changes.   

Depression and Anxiety. There are several reasons why a person living with DID would experience depression and anxiety.

One reason is that the alters in their system are not living in the now, they still exist in the past and the trauma that happened in childhood is still happening. The feelings of hopelessness and helplessness as well as the anxiety they carried as children, can surface and often the waking self does not understand where these emotions are coming from.

Also, depression and anxiety can be exacerbated by the tremendous stress on the waking self after entering therapy. One cannot overstate the enormity of having to not only face your past, but to have to also accept it as one’s own. 

Low Self-Esteem.  A person’s outlook upon themselves is greatly shaped by how they were treated in childhood. If the child is nurtured and told they are good and worthy, they will grow up with those same internal values about themselves.

However, if the child lives in a home where they are devalued, and where they are given negative messages about themselves, they will internalize these messages and as adults, will seem themselves as what they were told.

It is like a tape is played back in the person’s mind, reminding them over- and- over how they are not worthy of life, that they are a waste of space on planet earth.

The Long-Term Effects on Relationships

As children, adults who live with DID were not nurtured, rather they received the harshest of treatment from their caregivers. The results of that treatment, in adulthood, are devastating.

Interpersonal relationships become traumatic in and of themselves. The adult survivor tries very hard to make sense of what is expected of them, while struggling with the flashbacks that having a relationship can bring.

Parenting Difficulties. Having not experienced good parenting themselves, survivors find themselves not understanding what how they should handle their own children.

People who live with DID also find they are having difficulties because of the switching to other alters. They may switch to an alter who, either are children themselves are incapable of being a parent, or to alters who can parent but the amnesia keeps all knowledge of what was said and done apart from the waking self. The resulting confusion for both the survivor and their children can be tragic.

Trust Issues.It isn’t hard to see why survivors of severe and repeated would have trust issues in adulthood. As children, their caregivers often sent them mixed messages and the rules of what would get them acceptance or punishment changed. As children, they lived in a world of fear and longing. They feared their abusers but longed for their love.

In adulthood, these feelings persist. The adult survivors may hold all friendships and intimate relationships at an arms-length. They may either become clingy or push any kind of intimate feelings deep inside. Some survivors avoid relationships altogether, preferring to remain alone and isolated.

Sense of Betrayal.As children, adult survivors were living in a world where they were used and betrayed. These feeling persist into childhood, making the survivors suspicious and aloof.

They may have a sense that they are never safe and be ever looking for security. Unfortunately, for many, this means never stepping outside their comfort zone.

The Long-Term Effects of DID on Sexuality

Survivors have great difficulties when it comes to their sexuality. This is understandable, especially if the trauma involved sexual abuse.

Abusers of children give them such horrific messages. Some, but certainly not all the messages might have been:

“You’ll never have another lover like me”

“I’ll kill you if you ever have sex with anyone else but me”

“I’ll kill your pet if I catch you in the bushes with a boy/girl”  

Although the adult survivor understands that those messages were bogus and criminal, they still feel the emotions attached to them. This is especially true with people living with dissociative identity disorder. Their alters are still living in the time of the abuse (trauma time), and the emotions are in the here and now, not the past. 

Fear and Avoidance of Sex. Some people living with DID avoid any type of sexual activities. They may masturbate, but they cannot and will not engage in sex with another person. To them, sex is frightening. Even after many years of treatment and working to dissuade the negative emotions from the past, the fear of intimacy can persist.

For this reason, many survivors choose to live alone, and not to have anything in their lives more than casual acquaintances.

Promiscuity.It is interesting that some people who live with DID, will err on the other side of the sex continuum. They may have many sexual partners or become prostitutes.

This is also related to the maltreatment and message received in childhood. If a child is told they are a whore, or that the abuse is their fault, they may grow up believing they are a worthless piece of meat.

There is, perhaps, another explanation. Survivors of such hideous abuse may be   forever looking for someone to love them and have equated love with sex. They may feel if they fulfill another person’s sexual desires, that the other person will reciprocate with the love they crave.

Either way, the effects on the sexual behavior of a person who has lived through severe and repeated childhood abuse are horrific.

The Long-Term Effects on Social Functioning from Dissociative Identity Disorder

As on can see from the above effects, it is very difficult for people who live with dissociative identity disorder to have any kind of normal social life.

Isolating. Often people who have endured severe and repetitive abuse as children, will prefer to remain alone. Some will become agoraphobic (a type of anxiety disorder where one feels fear and avoids places or situations that might cause a panicky feeling of being trapped or embarrassed).  Even when forced to be in a group of people, such as at school or work, they remain aloof, choosing not to interact with others any more than necessary. 

Avoidance Behaviors.We have learned a few things about avoidance behaviors in a former chapter. People who live with DID often find themselves avoiding places or situations that they find triggering. This behavior is understandable, but such avoidances can rob them of two things.

One is the ability to go places that others take for granted.  A good example might be the perfume aisle in a department store. Strong odors, such as cologne, can set off the person with DID’s alarm system if they were abused as a child by someone who wore strong cologne.

Two. They rob themselves of allowing the past to become the past. A place, such as a building where, as children, they were abused, is just that, only a building. In allowing themselves to keep avoiding the building or other place where the unimaginable happened, is to live in the prison of the past and give power to their abuser.

Inability to Hold a Job. Holding down a full-time or even part-time job requires that one have some measure of control over their lives and actions. Unfortunately, this can be impossible for some who live with dissociative identity disorder. Because the alters are so active, and time so fluid, it can be extremely difficult to be a dependable employee.

Not only is the above true, but the extreme fatigue which accompanies working on these issues wears one down. After a while, many will become suicidal and need hospitalization. Employers can only be so patient before they are forced to fire someone whom they cannot count on being on the job.

There are many people who live with dissociative identity disorder who find themselves applying for disability from the federal government. While this is very helpful in sustaining their lives, it is also a trap. Once on disability, it is very difficult to get back to work.

Usually the person with DID will lose many years of work, leaving a huge hole in their resume. When they apply they are eyed with suspicion, or worse. 

Also, gaining employment that pays enough wages is getting tougher and tougher in today’s economy. The prohibitive cost of therapy and other services demands that the position not only pay enough to pay the bills, but also offers insurance that covers mental health providers.

A Disturbed Body Image. One of the least spoken about aspects of living with the diagnosis of DID is the way people living with the disorder perceive their bodies. People who live with dissociative identity disorder often ignore their bodies, as though it were foreign. Worse, they may abuse their bodies because they see it as enemy. This happens for two reasons.

One. They were told repeatedly as children that their bodies were gross, ugly, dirty, or all three. That is why so many people diagnosed with DID have eating disorders as well. It is easy to neglect or torture a body that you feel is not good, is ugly, or that you do not claim as your own,

 Two. The alters in the person’s system may all have different body images than what they should see in the mirror. They may be thinner, shorter, taller, or even a member of the opposite sex. It has been reported that some alters are animals either real or mythical.

The problems associated with having an altered body image aren’t only eating disorders. The person living with this diagnosis may be constantly frustrated because they are older or younger than the body’s true age. They may try to do things that their body can no longer do such as stay up late the night before work.

The treatment for a disturbed body image involves using a mirror to view oneself in the nude. This treatment should not be undertaken without a therapist’s knowledge, as the negative emotions that are evoked can be very strong as the old tapes of how ugly the body begins to replay.

The good news is that after spending time viewing their bodies, when reinforced by a therapist, a new body image can emerge where they no longer hate or want to harm their bodies. 

The Long-Term Physical Effects from DID

Since dissociative identity disorder is a mental health issue, many people overlook how having such a distressing disorder can affect people physically.

The list of physical problems in survivors is long and frightening. I’m going to list them below, to show how damaging abuse of children truly can be.

The list is longer, and more long-term physical effects are being found all the time.

It is believed that the constant influx of stress hormones flooding a child’s body compromises the immune system, setting the child up for enormous physical problems later in life.

Yet another sobering reminder of why we must end the epidemic of child abuse in our culture. 

The Topic of Self-Injury

Self-injury or self-harm is one of the most drastic effects that comes from having DID. A huge percentage of people living with the diagnosis of dissociative identity disorder will self-injure in one form or another.

What do I mean by self-jury?

Cutting, burning, or any other abuse of self, done by survivors to themselves. Many who do self-harming activities report feeling a profound sense of release from the horrendous stress and fear they had felt. Perhaps the brain release of endorphins explains this phenomenon. The jury is still out on this one. 

There is also passive self-injury such as not feeding oneself or exercising excessively. Lying about in bed and not bathing or eating is another form of self-harm.


Unfortunately, approximately two percent of those who are diagnosed with dissociative identity disorder will die by suicide. There are many possible reasons for this tragedy, including becoming too emotionally exhausted from the struggles of dealing with the disorder and therapy.

However, the most intriguing of these explanations come from a clinical observation paper of a doctor who lost six clients to suicide who lived with DID.

“Five of the completed suicides had in common the use of lying to attain their goals, ready rationalizations for dishonest and inappropriate behavior, disrupted or failed therapeutic alliances, a delusional intensity of the alters convictions that they enjoyed complete separateness, and the alters entertaining mutually incompatible subjective understandings of their personal realities.”  (Kluft, 1995)

Whatever the cause, suicide is a possible consequence of living with such a hard to understand and accept diagnosis as dissociative identity disorder.

Pulling Things Together

It may seem from what is written in this piece that one can never overcome all of the effects dissociative identity disorder has over one’s life. However, you would be wrong.

The things spoken of in this article are sobering, yes, and one can see the long-term effects of child abuse, which is believed to be the cause of dissociative identity disorder are devastating. However, there is life after treatment for this enigmatic disorder, life that is full of joy and triumph.

It takes many years of good therapy, dedication, and guts to gain any ground on these issues. However, although it is very hard to travel down the road less taken to recovery, many men and women have traversed it, nonetheless.

Some of the bravest people on the planet are survivors of childhood trauma who are facing their pasts and their lives head-on.

“Strength doesn’t come from what you can do. It comes from overcoming the things you once thought you couldn’t” ~ ​Rikki Rogers

“Trauma creates change you don’t choose. Healing is about creating change you do choose” ~ Michelle Rosenthall

“And here you are living despite it all” ~ Rupi Kaur​


Davis, S.J., 2019. The Last Comprehensive Resource Book About Dissociative Identity Disorder You Will Ever Need. Kindle Press.

Kluft, R. P. (1995). Six completed suicides in dissociative identity disorder patients: Clinical observations. Dissociation: Progress in the Dissociative Disorders.

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