Bipolar disorder and dissociative identity disorder are different types of mental health disorders that can affect how someone engages with their world. Because the two disorders can occur together — and they share some similar symptoms — distinguishing between them can be challenging.

From the community: “I was first diagnosed as a teenager back then it was called multipersonality disorder. I can map the year when most new personas appeared. Of course, I am not positive that I am aware of al of them. I think some psychs confuse bipolar with DiD or they crossover. I find some of the stronger more organized ones are very helpful and I miss them when I am alone with mainstay. #1 is emotionally stunted and depressed. I am happier when others show up to get me up and about again out of the dark pit and running around in life again feeling like I'm capable of anything. But the reckless one ,who I'm told can be … controlling … who has no impulse control and spends money i don't have so once she's done with her escapades, #1 is left holding the bag. I don't feel it's fair that I get left with her mess to cler up it usually take years. It feels like I was along for ride but it wasn't me doing those stupid things. Like my identity was stolen, I shouldn't been held responsible for those credit card debts. Lol.)” – Inspire member 

What is bipolar disorder?

Bipolar disorder was once known as manic depression because it brings on episodes of mania (high energy and happiness) that alternate or mix with depression (low energy and lethargy). A person also may have weeks or months when their moods are stable. 

There are different types of bipolar disorder. Symptoms vary depending on the type and whether someone is in the manic or depressive phase. Symptoms of bipolar disorder include:

• euphoria

• extreme fatigue or lethargy

• feelings of sadness, hopelessness, or worthlessness

• loss of interest in family, friends, relationships, and activities

• racing thoughts and reckless behaviors 

• suicidal thoughts

What is dissociative identity disorder?

Dissociative identity disorder was once known as multiple personality disorder. It’s a type of dissociative disorder that typically occurs after a traumatic event. It causes a person to develop and switch between two or more distinct identities that have unique names, mannerisms, memories, and ways of thinking. Someone with dissociative identity disorder can’t control when this change of identity occurs. Often, they don’t remember their actions or words when the identity was present.

Other signs of dissociative identity disorder include:

• difficulty functioning at work, school, or in society 

• feeling like your body is a different age (like a small child), gender, or size

• memory gaps or amnesia about personal information, daily activities, and past experiences like traumatic events

• out-of-body experiences that make you feel like you’re observing yourself in a movie

• relationship problems

From the community:“Hello. I have bipolar. Your description of being overly happy and wanting to hurt yourself seems to describe the swinging highs and lows of bipolar. I once had to go to the ER because I was experiencing what is called 'rapid cycling'. I was laughing hysterically one moment, then crying the next. It was weird. I was aware of what was happening, but I couldn't control it. I hope this explanation helps. Good luck, friend. I would check with your doctor soon.”– Inspire member 

How are bipolar disorder and dissociative identity disorder similar?

Similarities between bipolar disorder and dissociative identity disorders include:

• causes and risk factors

• symptoms

• diagnosis

Causes and risk factors

Atraumatic event almost always precedes the onset of dissociative identity disorder symptoms. Trauma may also play a role in the development of bipolar disorder. Trauma is more likely to trigger bipolar disorder when a person is already genetically predisposed to it due to a family history of mood disorders. 

Symptoms

Both bipolar disorder and dissociative identity disorder can cause symptoms like:

• Rapid mood changes: People with bipolar 2 disorder or cyclothymia are more likely to have large, noticeable mood changes. With dissociative identity disorder, a person’s mood may change instantly when an identity appears. Because each identity has its own emotions and behaviors, it’s possible for one identity to have lots of energy (mania) and another identity to show signs of depression or anxiety. 

• Grandiose thoughts: During manic episodes, a person with bipolar disorder may have an overly inflated sense of self or ego. They have a false belief that they’re superior to others. A person’s identity may also show signs of grandiosity, believing they’re better than others.

• Reckless behaviors: Mania can also cause someone to make reckless decisions or say things that are out of character. An identity may also do the same. Both mania and dissociative identity disorder can cause someone to make hurtful comments, decide to quit a job, drive too fast, or spend money they don’t have.

From the community: “Have you ever tried therapy? Therapists can educate us on our emotions and why we feel the way we do which can help us learn how to identify how to communicate our feelings with others. Once you can better communicate how you feel with others, then others will be able to better help you progress in your life and overcome struggles. I really think therapy would help you or maybe even teaching yourself more about bipolar disorder. I have bipolar 2 and once I identified my feelings and why I am feeling that way, it was easier for me to communicate better with others instead of causing conflict.” – Inspire member 

Diagnosis

Someone showing signs of a mental health disorder should see a psychiatrist. This medical doctor has the expertise to assess a person’s symptoms and risk factors. Doctors refer to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) to diagnose mental health conditions. The American Psychiatric Association (APA) outlines criteria in the DSM that helps doctors determine whether a person’s behaviors and symptoms indicate bipolar disorder, dissociative identity disorder, or a different condition.

How are bipolar disorder and dissociative identity disorder different?

Psychiatrists, psychologists, and other mental health professionals use slightly different approaches to treat bipolar disorder and dissociative identity disorder. 

Psychotherapy, also known as talk therapy, is the primary treatment for dissociative identity disorder. Some people also benefit from participating in eye movement desensitization and reprocessing (EMDR) therapy. This therapy helps people who have experienced trauma. Therapists often use it to treat post-traumatic stress disorder (PTSD). 

Doctors sometimes prescribe antidepressants or anti-anxiety medications to help people cope with the stress of living with multiple identities. However, there aren’t any medications that specifically treat dissociative identity disorder symptoms. 

This isn’t the case for bipolar disorder. Medications like mood stabilizers and antidepressants are the primary treatment for bipolar disorder. Most people with bipolar disorder can manage their symptoms by taking medications and talking to a therapist. 

Sources

• Steardo Jr. L, et al. Dissociative symptoms in bipolar disorder: Impact on clinical course and treatment response. Frontiers in Psychiatry. October 2021.

• Can one individual be both DID and bipolar? International Bipolar Foundation. 

• Bipolar disorder. National Alliance on Mental Illness. August 2017.

• Dissociative disorders. National Alliance on Mental Illness.

• Other disorders: Trauma-related disorders and misdiagnosis. Trauma Dissociation. 

Disclaimer

Member comments are lightly edited for length and to remove identifying information but are otherwise reproduced as they appear in the community as part of public posts.

This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition.