Dissociative Identity Disorder (DID) And Addiction

Medically Reviewed by Johnelle Smith, M.D. on April 19, 2021

A person with dissociative identity disorder has two separate personality states (formerly called multiple personality disorder). Substance abuse in people with this disorder can worsen symptoms, complicate diagnosis, and impede proper treatment.

Co-Occurring Dissociative Identity Disorder And Addiction

Dissociative identity disorder (DID) is a mental disorder where a person experiences multiple distinct personality states or identities.

Dissociative identity disorder is not caused by substance abuse, although substance use and substance dependence are extremely common in people with DID.

Many people with co-occurring DID and substance use disorder may use drugs or alcohol as a reaction to feelings of depression or anxiety associated with DID.

Read more about co-occurring personality disorders and addiction

What Is Dissociative Identity Disorder?

Dissociative identity disorder typically develops as a reaction to childhood trauma. It most commonly appears in adults that have experienced a natural disaster, war, or long-term, sexual, emotional, or physical abuse.

A person with DID has multiple identities with distinct names, voices, and mannerisms. Women are more likely to receive an accurate DID diagnosis since they present with more typical dissociative symptoms. They may experience amnesia and have “black-out” type states.

Men with DID may be more violent in alternative identities, which can make this disorder more difficult to diagnose in some men.

Symptoms Of Dissociative Identity Disorder

People with DID may experience a range of symptoms.

Typical dissociative symptoms include:

  • significant periods of memory loss
  • emotional numbness and detachment
  • out-of-body experiences (as if you’re watching yourself on a screen)
  • depression and anxiety
  • suicidal thoughts
  • exhibit at least two personalities
  • lack of identity

Signs Of Drug Or Alcohol Abuse

For people with co-occurring DID and substance use, some symptoms overlap which makes proper diagnosis difficult when one disorder is unknown.

While substance use does not cause DID, people with DID may use substances to escape from symptoms like anxiety or detachment.
Signs of drug or alcohol abuse may include:

  • behavioral changes/mood swings
  • lack of control over drug or alcohol use
  • engaging in risky behavior
  • withdrawing from friends or family
  • neglecting physical health or hygiene
  • being reliant on substances to function normally
  • lying about drug use

Many symptoms and risk factors of both DID and substance use tend to overlap, which can make it difficult to identify a second disorder when the other is known.


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What Causes Co-Occurring Addiction And Dissociative Identity Disorder?

Dissociative identity disorder occurs in people that have experienced intense trauma – typically in early life. DID is usually first recognized in adulthood.

People with DID that have a substance use disorder may use substances as a method of self-medication or as a response to external stimulus brought on by symptoms of DID.

Substance use in people with DID can exacerbate dissociative symptoms makes it more difficult to professionally diagnose a substance use disorder.

In many cases, certain substances like marijuana, alcohol, or stimulants may increase the frequency of personality shifts and worsen other DID symptoms.

Shared risk factors for dissociative identity disorder and substance abuse include:

  • history of trauma
  • history of family substance use

How Common Is Substance Abuse And Dissociative Identity Disorder?

Approximately 1.5% of the United States’ population has DID, while about 2.4% of the population has some form of dissociative disorder.

Dissociative identity disorder and addiction statistics:

  • Among a sample group of people seeking addiction treatment, 17.2% had a form of dissociative disorder.
  • Approximately 33% of people with documented mental illness have a dual-diagnosis substance use disorder.
  • The frequency of co-occurring substance use disorders and “severe” mental illness is approximately 50% of all people with severe mental illness.

What Are The Most Effective Treatments?

When DID and substance use are recognized as co-occurring disorders, treatment can include therapies and medication as needed.

Dual diagnosis treatment may involve:

  • medication to treat symptoms of anxiety and drug withdrawals
  • dialectical behavioral therapy (DBT)
  • cognitive-behavioral therapy (CBT)

Detox And Rehabilitation

For people with a dual diagnosis of DID and substance use disorder, the administration of medications like anti-anxiety medication can help people become more receptive to further intervention.

In an inpatient setting, a combination of supervised detox and administration of medications has been helpful.

Medications that mitigate symptoms of drug withdrawals like buprenorphine, naltrexone, or methadone often help people successfully move away from substance use.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a well-known and successful therapeutic intervention that can be administered in individual or group settings. It can be done in inpatient or outpatient settings.

CBT encourages patients to notice and address negative behavior and patterns. This type of therapy helps address patterns that contribute to substance use and stay sober. It can also help people with DID recognize and address past trauma over time.

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy helps people focus on positive growth, stabilize emotions, and become more mindful.

Tools gained from DBT may help lessen incidences of dissociation and can help people with co-occurring substance use disorders manage stress better without drug or alcohol use.

By encouraging a positive mindset, people with co-occurring DID and substance use can learn to maintain sobriety, and healthy coping strategies can be implemented for lifelong mental fortitude.

Finding Dual Diagnosis Treatment For Addiction And Dissociative Identity Disorder

Treating substance abuse in people with co-occurring DID can be accomplished in outpatient or inpatient settings.

If you or a loved one has a dual diagnosis, call our helpline to learn more about the best treatment options for you.

A treatment specialist can help you get started to find the right dual diagnosis treatment program to begin a substance-free life. Call today to learn more.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D. on April 19, 2021


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