Polly's pages (aka 'Donna Williams')

Ever the arty Autie

Fear of co-morbid mental health issues and ignorance about dissociative disorders


People feel afraid, awkward etc re co-occurring (co-morbid) mental health issues. A lot of those interested in autism are unnerved if I talk about DID, as if they can’t reconcile that someone with a mental health problem is still functional, knowledgeable, empathic, fully ‘human’. Yet, ironically, 30% of adults with autism will have co-morbids, including those which commonly occur in people with DID and PTSD which is part of the same spectrum of dissociative disorders as DID.

In terms of foreignness, many people are extremely alienated from DID, yet can cope with PTSD which is also on the spectrum of dissociative disorders. They can cope with OCPD and AvPD which are personality disorders but are nervous of NPD, BPD or sociopathy which are also personality disorders. They can cope with depression but are nervous of bipolar. They can cope with mental breakdown but are nervous of schizophrenia. They can cope with anxiety disorders but struggle with suicide or self harm. They can cope with alcoholism but struggle with drug addictions.

It’s as if they have such a hierarchy of mental illnesses. People may want those with mental illness to hide the issues they live with. But if we were in a wheelchair would we be expected to hide it? If we were pregnant, gay, blond, atheist, would we expected to hide those too? I think the biggest disability is being a bigot. I think if we can collectively help people overcome bigotry they and we will all be more comfortable.

I am diagnosed with DID as well as autism.

Dissociative Identity Disorder is a DISSOCIATIVE DISORDER and part of a SPECTRUM of DISSOCIATIVE DISORDERS… so is PTSD (Post Traumatic Stress Disorder) and all human beings dissociate, especially before age 5.

Autistic children dissociate more than most due to chronic stress and information overload. This does not mean they develop DID though, like any co-morbid condition some have been diagnosed with both conditions. The tendency of those with autism to dissociate more commonly than other children means they would be more at risk of dissociative disorders along the spectrum of dissociative disorders just as they are also more prone to anxiety disorders (and dissociation is a response to chronic anxiety).

The spectrum of dissociative disorders includes Derealisation, Depersonalisation and also PTSD. PTSD commonly effects those who have been subject to things like chronic bullying, restraint, even overly intensive interventions a child may find disempowering or traumatizing.

Next along the spectrum of dissociative disorders is DD Nos… a sort of lesser developed form of DID. DID is one of the most severe Dissociative Disorders with the most severe of the dissociative disorders being Polyfragmented DID.

Hence only those who have experienced severe ongoing trauma usually would develop a dissociative disorder as severe as DID. It is believed that 25% of chronically abused children develop it and that there are predispositions toward dissociation. Child abuse does not discriminate. It effects all kinds of children, including those with developmental disabilities. Child abuse does not cause autism, but there is a higher rate of child abuse of children with developmental disabilities than of typically developing children and a higher rate of children with disabilities going into care as a result. The murders of autistic children are testimony to this truth, a truth we must face.

One of the reasons people fear the DISSOCIATIVE DISORDER of DID is that it used to be called MPD (then wrongly believe to be a personality disorder). DID was also often confused with BPD (a personality disorder) or Schizophrenia (a psychosis) but is now differentiated from both though some people will have both or even all three and others will just have DID.

DID is part of a SPECTRUM of dissociative disorders where MPD was not considered part of a spectrum and was deemed a personality disorder. These days people diagnose DID, not MPD as they feel MPD was an anomaly, a misunderstanding of DID within the spectrum of dissociative disorders.

The mental disorders are many – dissociative disorders, identity disorders, personality disorders, compulsive disorders, anxiety disorders, mood disorders, psychotic disorders… none is actually nicer, neater, cleaner, trendier than another…. it depends on who has it, how they manage it, how they live along side of it.

those with autism often have AvPD or OCPD – personality disorders, or anxiety disorders or mood disorders or compulsive disorders or a combo of the lot – all of them MENTAL HEALTH DISORDERS! So its about time we drew the line against bigotry and the purists.

Donna Williams *)
author, artist, singer-songwriter, screenwriter.

You can find more info at my website http://www.donnawilliams.netincluding my consultation page for DID where I offer online Peer Support.