Basics
July 21, 2020

Pranav Harish

Dissociative Identity Disorder vs Schizophrenia: The Misconception

Some people believe that schizophrenia and dissociative identity disorder (DID) share the same symptoms of switching between personalities. However, this is rather far from reality. People with schizophrenia do not experience multiple identities, which is common in people with DID.

Both schizophrenia and DID are complex conditions that have no cure. But, they display different symptoms and treatments.

How is dissociative identity disorder different from schizophrenia?

In the case of DID, the primary cause is severe childhood trauma or abuse - physical, mental, emotional, or sexual. People with DID have at least two different personality states. The alternate identity takes control of the person's behavior and emotions.

DID is characterized by disturbance in consciousness, identity, emotions, thoughts, feelings, perception, behavior, mood, and motor control.

Characteristics of DID include:

  1. A person will alternate between two distinct identities.
  2. The identities have unique names, age, gender, mood, preferences, voice, and features.
  3. One of the alternate personalities tries to take control of the primary personality.
  4. A person with DID will experience memory gaps in daily events, personal information, and activities.
  5. Hearing voices or feeling thoughts that aren't theirs, but rather inserted in their mind or belong to someone else. These voices converse, argue, make threats, or command self-harm acts.

Related: Understanding Dissociative Identity Disorder (DID): Causes and Symptoms

Characteristic symptoms of schizophrenia are:

  1. Delusions - Schizophrenics have beliefs that aren't true as they are unable to differentiate between reality and imagination. For example, someone may have paranoid delusions such as aliens are communicating with them even though there is no evidence suggesting the same.
  2. Hallucinations - Individuals will hear, see, or smell things that appear to be real. But, these sensations are made up by the mind. For example, someone might experience something crawling under their skin.
  3. Jumbled Speech - This includes repeated utterances of words or phrases, using meaningless words together, unable to hold a conversation due to speech impairment, or saying made-up words that make sense only to the individual.
  4. Disorganized Behavior - People display behavior that affects their functioning, or unresponsive despite being awake.
  5. Negative Symptoms - Difficulty expressing emotions, or facial expressions and speech lack emotions

However, schizophrenia is genetic or sometimes caused due to substance and drug abuse. It is more common than DID and develops in late teens to young adulthood. There is a gradual decrease in functioning with visible psychotic symptoms.

Essentially, "psychosis" is a diagnostic key for schizophrenia.

DID is a reaction of trauma, but people with schizophrenia are likely to experience trauma.

Treatment

People with DID have dissociated identities that are misdiagnosed as delusion or auditory hallucinations. Due to this, antipsychotic medication does not ease the symptoms, which otherwise works on people with schizophrenia.

Treatment for schizophrenia involves antipsychotic medication, psychotherapy, and hospitalization in severe cases. Treatment for dissociative identity disorder involves antidepressants, cognitive-behavioral therapy (CBT), and behavioral modifications.

Often schizophrenia is mistaken with DID. The difference between schizophrenia and dissociative identity disorder is that, while schizophrenia is a "split from reality", DID is a "split in the person's personality".

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