Is Mulitple Personality Disorder still a valid DX

Often communication across between separate alters takes place in the form of hearing voices, hence these folks frequently get misdiagnosed as schizophrenic. The key distinction here is whether the voices are experienced as coming from inside the person's head (DID) or outside one's head (Schizophrenia/Bipolar Disorder).

The separate identities develop in response to traumatic experiences which the child is unable to integrate and so they become "split off" from awareness and begin to take on a life of their own.

Folks with DID often self-injure, frequently a result of internal battles between persecutor alters and weaker alters and there are continual battles for control of the body and "time out" in the body between competing alters.

Symptoms of depression and anxiety are frequent and common and the picture is further complicated by the fact that one alter can meet all clinical criteria for Depression, while another part experiences no symptoms whatsoever. One part can be psychotic and experience no side effects from meds while another non-psychotic part has all the side effects and will stop taking meds.You can imagine that attempting to medicate such a disorder becomes an absolute nightmare.

Other symptoms include flashbacks and nightmares, hence the confusion with PTSD. Sometimes there are fugue states and clients will switch and "come to" in the body and have no idea how they arrived in the situation they are in, not know the people they are with and be completely disoriented. I had one client call me from another state after being away for a few days and having no idea how she got there or how to get home. Depersonalization and trance states are common and hence the overlap with other Dissociative disorders.