What medication is used for Multiple Personality Disorder?

[robert_columbia]

In a recent episode of South Park, Butters is diagnosed with Multiple Personality Disorder by a doctor and his parents are told that he will needs lots of "tender loving...medication...heavy medication". What medication is used for multiple personality disorder, and how does it work? Does the medication simply put the person in a stupor where multiple personalities can't significantly manifest inappropriate behavior, or does the medication somehow target the personalities for destruction, or provide the person the ability to somehow destroy the other personalities?

[Uncertain]

I wouldn't assume that South Park is a reliable source for medical information.

As I understand it, people with dissociative identity disorder (as it's now called) are sometimes given antidepressants because they are often depressed.

[BigT]

Well, on the show, the doctor is not remotely surprised when the medication doesn't work.

I think the only medication given is to try to deal with the underlying problem. MPD is an extreme dissociation disorder and has actually been renamed "Dissociative Identity Disorder." The alt exists to hide unwanted feelings and thoughts from the main personality. Up until the big reveal at the end, the show does a pretty good job of showing how DID is supposed to work. The alt shows up when ever there is conflict, to isolate the more destructive thoughts from the main identity.

I say supposed to work because there are people who believe DID doesn't exist. Heck, the episode even plays on that early on, with how Butters is diagnosed and what happens when he confronts the doctor. Yeah, they took some liberties (especially at the end), but I'm impressed with what they knew about the subject.

[njtt]

If Dissociative Identity Disorder/Multiple Personality Disorder really even exists, which is by no means firmly established (although no doubt people diagnosed with it do generally have some sort of fairly serious psychiatric problem), then the primary indicated treatment would be psychotherapy, not drugs. There is no drug that will "cure" DID as such, although, as Uncertain says, it may well be useful to treat some of the associated symptoms or disorders with antidepressants or other medications.

[TriPolar]

All medications are equally effective at treating this disease, because it isn't a disease. You could call the people who claim to have MPD even though they know that they don't as a disease.

[alice_in_wonderland]

I know a woman who has been diagnosed with this - her treatment consisted of primarily intensive, in-patient psychotherapy to begin and then on going counseling afterwards. She mentioned an anti-anxiety med I think, but it may have been an anti-depressant; however, I'm sure she was on that before she was diagnosed.

I haven't seen her or heard from her in quite a long time (a couple of years) - we used to catch up at parties and get togethers fairly often (a couple of times a year). She was quite a nice person, friendly to talk with an whatnot, but was...off when you spoke to her. I'm not sure about DID but she did have dissociative fugues on a fairly regular basis where she sort of 'come to' with multiple missed days, weird purchases in her house that she had no memory of buying (rock climbing shoes but she doesn't rock climb, weird formal clothing but she had no events coming up, etc) and cutting signs all up both arms that she didn't remember doing. I don't know what was wrong with her but specialists said DID and it could certainly be possible I suppose.

[Silver Tyger]

Originally Posted by njtt

If Dissociative Identity Disorder/Multiple Personality Disorder really even exists, which is by no means firmly established (although no doubt people diagnosed with it do generally have some sort of fairly serious psychiatric problem)

Not necessarily.

I've done some casual research into healthy multiples (that is, systems that function to a point that people can't tell they're multiple unless told. Most of them describe it as like a family living in one house). The ones that go to doctors are not usually functional. Several of them argue that multiplicity should not be categorized as a mental illness*, in and of itself. But I am not a doctor, nor a multiple, have no dog in the fight, and just got this info off of the web so... (I can provide the sites if anybody cares, just PM me)

* individual alters may be mentally ill, but not necessarily, and they're not usually psychotic or whatever, just normal stuff like depression, etc.

[Uncertain]

Originally Posted by TriPolar

All medications are equally effective at treating this disease, because it isn't a disease.

The American Psychiatric Association would disagree. That doesn't men they're right--they still, for example, stubbornly refuse to recognize tripolar disorder--but I wouldn't dismiss it so easily.

[Markxxx]

Cases like Sybil were probably not multiples, but they almost certainly did exist. You can find it was very rare and a type of hysteria. Looking at DID as a hysterical condition it does make sense.

The question to most isn't whether or not it is real but what is the extent of it. Fugue states have existed since ancient times, it's the ability to go back and forth in and out of them that has people wondering.

Cases like Sybil are complex as Sybil was treated by Dr Wilbur with psychoanalysis. Dr Wilbur did not treat any of her other multiple personality cases with this.

Psychoanalysis isn't a very effective technique for a lot of conditions but it is very useful in treatment of hysteria. And everyone agrees that Sybil suffered from hysteria. Even those who say she wasn't a multiple have no issue agreeing she was a brilliant hysteric.

How to treat DID is basically with behaviour therapy, anti-anxiety drugs and hypnosis. Other drugs like anti-depressants and anti-psychotics have also been used to control unusual behaviour, but it's on a case by case basis

[Farmer Jane]

Probably an anti psychotic and an anti-anxiety drug.

[Guinastasia]

I thought they also used cognitive behaviral techniques to try and "merge" all of the different personalities into one.

[TriPolar]

Originally Posted by Uncertain

The American Psychiatric Association would disagree. That doesn't men they're right--they still, for example, stubbornly refuse to recognize tripolar disorder--but I wouldn't dismiss it so easily.

My username comes from an old joke about George Bush and his Axis of Evil. If they name a disorder after me I'd be proud to use my real name.

I think the problem with recognition of tripolar disorder is that it is just two different problems. We don't have special names for having the flu and a sprained ankle at the same time, so there would have to be a good reason to do that for people who have both BD and BPD. It looks like there are those who believe there is close relationship between these conditions that would warrant a unique name. Others find there is too much difficulty in clearly identifying conditions to continue to specify new combinations and variations.


As for MPD/DID, the distinquishing characteristic is the idea that multiple personalities are unaware of each other, and have no recollection of time spent in other personalities. There's no way to prove whether or not these people are actually aware of the other personalities, but over time, in many cases, those diagnosed admit that they are and were always aware. And in cases where veracity can be challenged through conflicting statements and inconsistency in the symptoms there seems to be a redefinition of 'unaware' that can include everything else defined as awareness in order to maintain the diagnosis.

Of course the damning evidence against MPD/DID is the fact that the disorder rarely occurs outside of North America. There is no reasonable explanation for how longitude causes MPD/DID.

[RaftPeople]

Originally Posted by TriPolar

Of course the damning evidence against MPD/DID is the fact that the disorder rarely occurs outside of North America. There is no reasonable explanation for how longitude causes MPD/DID.

A little googling on the topic shows evidence in various countries - Turkey, Netherlands, Switzerland, Australia, Japan.

I don't think those countries are in North America. Well, I know for sure Turkey isn't, not sure about the other four, I guess they could be hidden just north of Canada.

[TriPolar]

Originally Posted by RaftPeople

A little googling on the topic shows evidence in various countries - Turkey, Netherlands, Switzerland, Australia, Japan.

I don't think those countries are in North America. Well, I know for sure Turkey isn't, not sure about the other four, I guess they could be hidden just north of Canada.

Rarely doesn't mean never. Last I heard, almost all cases occur in North America, and most of those others are very recent. Maybe those cases from other continents involved a North American personality. Or the patients just weren't aware that they were North American. Or maybe, I know it's a longshot, but maybe the method of psychiatric treatment in North America has something to do with it.

[Derleth]

Culture-bound disorders aren't unknown, and I don't know of anyone who thinks all culture-bound disorders are fake.

[sandra_nz]

Originally Posted by TriPolar

Last I heard, almost all cases occur in North America, and most of those others are very recent.

I think you are confusing diagnosis with occurance.

[njtt]

Originally Posted by TriPolar

Rarely doesn't mean never. Last I heard, almost all cases occur in North America, and most of those others are very recent. Maybe those cases from other continents involved a North American personality. Or the patients just weren't aware that they were North American.

If they do not know what continent they are from they have worse problems than DID.

What is a "North American personality"?

[TriPolar]

Originally Posted by Derleth

Culture-bound disorders aren't unknown, and I don't know of anyone who thinks all culture-bound disorders are fake.

I'm not calling them fakers. I'm saying these people have disorders other than that categorized as DID. Remove the common link in DID, the complete diassociation of experience across multiple personalities, and you're left with other known disorders.

I don't know if I can find old cites on this subject (less than 10 years old), but look at the controversy section of the Wiki page .

Unlike the more empirically verifiable mood and personality disorders, dissociation is primarily subjective for both the patient and the treatment provider.

An inability to define MPD/DID consistently across patients shows a serious problem with using it as a diagnosis. And I would suspect that is detrimental to the patients who likely have a more definable problem.

Originally Posted by njtt

If they do not know what continent they are from they have worse problems than DID.

What is a "North American personality"?

Just being facetious there.