Tag Archives: Dissociative Identity Disorder

How Far I’ve Come

Today, in a complex PTSD support group, a member shared her story of hope and healing to lift other members up. I was inspired to share mine. Not that I’m as successful as she is, but I’ve come a long way on my healing journey especially given how deeply troubled I was several years ago. Regular readers will know most of this already, but I’m still going to share where I’ve come from and how far I’ve come so far.

In 2007, I started university in Nijmegen. I didn’t really want to go to university, but I felt I had to because my parents expected me to. I felt I had to live up to their expectations or I wouldn’t be worth much and would not have anyone to support me. My parents had instilled in me that I wasn’t wired for relationships, so if they decided to abandon me, I’d have no-one left.

Two months in and I crashed. I was so dysregulated and suicidal that I had to be admitted to a mental hospital. The psychiatrist who admitted me felt I needed supported housing. We searched for this for many years, but no place wanted me.

Meanwhile, the other half and I started dating. This could’ve given me some hope that I may in fact be able to develop social and even romantic relationships and wouldn’t be dependent on my parents for the rest of my life. You see, despite the fact that my parents only ever visited the hospital to argue with my treatment team, I was still heavily emotionally dependent on them. I still felt I needed their approval to be able to have any sort of meaningful life.

That changed around late 2010 to early 2011. The other half had proposed to me in June of 2010. I was diagnosed with dissociative identity disorder and PTSD in late 2010. Finally finding a treatment provider who believed me and realizing the other half was here to stick by me, gave me the strength to stick up for myself.

I still had many setbacks in the years that followed. I changed hospitals and my new psychologist didn’t believe I had DID/PTSD. The next psychologist even removed my autism diagnosis that I’d had for many years. She diagnosed me with dependent personality disorder, not because I was passive and compliant, but because I was too assertive, claiming care she felt I didn’t need.

In early 2017, I finally found the determination and courage to fight like a lioness for what I need. I sought an independent second opinion on my diagnosis. I started the process of finding suitable support, eventually enlisting the Center for Consultation and Expertise. I started to realize that I’m not just the crazy one in my family. In fact, even though no-one has a diagnosis other than me, I’m pretty sure my entire family has fallen a bit off their rocker. I finally realized (though I still don’t fully feel it) that the trauma I endured wasn’t my fault.

These strong parts of me are still a bit split off from the core of me, but that’s okay. Ultimately, I will hopefully learn to synthesize their qualities with the ones of the weaker or smaller ones. I don’t need to become “one”, but I hope I can someday live as the whole person, made up of all these parts, that I am.

Suddenly I Am

Sometimes, I am the wise woman. Inside, I am a college sophomore, though on the outside, life has moved on. I call myself Clarissa. I can talk up a storm about psychology and psychiatry, arguing that, yes, in fact autistic people can have multiple personalities. It’s a shame people tell me they can’t just because that person’s psychiatrist has told them so. It’s nowhere in the DSM-IV or DSM-5. In fact, autistic people are quite a bit more likely to suffer from trauma-related disorders like this.

Then suddenly, I am that autistic teen. Inside, I am 19-years-old, though on the outside, life has moved on. I call myself Carol. I am not your typical intelligent Aspie. In fact, I am quite severely autistic. I use repetitive language and engage in self-stimulatory behavior all the time. I can barely function at a day activities center for people with severe intellectual disabilities, even though I’m not intellectually disabled. I’m not gifted either, no matter what some people like to believe. I’m just average intellectually, but emotionally, I’m severely impaired.

Then suddenly, I am a little girl. Inside, I’m a shy and scared five-year-old, though on the outside, life has moved on. I call myself Little. By the time I first emerged, it was thought I was the youngest alter. I am not. I can’t breathe sometimes. Sometimes, I have to color inside the lines, and I can’t, because I can’t see very well. I am very scared.

Then suddenly, I am a precocious seven-year-old. Inside, I take care of the baby self (with help from the inner mother figure), though on the outside, life has moved on. I call myself Suzanne. As much as I want to help the baby,I also want my stuffie sheep meh-beh and beh-meh.

Then suddenly, I am that mother figure. Inside, I am 28-years-old, though on the outside, even now life has moved on. I call myself Esther. I sometimes go on Mommy forums as a child advocate, even though in real life, I don’t have any children. I grievethis fact, but don’t let it show.

Then suddenly, I am a childfree woman. Inside, I am 35-years-old, t hough life hasn’t caught up with me yet. I call myself Annemiek. I like to craft and like my childfree life with just my husband and Barry, our cat.

I don’t know whether switching several times a day, like I described above, is common in people with dissociative disorders. I don’t have a diagnosis of a dissociative disorder anymore, after all. To be honest, I don’t care. I have been told, when I write on this blog about my parts, that I’m obviously a really bad case of borderline personality disorder (BPD( trying to fake having dissociative identity disorder (DID). I don’t care. This is my experience and I don’t care what label best describes it.

This is not always how switching happens either. Usually, one of the functional adult parts is out in the body or “in front” about 80% of the time, though it depends which of the functional adult parts is. I didn’t describe either of the two current main fronters in this post.

It is also possible that multiple parts are out in the body at the same time. This can lead to what psychiatrists call identity confusion and also depersonalization and derealization, where you feel as though your body, mind or the world around you is unreal. The switchig I described above is called identity alteration. Then there is amnesia, which is a hallmark syptom of DID we don’t experience that often at all (so I don’t believe we actually have DID).

With this post, I didn’t mean to give you a thorough overview of dissociation. In fact, it was what randomly popped up in my mind when reading today’s prompt on The Daily Post, which is Suddenly. Like I said, I am not claiming that my experience is representative for those with dissociative disorders. It is just a tiny part of my experience, too.

Psychiatric Diagnoses I’ve Been Given

I just checked out the “30 days of mental illness awareness” challenge and was inspired to write a timeline of my mental health. Then I realized I already wrote it in 2015. Another question in the 30-day challenge though is what you’re currently diagnosed with. Seriously, I don’t know what exactly my current diagnosis is. I know what the university hospital psychologist diagnosed me with, but I am not sure the psychiatrist at my current community treatment team agrees.

I’ve had a lot of diagnoses in the past. I’ve had even more suggested diagnoses that never made it into my file. Today, I will write a list of the diagnoses I’ve had. I will comment on them too.

1. Autism spectrum disorder. I was first diagnosed with this twice in 2007, then again in 2010. I lost my diagnosis in 2016 and was rediagnosed in 2017. This is the only diagnosis I’m pretty sure of that I agree with 100%. It’s the only diagnosis that I’ve been given through a proper evaluation (several, in fact).

2. Adjustment disorder. This was my diagnosis upon admission to the mental hospital in 2007. I didn’t meet the criteria for depression or any other serious mental health condition but needed care anyway. I was at the time fine with that diagnosis and think the crisis team psychiatrist who made it, did a pretty good job of assessing me.

3. Impulse control disorder NOS. I was never told why I got this diagnosis. I just found it on my treatment plan in May 2008. Probably, it was a replacement for the adjustment disorder, which you can only have for six months once the stressor that caused it goes away. I never agreed with this diagnosis and didn’t really take it all that seriously.

4. Dissociative identity disorder. This was diagnosed in November of 2010 and was probably the most controversial diagnosis I’ve ever had. I wasn’t properly assessed for it and my psychologist at the time took what I told her almost at face value. I never believed deep down that I met the full criteria for this. I mean, yes I do have alters and I do have pretty bad dissociative symptoms sometimes, but amnesia is the exception. I find this terribly hard to admit but I do have to acknowledge this diagnosis was in part based on (self-)suggestion. I do believe, like I said, that I have some dissociative symptoms.

5. Post-traumatic stress disorder. I got this diagnosis together with the DID. I don’t really know why. I mean, yes, I did (and still do) have some symptoms, but I’m not sure I have nough and I never reported more than I actually had. I did get some assessment for this. I do currently believe I definitely do have some PTSD symptoms, particularly complex PTSD symptoms. Then again, there is a lot of overlap with borderline personality disorder traits.

6. Borderline personality disorder. This was diagnosed in 2013 and replaced DID and PTSD. It was later “downgraded” to BPD traits. I do agree I have BPD traits, but I am more the quiet borderline type.

7. Dependent personality disorder. I was given this diagnosis in 2016. Never quite agreed with it, except in the sense that I could be led to believe I had every disorder that was ever suggested to me.

8. Depression. This was diagnosed in 2017 by the university hospital psychologist. I had previously been diagnosed with depressive disorder NOS, but that, according to my psychologist, was only because a diagnosis on axis I (anything other than a personality disorder) is required for treatment. I admit I was pretty badly depressed in the months that I had my assessment at the university hospital, but am not sure it was bad enough for a diagnosis. I mean, I didn’t meet the criteria in 2007, so how could I meet them in 2017? I’m assuming my current psychiatrist removed that diagnosis.

Just One Thing

Last week, I started a journal-style blog to explore my inner world. As usual, I didn’t write in it much at all, so I’m resorting back to this blog. The reason I wanted another blog is because of the derogatory comments I’ve gotten here regarding my dissociation. No, I don’t have a diagnosis of dissociative identity disorder anymore and no, I don’t claim to be DID. I do however have insiders, parts, alters or however you’d like to call them. I don’t care what people think of this, or at least, I try not to care. To reclaim myself and my experience, here I’m sharing a post I wrote last week.

Manyofus1980 from Therapy Bits posed an interesting question: if the world could understand just one thing about your mental health diagnosis, what would it be? In the post title, the question is about your “mental illness” rather than your “diagosis”. This is important to my answer, as my short answer is: my diagnosis does not dictate my experience.

I have had countless diagnoses over the years, some of which I agreed with and some of which I disputed. I don’t even know what my current diagnosis is according to my community treatment team. According to the university hospital where I got a second opinion last spring, it’s autism spectrum disorder, recurrent moderate depression and borderline personality disorder traits. Of this, I doubt the depression, because my default mood is low. Then again, I do seem to remember feeling much lower than low in the months that I had my assessment at this hospital. The thing is, I can’t usually connect my feelings from the past to the present if they’re very different.

We didn’t really go into my trauma experience, as my assessment was primarily focused on autism. However, the university hospital psychologist did recommend I get EMDR treatment for the negative experiences I had in the process of moving towards independence. I have not had a trauma-based diagnosis since 2013 and that’s fine by me. I don’t need a diagnosis to justify my experience.

I am who I am. We are who we are. We don’t fit in a diagnostic box, because, well, we’re we.

Sometimes, we feel upset that we don’t get recognition from our treatment team (as far as we know) for our traumatic and post-traumatic experiences. I had a lot of difficulty answering my psychiatrist’s questions about this during my intake interview. I mean, most of the trauma we endured, didn’t leave visible wounds. I know that dissociation can be caused by attachment issues, sometimes even too mild to create PTSD. However, there is still a common belief that only prolonged sexual or ritual abuse can create alter parts. I try not to care. We are we are we, so deal with it.

Then and Now: A Timeline of My Mental Health

It is often hard to see how far we’ve come on our journeys in life until we look back at where we came from. I am no exception to this. I tend to feel that I’m not improving in my coping with my mental health issues. There’s still this hurricane in my mind, after all. It is also hard because, whenever I seem to improve in my behavior, people’s expectations rise even higher. To shed light on the positive changes I’ve made on my journey through life with mental illness, today I will write a timeline of events related to my mental health.

2007: I was hospitalized on the acute ward on November 3 of this year. I was not allowed to leave the ward without someone accompanying me. For the first few days, I even had to have a nurse accompany me. After those first few days, any adult could accompany me, but they had to sometimes assure the nurses I was safe with them.

2008: I started out the year with a setback: I was given a seclusion plan, which meant I could be secluded if I was a burden to other patients or staff. By early February, however, my privileges were finally extended so that I could go off the ward unaccompanied for fifteen minutes. By early March, my privileges were quite suddenly extended to four hours of unaccompanied time off the ward, which is the maximum you could get at that unit. If you had this privilege, you could ask for extended leave if you had a reason for it. My seclusion plan was also lifted, only to be reintroduced again by June. Fortunately, I never had to actually be secluded, but the nurses frequently used it as a threat. The plan was lifted again in September, but only so that I could be moved to the resocialization unit.

2009: I transferred to the resocialization unit in March of 2009. I did mostly okay until September, when I had a major meltdown which elicited another patient’s aggression. The possibility of moving me to the locked ward for a few hours if I acted out was introduced into my treatment plan.

2010: I was sent to the locked unit for the first time. This did lead the staff to consider medication, and I agreed. I started on a low dose of Abilify, an antipsychotic, in late February. It had to be increased to a moderate dose by the summer and by September, Celexa, an antidepressant, was added. Both helped calm my anxiety and irritability. In November of this year, I was diagnosed with dissociative identity disorder and PTSD.

2011: I was on the waiting list for an autism-specialized group home and went there to stay over for a week-end in October of 2011. Unfortunately, the group home had changed its target population and there was too little support by the time I stayed over there. I didn’t end up going.

2012: I started planning to live with my husband by this time, originally pretty much solely because I didn’t have any suitable alterantive. I don’t mean this to insult my husband, but I didn’t feel I should be burdening him with care duties if at all possible. We moved into our aparetmetn by December. Meanwhile, I was trying to get treatment for my DID/PTSD.

2013: I had an intake interview with a psychiatrist who thought she could treat my DID/PTSD. She ultimately ended up turning me down. It had nothing to do with me, but she was too busy with her physician duties. I moved to my current institution, where i was soon diagnosed with borderline personality disorder. I started schema-focused therapy, but this had little effect. My Abilify also got increased some more.

2014: I continued to struggle, but for the most part was quite stable. My Abilify had to be increased one last time in late 2014 (I am now at the highest dose). I did improve in my behavior and got a more cooperative relationship with my staff. I spent a few times in seclusion, but always voluntarily.

2015: I decided I wanted to live with my husband for real this time. We have been making arrangements, though it’s been slow-going. We will be moving to the tiny village sometime in December, so concrete arrangements cannot be made till then. I have been trying to get a med review for a few months now. Though my mind is still very unquiet, particulalry as my discharge out of the institution draws closer, I don’t tend to act out as much as I used to. I was in seclusion for a while last Monday, but before then it’d been over six months.

As I look back, I see that sometimes I take steps back and sometimes I take leaps forward, but in general, I’m moving up. I’ve never had to be moved back to a more restrictive unit, though I’ve sometimes wanted it. My medication did have to be increased a lot, but I don’t see that as entirely negative.

I am linking up with the 1-word blog challenge hosted by Lisa and Janine. The word choices for today are THEN and BREAK.

Dissociation #Write31Days

31 Days of Mental Health

Welcome to day 28 in the 31-day writing challenge on mental health. Today, I will be discussing dissociation. I used to have a diagnosis of dissociative identity disorder, but dissociation is also common in post-traumatic stress disorder and borderline personality disorder.

Dissociation refers to a detachment from reality: disconnection from one’s surroundings, one’s own body, one’s mental processes or one’s identity. there are five different domains of dissiociation:


  • Depersonalization: a disconnection from one’s own body or mental processes. People who experience depersonalization feel “unreal”.

  • Derealization: a disconnection from one’s environment. The world around people who are derealized seems unreal or vague, as if looking through a glass wall.

  • Amnesia or memory loss. People who experience dissociative amnesia can be triggered by things that remind them of an unpleasant memory, but they do not remember the unpleasant event. Amnesia can also refer to “time loss”, where the person does not know what happened during a specific time period. Identity amnesia refers to a person not remembering who they are.

  • Identity confusion. This refers to being unsure of who one is. I have always believed that everyone has a level of identity confusion, but when I did a structured interview for dissociation, it appeared as though this isn’t really normal.

  • Identity alteration or “switching”. This refers to a person becooming “someone else”. This ccan be apparent on the outside, like by the person having a change in non-verbal communication that is unlike them. It can also be apparent on the inside, where the person just feels as though they’re “someone else”.


Dissociation is different from psychosis in that people who dissociate are still aware of reality. Most people with dissociative experiences do not experience delusions or hallucinations, though a PTSD flashback coupled with dissociation can look like it. At least in my case, I’ve appeared quite disorganized and out of my mind when in a flashback.

Dissociation to a certain extent is normal. Most people on occasion get “lost” in a book or movie, for example. When dissociation is more severe, you may have a dissociative disorder. There are several different dissociative disorders.


  • Depersonalization/derealization disorder is characterized primarily by depersonalization and/or derealization. This disorder can only be diagnosed if the depersonalization/derealization is not due to another mental disorder, such as a panic disorder.

  • Dissociative amnesia is primarily characterized, as the name suggests, by amnesia.

  • Dissociative fugue. This is a subtype of dissociative amnesia where the affected person travels away from their home or work and has amnesia for their entire life prior to travelling away. They also often adopt a new identity.

  • Dissociative identity disorder is characterized by both amnesia and dissociative phenomena affecting identity, ie. identity confusion and alteration. DID is considered to be the most severe dissociative disorder.

Depersonalization and derealization can, as I said, be part of another mental disorder, such as panic disorder. There is also a subtype of PTSD which is characterized by depersonalization and derealization. Other causes of depersonalization and derealization include stress and certain substances, such as marijuana.

The other dissociative disorders are believed to be trauma-based. Treatment involves psychotherapy. The psychotherapeutic treatment of DID consists of three phases:


  1. Stabilization. In this phase of treatment, a person learns coping skills to deal with flashbacks, keep themself safe and stay grounded.

  2. Processing the trauma that caused DID.

  3. Integration. This can refer to merging of the alters, but also to rehabilitation.


In 2011, Onno van der Hart, Kathy Steele and Suzette Boon published a manual for skills training in the first phase of DID treatment called Coping with Trauma-Related Dissociation.

My Experience With Therapy and Counseling #Write31Days

31 Days of Mental Health

Welcome to day 23 in the #Write31Days challenge on mental health. Today, I’ll focus on another question in the 30-day mental illness awareness challenge. For day 23, the topic is your opinion on therapy. I will share my experiences of therapy and my opinion on various approaches. I have decided to include both traditional psychotherapy approaches and non-verbal approaches.

I had my first experience of therapy as a child, when I had four sessions of play therapy. I didn’t like the therapist, didn’t have insight into my problems, and four sessions obviously wasn’t enough to garner any results. In hindsight, my play behavior did show my problems with rigid thinking, emotion regulation and behavioral control. For example, I’d throw out the dollhouse dolls with purple hair because “people don’t have purple hair”. I also preferred to play with toys that allowed me to show anger, such as toy guns. One vivid memory I have is of me trying to overflow the water tray. The therapist did show me why it wouldn’t work, but I tried anyway.

My first experience with verbal therapy was when I was nineteen and attending the rehabilitation center for the blind. Once again, I didn’t like the therapist, who appeared a bit inpatient towards my difficulties adjusting to blindness and misunderstanding of my social ineptitude. She tried to offer practical advice, while I felt I needed to process the rollercoaster ride that my life had become. Of course, time constraints – I had only about twelve sessions -, prevented us from going deeper.

During my first sixteen months in the psychiatric hospital, I didn’t have a psychologist. I did do movement therapy, which helped me greatly to release my emotional tension. It was here that I learned to rate my distress level – I came up with a system myself. Thhat being said, when later people asked me to rate my distress level, I was often stuck. This moveement therapist I had at the acute ward was one of the more helpful therapists I’ve had.

At the resocialization ward, I tried cognitive-behavioral therapy for a bit. It hardly worked, because I and my therapist agreed I had good reason to be anxious. Then, when I was diagnosed with DID and PTSD, the therapist pushed me to try EMDR, but I resisted. I didn’t have that severe PTSD symptoms, after all, and did have quite a bit of trouble with self-regulation and dissociation.

When I moved to my current institution, I got diagnosed with BPD. My therapist’s expertise was schema-focused therapy, an approach I’d wanted to use for a while. Unfortunately, it didn’t work out. The therapist told one of my parts, who hides her inner weakness behind a stubborn attitude, that she’s a “punitive parent” and needs to disappear. I strongly feel that each part of my personality has a function, so this dismissive attitude didn’t fit me well. Besides, though I learned some from the book the therapist recommended, most of the information was just a bit too abstract.

This therapist left in 2014 and I’ve had a new psychologist for a little over a year now. With her, I focus on supportive counseling and rehabilitation. I find this is most constructive. I do hope that, in the future, I can get some formal psychotherapy again. I have a dialectical behavior therapy self-help book, which is quite interesting. Then again, I find it hard to make a long-term commitment to sticking to one thing to focus on. That is probably the main thing keeping me from engaging properly in psychotherapy.

Animals and Mental Health #Write31Days

31 Days of Mental Health

Welcome to day 21 in the 31-day writing challenge on mental health. Today on a mental health E-mail list I’m a member of, the daily question for discussion was about animals. This inspired me to write a post on how animals can impact mentnal health and help people who struggle with mental illness.

There are many ways in which animals, and especialy pets, can help someone with a mental health problem. For example:


  • Pets provide uncomplicated love. While your relationships with family and friends might be strained because of your mental illness, a pet doesn’t care whether you hurt its feelings and doesn’t give you unwanted advice.

  • Pets give you a sense of responsibility. While pets do not ask for much, they require a certain level of care. This may seem overwhelming when you’re struggling with mental illness, but it can actually help you focus on something positive instead of on your negative mood.

  • Pets require you to get moving. While becoming physically active may seem hard when you’re in the pit of depression or another mental illness, it will actually help improve your mood. Having a pet who requires you to be active, such as a dog, can really help you get motivated to get your butt off the couch.

  • Pets help establsih a routine. They need regular feeding, walking or other care. A proper daily routine is good for your mental health.

  • With a pet, you’re never alone. You may withdraw from contact with friends or relatives, but your pet is always by your side.

  • Pets can help you engage in social interaction. Pets can be an easy topic to talk about that is not laden with negativity. Pets also often function as ice-breakers, for example when you are walking your dog or waiting at the vet’s. Even when your mental illness makes you appear reclusive, people will start interacting with your pet.

  • Touching pets can be soothing and thereby improve your mental health.

The benefits of pets can be even greater when the pet is trained as a service or therapy animal. Pet therapy, also known as animal-assisted therapy, is a form of therapy by which a specially trained pet interacts with individuals with mental health problems. The benfit of animal-assisted therapy over human interaction is that an animal accepts the individual as they are without judging or being threatening. Like I said before, they don’t care whetehr their feelings are hurt. People with emotional difficulties in particular often find it easier to trust pets than humans.

Like I said, animals can also be an ice-breaker, allowing the mentally ill person to open up more eaisly when interacting with the pet and its handler.

Psychiatric service dogs can be helpful to people with post-traumatic stress disorder and dissociative identity disorder, among others. They can, for instance, signal when a person with PTSD or DID is going to dissociate or have a flashback. They can then comfort the person or alert someone else. PTSD service dogs can sense when the sufferer is experiencing a nightmare and then wake them up. They can also enhance the sufferer’s feelings of safety by for example keeping strangers at a safe distance while at the same time encouraging social interaction.

Emotional support or companion animals do not provide any specific tasks for a person with a mental illness, like service animals do. Rather, they are solely there to provide emotional stability and companionship to the mental health sufferer. A licensed mental health professional should indicate that a mental health sufferer requires an emotional support animal. Emotional support animals should wear an identification vest or tag that says they’re an emotional support animal. In the U.S., people with registered emotional support animals are allowed to have their pets live with them even when no-pet policies are in place. People are also entitled to fly with their emotional support animals. However, unlike service animal owners, people with emotional support animals cannot claim access to other public or private places (such as restaurants) with their animals.

Life Events and My Mental Illness #Write31Days

31 Days of Mental Health

Welcome to day 8 in the 31 Days of Mental Health. Today, I have yet another post inspired by the 30-day awareneess challenge. This one is a personal post. Two fo the questions in the chalenge are about when your symptoms started vs. when you were diagnosed and what important life events affected your mental health for the better or worse.

I have in a way always had mental health problems. That is, I was always a socially and emotionally delayed child, but my parents say I was relatively calm and cheerful until I was about seven or eight years of age. At age seven, I started learning Braille. I hated it with a vengeance. It probably was my increased awarneess of my blindness that set off my mental health problems, but it could also have been my becoming aware of my social deficits.

After all, my problems didn’t start to become severe till I moved schools at age nine, and this was precisely the time my peers stopped being protective and started excluding me. At my old school, I’d always gravitated towards older girls, most with mild learning difficulties, who acted like they were my babysitters while I showed them my academic ability. At my new school, I started in a combined fourth/fifth/sixth grade class and I was a fourth-grader. The other girls were all sixth-graders, so they knew more than did I. I did have a friend in third grade, but even with her my social deficits were becoming more pronounced.

Once I entered secondary school, my problems became even more severe. I was twelve when I experienced my first state of depression. That is, the first I can clearly remember. I do vaguely remember being suicidal (or parasuicidal) for a while when i was around eight or nine, but I’m not too sure of this. When I was twelve, I became acutely aware of my social difficulties. I devised my own interventions, but never quite knew how to follow through and, when people tried to help me, I was resistant.

At age thirteen, I went to a mainstream secondary school. I stayed there for six years and was mildly to moderately depressed all along. In fact, I think I may’ve been diagnosable with dysthymia at the time.

In the summer after my eighth grade year, when I was fifteen, I started experiencing dissociation. I felt as though I was in a movie a lot of the time and my alter parts appeard. I had had imaginary friends before, just like most girls, but this was different. I may or may not have been hearing voices at the time. I think it was more an overactive imagination coupled with some dissoication than something akin to psychosis, but my diary entries of the time make me wonder whether I was slightly out of touch with reality.

I spent the last three years of my secondary school experience functioning on autopilot most of the time. I had meltdowns several times a week and started self-injuring at age sixteen. I had been head-banging from a young age on, but had stopped more or less. At age sixteen, I started cutting.

After I graduated high school at age nineteen, I had a few months of relative calm. I went to the blindness rehabilitation center, where we had a lot of structure and one-on-one therapies. I for a bit thought I must be okay. Then when I moved to a training home for the disabled in early 2006, after a few months, the mask fell off and I crashed. I started dissociating more than I’d done before and experienced severe emotional dysregulation. Finally, in early 2007, I was diagnosed with autism.

I moved into independent living that summer and broke down within months. I was hospitalized on the acute unit in November of 2007.

To be honest, I don’t know what led to me being diagnosed with first DID/PTSD and then BPD. I mean, I know when I was diagnosed but I don’t know what got me to share my experiences of dissociation. In hindsight, however, it surprises me that BPD wasn’t diagnosed on the acute unit, because I displayed many classic signs.

Mental Illness: Nature or Nurture? #Write31Days

31 Days of Mental Health

Welcome to the seventh installment of the 31 Days of Mental health series. Today, I picked another of the 30 questions from the 30-day awareness challenge: do you believe nature (biology, physiology, etc.) or nurture (your psychosocial environment) causes mental illness? I am very tired, too tired to find the scientific evidence to back my post up with. will share what I do know off the top of my head, but please don’t ask me to cite my sources.

In medicine in general, there used to be a strictly nature-based model of illness and health. This determined that biological and physiological processes in the body caused illness and there was no contribution of psychological or social influences. This model is called the biomedical model and my health psychology book used it to describe the history of views on physical illness.

In mental illness, there have been many schools of thought that laid blame on the environment, in fact. For example, Freud blamed fixations in one’s psychosexual development for mental illnesses. The school of behaviorism also blamed the environment. Watson, the founding father of behaviorism, at one point said that, if given a handful of babies at birth to raise, he’d be sure he could make whatever you wanted the babies to become from them purely by processes of conditioning (behavioral learning).

It is interesting that there is such a distinction between the biomedical views on physical illness and the psychosocial views on mental illness. After all, though religion may say otherwise, scientists usually see the mind as part of the body. At least the brain is and dysfunction in the brain can cause mental disorders.

I currently study healht psychology at university. Health psychology feels illness as resulting from an interplay of biological, psychological and social factors. Again, they usually study physical illness, but I must say I believe the same goes for mental illness.

I remember when I was still diagnosed with dissociative identity disorder reading a scientific article that said in part that the role of psychological trauma in the cause of what is often diagnosed as DID may be less significant than people think. They used the analogy of borderline personality disorder, which they said most people diagnosed with DID truly have. BPD is commonly thought of as a developmental trauma disorder, but research shows that there may be genetic and other biological factors predisposing to its development. Then again, trauma researchers have made it very clear that trauma and other strong environmental factors alter the brain.

I personally tend to believe there is not a single mental illness that is solely caused by nature or nurture. There are illnesses where biology is the main causative factor, such as schizophrenia, and illnesses where psychosocial factors are the main cause, such as post-traumatic stress disorder. However, stress can trigger psychosis in vulnerable people and trauma only causes PTSD in some of its victims, presumably those biologically predisposed to PTSD.

As for my own mental illness, there are biological factors predisposing me to developing mental disorders. Though I don’t have any family members diagnosed with a mental illness, autistic traits run in my family. NOw again I don’t see autism as a mental illness, but autistic people are more vulnerable to mental illnesses than neurotypicals. I also was a preemie, which may’ve caused brain dysfunction. Lastly, though none of my famly members are mentally ill, a difficult temperament tends to run in my family.

As for psychosocial factors, I am a childhood trauma survivor. I also have had high levels of stress in my life, possibly due to the incongruence between my autistic self and the neurotypical environment. It was a stressful event that sent me over the edge, but it was probably biology that predisposed me to vulnerability to stress.