Dissociative Identity Disorder: Identity Switch Triggers

What to Watch for With Dissociative Identity Disorder

Dissociative identity disorder (DID) is a mental health condition that was formerly known as multiple personality disorder or split personality disorder. This condition causes a person to have multiple distinct identities. It typically develops from significant childhood abuse, traumatic events, or overwhelming experiences.

This article discusses triggers that can cause "switching" between identities, or alters, in people with DID.

Potential Switching Triggers for People With Dissociative Identity Disorder - Illustration Jiaqi Zhou

Verywell / Jiaqi Zhou

Dissociative Identity Disorder Stats

Dissociative identity disorder is a rare condition, affecting about 2% of people worldwide.

What Is Switching?

People with dissociative identity disorder have at least two distinctly different identities, but some believe as many as 100 can emerge. Switching is the process of shifting from one identity state to another. This can occur slowly, with obvious signs, or very fast.

According to some research, switches can be consensual, forced or triggered. A consensual switch might be planned ahead of time. For example, an alter who is educated might plan to take over during a scheduled exam at school.

Forced switches are agreed upon by some of the alters, but not all of them. A stronger alter might be pushing out in front of a weaker alter in a particular situation.

Triggered switches are not intentional. Rather, they occur when a situation forces a particular alter to come forward. There are a variety of triggers that can lead to switching.

Outward Signs of Switching

A variety of physical signs can indicate that a person with dissociative identity disorder has switched from one alter to another. These can include:

  • Muscle twitching
  • Confusion
  • Slow, heavy blinking
  • Memory loss
  • Headache
  • Clearing the throat
  • Change in the pitch of their voice
  • Change in vocabulary
  • Different temperament
  • Different functional abilities or skills
  • Lack of eye contact
  • Change in handwriting
  • Appearing "spaced out"
  • Adjusting clothing
  • Change in posture

Causes of Triggered Switching

Triggered switches can be caused by many different things. In some cases, the trigger is not known.


Stress is a big trigger for switching. In fact, periods of heavy stress can lead to rapid cycling between alters, causing the person to display multiple identities within as little as a few minutes. This type of switching has been referred to by some as carousel-switching or rolledexing.

Memories and Strong Emotions

Memories can cause a person with dissociative identity disorder to switch from one alter to another. These memories can be either good or bad. An alter switch might occur while a person is looking at old pictures or other memorabilia.

Sudden changes in a person's emotions, whether positive or negative, can also trigger an alter switch.


Switches can be triggered by a person's senses. Smell, sound, taste, textures, and sights can all cause a particular alter to present itself. For example, a person who has a history of abuse might smell or see something that brings up past experiences.

The result is alter switching—whether the alter appears as a frightened child, or an aggressive, dominant alter who is going to stand up for the abused child.

Many movies will depict characters with DID as having a "bad alter"—someone sinister or violent. It is important to note that these characters are not representative of a strong majority of people with DID.

Other Causes of Switching

Drinking alcohol and using drugs can be a trigger for switching. Changing of the seasons or special events such as holidays or birthdays can also be a trigger.

Switching can be triggered by a particular situation that requires specific skills, such as public speaking. It can also occur when a person encounters another person who has a relationship with a particular alter.

When to Talk to Your Healthcare Provider

If you suspect that you or someone you know has dissociative identity disorder or is experiencing alter switching, talk to a healthcare provider, such as a mental health professional. DID is a serious condition that can significantly impact a person's daily life, but treatments are available.

Inward Signs of Switching

A person might not always be aware that they are switching between alters, but in many cases, there are some inward signs. These can include:

  • Time-lapse
  • Memory loss
  • Forgetting how to perform a skill
  • Auditory or visual disturbances
  • Having an "out of body" experience
  • Being in a trance-like state
  • Being out of touch with reality
  • Flashbacks


There are a variety of triggers that can cause switching between alters, or identities, in people with dissociative identity disorder. These can include stress, memories, strong emotions, senses, alcohol and substance use, special events, or specific situations. In some cases, the triggers are not known.

A Word From Verywell

Dissociative identity disorder is a condition that impacts every area of life. It can even keep a person from being able to work, go to school, or develop meaningful relationships with other people. This condition is typically treated with psychotherapy (talk therapy), and consistent participation in treatment can be very helpful.

Medications can also help treat anxiety and depression that often occur with DID. Talk to your healthcare provider about treatment options.

Frequently Asked Questions

  • How do doctors treat patients with dissociative identity disorder?

    Therapy is the most common treatment for DID. In some cases, medications are also prescribed to treat anxiety and depression that often occur with DID.

  • What causes dissociative identity disorder?

    There is no single cause of DID, but it often develops in people who have a history of significant childhood trauma and/or abuse.

  • Is there a test for DID?

    There is no specific test for dissociative identity disorder. A diagnosis is based on the person's symptoms, after other possible medical and psychiatric conditions have been ruled out.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. What are dissociative disorders?

  2. The Recovery Village Drug and Alcohol Rehab. Dissociative identity disorder facts and statistics.

  3. Cleveland Clinic. Dissociative identity disorder (multiple personality disorder).

  4. Dissociative Identity Disorder Research. Switching and passive influence.

  5. Loewenstein RJ. Dissociation debates: Everything you know is wrongDialogues Clin Neurosci. 2018;20(3):229-242. doi:10.31887/DCNS.2018.20.3/rloewenstein

  6. Dell. PF. A new model of dissociative identity disorder. Psychiatric Clinics of North America. 2006;29(1):1-26. Doi:10.1016/j.psc.2005.10.013

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.