What is dissociative identity disorder?
Dissociative identity disorder, previously known as Multiple Personality Disorder, is a complex psychological condition which is characterized by the presence of two or more distinct personality states or identities occurring within an individual. Each of these personalities will have their own distinct way of relating to, interacting with, and perceiving the world. Often the personalities vary from each other significantly. A person affected with dissociative identity disorder may have one personality who can be described in negative terms and relates to the person in a harmful manner, while the other personality may relate to the person in a friendly manner. The personalities, also referred to as “alters,” often have distinctive physical and mental characteristics as described by the affected individual. People who experience dissociative identity disorder may experience gaps in memory and have difficulty remembering important personal information, periods in time, or events. This is referred to as dissociative amnesia. Often, the gaps in memory are associated with switching between the different identities.
What causes dissociative identity disorder?
The causes of dissociative identity disorder are complex and not fully understood. The condition may develop as a result of a combination of certain factors. One widely accepted cause of dissociative identity disorder is childhood trauma. The type of trauma that may cause dissociative identity disorder is often repetitive and severe, and typically occurs before the age of nine. In this instance, the dissociation is a defense mechanism to cope with traumatic experiences. The trauma can be physical abuse, sexual abuse, or emotional abuse. It may also include witnessing a traumatic event. The creation of separate identities allows the person to compartmentalize traumatic memories and emotions, and allow them to function daily without experiencing feelings of overwhelm from traumatic memories.
Inconsistent caregiving or neglect may also cause the development of dissociative identity disorder. Identity development can be disrupted with fragmentation of the self if a child’s need for a secure and stable attachment figure is not met.
How is dissociative identity disorder diagnosed?
In order to diagnose dissociative identity disorder, a comprehensive evaluation should be performed by a psychiatrist or clinical psychologist. The psychiatrist or psychologist will perform an initial assessment detailing the person’s background, experiences, and symptoms. The psychiatrist or psychologist will evaluate for the presence of dissociative symptoms such as amnesia, memory gaps, and identity confusion. The psychiatrist of psychologist will explore the characteristics, behaviors, and relationships between the alters. As often individuals are not fully aware of their dissociative identity states, family members, friends, or other treatment providers may be able to provide valuable insight as to the person’s overall psychological functioning. The DSM-5 requires that, for a person to be diagnosed with dissociative identity disorder, they must have the presence of two or more personality states or identities, recurrent gaps in recall of everyday events, and significant distress or impairment in the person’s functioning. The symptoms should impair various areas of functioning such as work, self care, and relationships.
How is dissociative identity disorder treated?
The primary treatment for dissociative identity disorder is psychotherapy. Therapists may use trauma-informed therapy, dialectical behavioral therapy, or informed family systems therapy. The goal of therapy is to help the person with dissociative identity disorder develop a cohesive sense of self. Trauma informed therapy focuses on processing and resolving past traumatic experiences that may have contributed to developing dissociative identity disorder. This may include techniques such as EMDR or cognitive behavioral therapy. Dialectical behavioral therapy helps individuals with regulating their emotions, developing coping mechanisms, and developing their interpersonal skills. Internal Family Systems therapy works with different identities within the person and fosters cooperation and collaboration among them. Medication may also be prescribed to manage depression, anxiety, sleep disturbances, and mood swings. However, the condition cannot be treated with medication alone.
Eligibility for Social Security Disability benefits
If you or a loved one is suffering from dissociative identity disorder and are having difficulty with maintaining normal work activity, you may be eligible to receive Social Security Disability Insurance benefits.
Social Security Disability Insurance is a federally administered program for people with a condition which has lasted or is expected to last for at least one year or result in death. The person must have worked and paid taxes on their earnings for at least five of the past ten years in order to have sufficient work credits to be eligible for benefits.
Social Security follows a five step evaluation process when determining a person’s eligibility for benefits. First, you must have stopped working, or be working at less than “substantial gainful activity” levels. For 2023, Social Security defines “substantial gainful activity” as $1350 in gross earnings per month. Then, Social Security will determine whether the person has a severe impairment. This is evaluated based on your medical records, which should be comprised of your therapy notes, psychiatry notes, a record of medication prescribed, and any assessments performed by your psychiatrist or psychologist. It is very helpful to get a statement from your psychiatrist and/or psychologist regarding the limitations you experience as a result of dissociative identity disorder. However, the statement needs to include very specific information addressing Social Security’s criteria. It is best to hire an experienced Social Security Disability firm for guidance on the best way to document your condition.
Social Security will determine your ability to perform certain work related activities such as understand, remember, and apply information; follow work like procedures; and interact with coworkers, supervisors, and the public. With these limitations, Social Security will determine whether you can return to the work that you have done in the past fifteen years. If you are unable to perform your past work, Social Security will find you disabled if you are unable to perform any other jobs at all. It is important to note that Social Security cannot approve the case if it finds that alcohol or drug use made your condition worse. Therefore, it is highly recommended that you abstain from use of alcohol or any drugs not prescribed by your providers.
Navigating Social Security’s system with a complex psychological condition like dissociative identity disorder can be very challenging, and it is important to choose a law firm who has experience with your condition. Our attorneys at LaBovick Law Group have successfully advocated at hearings for our clients with dissociative identity disorder. Give us a call at (561) 625-8400 so we can help you get the process started today.