Schizophrenia vs. Dissociative Identity Disorder - Psychiatry

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Schizophrenia or Dissociative Identity Disorder (formerly known as Multiple Personality Disorder)


In high school, I was bullied by my classmates, going through cycles of reconciliation and exclusion.
Eventually, I felt I didn't want to face them anymore, but I sensed that another person would emerge to help me cope.
I could clearly feel their presence, so when I didn't want to confront the situation, I would relax and allow myself to rest.
Sometimes, I would come to my senses and realize it was already the next day at school or after school.
I wonder if this is a result of trauma from being bullied that has led to the development of another personality.
A colleague mentioned that I often experience significant mood swings or changes in my manner of speaking, and sometimes I have no recollection of these changes.
At times, I even engage in behaviors I don't want to do without being aware of it.
I would like to ask if this is schizophrenia or dissociative identity disorder?

Xiao Bai, 10~19 year old female. Ask Date: 2017/06/03

Dr. Li Zhengfeng reply Psychiatry


Hello: According to your letter, the symptoms are neither indicative of schizophrenia nor dissociative identity disorder.
It is recommended to consult a specialist for an in-person diagnosis.

Reply Date: 2017/06/03

More Info


Understanding the distinction between schizophrenia and dissociative identity disorder (DID) is crucial, especially given the experiences you've described. Both conditions involve complex psychological processes, but they manifest in significantly different ways and have distinct underlying mechanisms.

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It is characterized by a range of symptoms, including delusions (false beliefs), hallucinations (seeing or hearing things that are not present), disorganized thinking, and impaired functioning. People with schizophrenia may experience a disconnection from reality, which can lead to significant distress and impairment in daily life. The onset typically occurs in late adolescence or early adulthood, and the symptoms can be persistent and debilitating.

On the other hand, Dissociative Identity Disorder (DID), formerly known as multiple personality disorder, is characterized by the presence of two or more distinct personality states or an experience of possession. These distinct identities may have their own names, ages, histories, and characteristics. Individuals with DID often experience gaps in memory regarding everyday events, personal information, and traumatic events. This disorder is often a result of severe trauma during early childhood, usually extreme, repetitive physical, sexual, or emotional abuse. The dissociative aspect serves as a coping mechanism, allowing the individual to detach from a painful reality.

From your description, it seems you are experiencing symptoms more aligned with DID rather than schizophrenia. The feelings of having another person emerge to help you cope with social situations, along with the memory gaps and emotional fluctuations, suggest a dissociative process. This is particularly relevant given your history of being bullied and the emotional distress that followed. The fact that you sometimes do not remember actions or conversations indicates a dissociative experience, which is a hallmark of DID.

It's important to note that while both conditions can involve significant emotional distress and can impact daily functioning, the treatment approaches differ. Schizophrenia is typically treated with antipsychotic medications and psychotherapy, focusing on managing symptoms and improving functioning. In contrast, DID treatment often involves psychotherapy aimed at integrating the separate identities and addressing the trauma that led to the dissociation.

Given your experiences, it would be beneficial to seek a comprehensive evaluation from a mental health professional who can provide a proper diagnosis and develop an appropriate treatment plan. They can help you explore your feelings, understand your experiences, and work towards healing from past traumas. Therapy can be a safe space to process your emotions and develop healthier coping strategies.

In conclusion, while both schizophrenia and DID are serious mental health conditions, they are fundamentally different in their symptoms and underlying causes. Your experiences suggest a possibility of DID, particularly in the context of trauma. Seeking professional help is crucial for understanding your experiences and finding effective ways to cope and heal.

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