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Summary
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A person diagnosed with Post-traumatic stress disorder (PTSD) describes internal voices and changes in their sense of identity and control. They ask whether these experiences point to DID or can occur with PTSD.
The answer discusses the possibility of overlapping trauma-related and dissociative symptoms, while also considering other explanations for voices.
It emphasizes that the treating therapist is best placed to clarify the diagnosis and that different causes may call for different treatment, rather than settling the question from the description alone.
Question
Reader · Identity withheldHi,
\nI read the previous question about diagnosis of PTSD vs. DID. My therapist also diagnosed me with PTSD. However, I do hear voices, like loud thoughts in my head, and they can carry on a lengthy dialogue.
\nThis particular part talks to me a lot, and there have been times where I feel possessed by her. When another person comes out, I go to a place like in my head and hide in the distance. It’s like she’s in the drivers seat and I’m in the back seat. She buys things I do not like, and she does things I hate. The therapist even admits she comes out in therapy, at times, plus I feel different when she does, like another person.
\nAnyway, his diagnosis is PTSD. He also feels once the abuse is dealt with, her volume should diminish greatly, and she won’t take over as much. Are these symptoms of DID or PTSD?
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Answer
Allan Schwartz, Ph.D.You are diagnosed with PTSD, Post Traumatic Stress Disorder and you experience Dissociative symptoms that your therapist diagnosed as DID, Dissociative Identity Disorder.
\nYou report that you also hear voices that you experience as thoughts in your head. Your question is whether you have symptoms of DID or PTSD. The most probable answer is that you have co-occurring symptoms. In other words, you have PTSD and a Dissociative Disorder.
\nDissociation is a way for the mind to escape overwhelming trauma. Through dissociation a person alters their state of conscious. There are many accounts of political prisoners, Holocaust survivors, people trapped in mines when they collapse, and etc. surviving altering their conscious so that they can live in an alternate world until the trauma passes.
\nAt it’s worst, dissociation becomes Dissociative Identity Disorder, sometimes known as Multiple Personality Disorder. In this, the individual escapes the present by becoming someone else with a different name and a different set of talents and abilities. In this shift of identity, amnesia may occur about the previous identity. Usually, this shifting personality is temporary. In addition, it is possible for a person to have more than one personality.
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Having said all of this, it is also important to understand that a high percentage of those with PTSD also experience hallucinations, in which they hear voices that do not exist in reality.
\nFor you, the question is not whether you have PTSD vs. DID but whether you have hallucinations along with DID and PTSD? By the way, I apologize for the alphabet soup.
\nTherefore, its possible that the voices you report are a result of dissociating. It’s also possible that these are symptoms of a psychotic illness brought on by the trauma. If these are psychotic symptoms you may need anti psychotic medication. Hallucinations in causing harm to yourself or others if the voices tell you to commit these types of violent acts.
\nYour psychotherapist is in the best position to diagnose what is going on with you. I suggest that you ask your therapist about this as a way of clarifying your confusion about difficult psychiatric matters.
\nBest of Luck
\nBest of Luck
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