DID masking other disorders

Hello everyone,

Trigger warning, possibly, for suggestive language associated with depression and psychosis.

I thought I'd post this question here instead of my journal. Lately I've started to realise just to what extent my alters have tried to make me seem "normal". Our failed therapy was also aimed at us/me fitting into society better rather than healing and feeling safe. I suspected they helped keep up appearances but only now do I get just how much they've protected me in this manner. So, now I wonder how has that been for others on this forum. What are your experiences of having other disorders etc. masked because alters hid your symptoms?

Some of my personal experiences include:
- My alters have managed to keep us all quiet about what I understand now were episodes of psychosis, which kept me out of the hospital/a mental ward. They did this by being a voice of reason.
- They've countered hallucinations (mostly auditory ones). I.e. when I heard voices telling me to do certain things, they'd tell the voices to shut up and for me not to listen.
- They managed to stop me from acting on depressed thoughts by being uplifting and inspiring. They also managed to stabilise minor moodswings.

Most of it was them making sure people wouldn't notice my struggles and oddities. Especially with my parents and their unpredictable responses, they made sure I'd always face them with the same emotionless demeanour to avoid conflict.

In the end this and more gives me an idea of how I missed out on the right diagnosis during therapy. I'm certain a lot of you also went through misdiagnosis so this is basically a thread to share this and discuss to what extent alter interference like this is helpful I guess? It's also a bit of a not-so-subtle attempt to see if anyone else experienced psychosis and was spared a hospital trip thanks to alters remaining somehow stable enough to help.

Please apply trigger warnings where necessary, I'm not sure if paraphrasing like I did is triggering to anyone but I put a heads up anyway.

~ Grey

Hi

I think ours kind of happened the other way around and the fact that we'd had developmental delays meant Doctors never looked any futher! Neither did they explain anything to us fully as they considered us 'a little slow'..other kids used to call us the r word. (r****d) ..maybe thats why 'Thea' was created to go to university, to prove we weren't! .

Anyway ..when the autism was re-diagnosed in our late 20's it was the same again. We were probably the closest we could have got to been diagnosed with a dissociative disorder, had anyone known enough about it or looked a little deeper, but instead they checked old records..we had history of epilepsy and autism had been suspected ..ok thats why...put us back on anti-epileptic medication and pass us on to someone who knew about autism!

I guess up to that breaking point our alters had successfully passed us as NT to the world so we could get to university and was only when the breakdown of Thea was triggered we 'suddenly became more autistic'.

After a break from life demands Kit managed enough to get us back out of an autism unit and into a small flat...getting a dog triggered Bobby back out but the increasing social demands again (FB had started up by this time 2002) and having a social worker who seemed insistent on us reconnecting with friends from uni etc resulted in the creation of 'Maddie' to deal with those demands...again we seemingly became 'less autistic' whilst everyone worked together to host as 'Maddie' in front of others. (though many still being unaware of each other).

Again the breakdown of Maddie many years later (after that dog died) resulted in us 'becoming more autistic' but by then we were the age of peri-menopause starting so we (consciously this time) hid behind that excuse whilst Kit started to do more research as she was becoming more aware of more of us and aware we were 'seen' as a different person with different levels of ability in different situations. (Kit was the first to realise this...from other people's perspective). She didn't know what to do about it though so she just effectively became 'gatekeeper' and then we started to consciously switch to specific people for specific situations. Eventually Kit found this board and began to relaise 'what was wrong with us'...she always felt it was more than 'just autism'.

I think too because of Bobby's early 'therapy' and the threats back then that anyone who wasn't 'normal' was shipped off to a special school or institution for life, all our alters without realising it saw it as their job to hide Bobby's existence as they weren't supposed to 'still be here' after all the therapy we'd been given to have 'a normal life'.

I'm not sure about 'psychosis' though, Bobby has always known the difference between the Inner world and the outside world, just because they prefer the inside world doesn't mean they are psychotic and can't distinguish between the two! It's just the only method of escapism they had back then (before video games) to replay stuff, process it, try and make sense of what was happening in the outside world etc and they weren't supposed to still exist..ALL the outside world ever wanted to see was 'the perfect child/teen/NT adult' performing their 'normal life'.

because we'd never met any other high functioning autistic people though we didn't relaise until we did ..much later in life how much our other alters had been able to completely hide in some circumstances the fact that we were autistic at all. The one's best at it were the ones who never knew they had autism or DID! (at the time of hosting) Now everyone in the system knows it feels harder to fully mask and much more exhausting!

A semi-mask is about as much as we can manage these days 4-5 hours tops.


Lily
(with Kit dictating some details to me in the background!)

Our dissociative disorder was made to not attract attention. It worked well to hide our most obvious symptoms of ADHD and our autistic traits. They were noticeable until the age of 7-8, then we learn how to mask in public. I didn't really need to mask at home, all my family has AuDHD and didn't realize we're all neurodivergent before my brother was referred for an autism diagnosis in 2021, and before I get my ADHD diagnosis mid 2022. Since then, I had an aunt and cousin diagnosed with autism, and my mom is in the process of getting her ADHD diagnosed. The only things I needed to mask were the autistic traits (stimming, echolalia...) that were overstimulating for my mom.

So yeah...
Bored and understimulated? Dissociation.
Overstimulated? Dissociation.
Need to stim? Dissociation.
Hypersensorialities hurting me? Dissociation.

I ended up with fragments dedicated to hold stimming behaviors. I had alters dedicated to not feel any needs of the body while in hyperfocus, to not have to break it and keep the dopamine flowing. I had an alter made specifically for school, so we would look "normal" there - she was able to dissociate during classes without going full "bored disruptive ADHD" at the end of the day. She slowly became our host while we grew up. Since others were expecting us to be "calm and quiet" more and more, we needed her to not attract attention full-time.

We also compensated our social awkwardness with our DID. Like I said, our previous host was made to not attract attention, and when she realized, at 17, that she didn't know how to interact properly with other humans, she started to train herself. She watched how NT were interacting, practiced small talk and developed scripts, read things about psychology and testimonies of people living through various life events to create a "mental catalog" of human behaviors - and training her cognitive empathy.

The more she learned, the more she realized in order to fit in, she will have to attract some amount of attention. Long story short, it leaded to the creation of a new alter, holding every social things she had learned. It wasn't a mask, it was a fully formed alter enjoying social interactions, being often clumsy, but trying his best. He was thinking of interacting with NT like interacting with another culture, learning how to blend in like learning a new language. If I'm able to adapt myself that well now, it's thanks to all of that. It's exhausting, but since I'm the "very social" type of A(u)DHD, I love it.

So yep, DID and dissociation masked very well our comorbidities. Plus, some symptoms of PTSD and ADHD overlaps. I had to wait until my PTSD was almost healed to find a psychiatrist who knows both about ADHD and dissociative disorders, so I could go through a proper differential diagnosis process.

Thanks for sharing your experiences!

@Tri - Lily
Autism is a much more acceptated diagnosis than DID, I think, so that may have interfered in your case too.
To think you got into university is really impressive. I'm always impressed when ND people manage to get to and even through university. It's not easy for NTs either so I hope you were/are all proud despite of the breakdown Thea had.

My psychosis moments are different from the inner world too. I can tell whenever I manage to connect with the inner world that I'm "in my head" somehow. Almost like I projected myself into the landscape of my brain.
The psychosis episodes I had, as I remember, were convincing to me in that moment and afterwards I was embarrassed and confused.

(Trigger warning for elaborate psychosis experience with odd/ disturbed thinking and possession)

So I used to believe I embodied a magical portal to another dimension and souls from that dimension could enter this world through me and posses me. These were all non-human creatures such as vampires, werewolves, types of undead, angelic and demonic creatures etc.
These creatures each had voices of their own which I could hear outside of my head, and I could see their shapes merging with my body or stand by my side.
My alters were in my head, warning me, telling me what not to say, what not to listen to or act on, etc. Actively protecting me from myself.

(end trigger)

I didn't have an inner-world to speak of at that time, but I know this is different from that.

I wondered for a while actually if my alters were a sign of psychosis, but they remained after I finally realised that the entire psychosis was utter bull. They've been there even when my moods and energy levels were stable. That gave me the idea that something else was up and I went into therapy. There I was first confronted with messages my alters had written to other people and when I brought it up, my therapist concluded "borderline with dissociative tendencies and psychosis under stress" which I now think was a rather odd diagnosis.

@Dwelt
Sounds like your alters did for you what they did for me. I'm honestly so impressed at how the brain manages to do this! I dare say it may be one if the few things that are good about DID. The memory lapses, anxiety at switching, headaches etc. are all distressing but at least it somehow in a way helps us be "high-functioning" to some extent.

I often see ADHD and Autism as comorbid disorders for DID. Wonder if there's an increased likelihood there. Adhd already spaces out easily of course so maybe?

~ Grey

Thanks we are proud yes and did manage to complete the course and get the degree 2:1 BA (Hons) ...won't say what in exactly incase it could identify us...but it did cause the breakdown of 'Thea' and cos we didn't know of DID or understand what has happening at the time either it was quite stressful.

Kit has wondered if adhd applied to us as we are much more disorganized than alot of high functionoing autistics who tend to be almost OCD when it comes to their houses and spaces. Our sibling for eg is more the typical aspie male, everything in its place, doesn't believe in anything he hasn't seen with his own eyes.

We'd never heard this AuDHD term before though and there's so much overlap, especially if you're throwing DID into the mix too...and some of the stuff like being unable to focus due to brain fog could have been due to peri-menopause, or the others wanting to switch to get some time out when host was trying to work/revise etc, so until we're clear of that and symptoms are still persisting that fit, it would be hard to know I guess?? ...and besides we're fed up with 'labels' ...we have more than our fair share of them with the physical and sensory issues too! ..we're not sure they're all correct given that they were diagnosed in isolation with the Doctors having no knowledge of the fact that we had different alters that were showing different symptoms and different levels of ability! ..and our hosts at the time also being unaware of 'the others'.

Lily

Triskelion wrote:I often see ADHD and Autism as comorbid disorders for DID. Wonder if there's an increased likelihood there. Adhd already spaces out easily of course so maybe?

~ Grey

ADHD and autism are risk factors for dissociative disorders. For autism, there's a pre-study explaining some of the reasons here: Dissociation in Autism.
Long story short, autism means more prone to anxiety, more at risk to develop disorganized attachment because of the issues with communication, more at risk to be abused because of the other symptoms (stimming triggering violence from the others, for example), the hurt done by masking (in terms of energy, but also beliefs about one's self, diagnosed or not). To this, you can also add emotional (dys)regulation, difficulties to develop a good support system, hypersensitivies that can be very distressful...

For ADHD, there are two main issues. First one, emotional (dys)regulation. Emotions go very high very quickly, to the point where even positive ones can lead to feeling like "it's too much". If there's no one to teach you how to regulate them according to how your brain works, you will end up using dissociation to stop the suffering. This lead to issues with attachment, of course, and it can be to the point of developing rejection sensitive dysphoria.

Second one, the hyperactivity. Every ADHD person is hyperactive, the "3 types" (hyperactive, inattentive, mixed) is just a way to make the difference between those who have motor symptoms (the one who can't physically stay still) and those who have mental symptoms (the one who have racing thoughts instead of racing literally). Being hyperactive and always chasing the dopamine you lack, it means being bored is a source of intense dysphoria (dopamine is vital for the brain and its functioning). When you are forced to stay still, to listen to someone for a long period, it can become incredibly painful. Not just hard, but physically painful.

And "a long period" is really subjective. Like, in class or when reading, if I'm not in hyperfocus and without treatment, my attention span is 5-10min max (this is the one of a 7yo) - if I'm tired, it doesn't go over 1-2min. With my treatment, it can go up to 10-15min (an adult is supposed to reach 20-30min). Classes are basically torture for me.

So yep, having autism and/or ADHD often means you're dissociating to some level - not necessarily to the point you'll have a dissociative disorder, but dissociation is one of the most common ways to deal with the symptoms. The "spacing out" in ADHD or shutdown in autism can be understood as dissociative reactions to handle the hurt.

TheTriForce wrote:We'd never heard this AuDHD term before though and there's so much overlap, especially if you're throwing DID into the mix too...

It's a fairly new term, created by the community. It's kind of hard to have your autism diagnosed when you already have an ADHD diagnosis, and reverse, because some doctors have this myth that you can't be both (which we know well by now it's false, but not everyone is up-to-date about this, specially because psy training often forces professional to specialize into one of them, not both), and others think that you don't need both diagnosed, because "a lot of autistic people have ADHD, you'll have the accommodation you need anyway" (spoiler: no.).

If you also have a PTSD diagnosis, it's almost impossible to be correctly diagnose without fighting for it. So yep, the community came with its own term for those who have ADHD and autism, often used by those who have one diagnosed and the other self-diagnosed (or not officially diagnosed by a doctor, like me - I have a bunch of mental health professionals used to work with people with ADHD and/or autism who still don't understand why the public services didn't give me the autism diagnosis...).

When you step away from the biased diagnosis criteria and diagnosis tools, to really understand how each disorder works within itself, you can make the difference between autism, ADHD and DID. But that takes A LOT of time, to do A LOT of research (about theory and about the patient and their symptoms), and it means the professional assessing you know about all three - which is basically a miracle at this point.

It's just exhausting. That's why I have given up the idea of having my autism properly diagnosed one day. Which is ironic, because I show even more signs of autism than my brother - who, on the other hand, shows even more signs of ADHD than me.