Sorry I’m late but today we’re talking about the difference between schizophrenia and DID (previously known as multiple personality disorder). People confuse them often but the difference is really obvious, I don’t know how everyone mixes it up. Stop it.
Deviant, disabling, and distressing are the three criteria that psychologists use to define a disorder. If it’s significantly deviant from what’s “normal”, if it causes problems for every day life, and if it is distressing, either to the afflicted or the afflicted’s close associates (y’know, like family), it’s a disorder.
Every time I hear things like the above line, I want to punch someone in the face. Even if it’s one of my favorite actors in a hilarious comedy (or the script writers). Rather than punch people which doesn’t tend to solve much, I will instead explain what schizophrenia involves (I’ll bet you think it’s just halucinations. You are so ridiculously wrong) and what DID is. We’ll start with DID because that’s sort of? easier.
DID stands for Dissociative Identity Disorder. Psychologists changed the name because it is a part of a strain of mental diseases that are called dissociative disorders. The idea of dissociative disorders is that you are lost from yourself. One of the more mild dissociative disorders is like an out-of-body experience. So with DID, it’s not so much that there are multiple personalities in one body but that a person mentally hid themselves from the circumstances around them to the point that their personality shattered, putting someone else in charge of being conscious and dealing with stuff so another fragment could hide. A person dissociates from their situation (think, “this is not my life” to an extreme) to the point their personality shatters.
What DID therefore looks like is someone who is more than one person, perhaps with each person displaying dominance in a certain emotion or aspect and lacking heavily in others. Usually each personality has a different role – one is in charge of protecting the host, one is in charge of sexual pursuits, one is a scared child, one is a host that tries to manage the other personalities and affairs, etc. You have one person who could change into a different person on a trigger. Maybe anger brings out the protective personality. Maybe adrenaline. When you are dealing with one personality, you are NOT dealing with other personalities. It’s like several different people trapped in one body, but all those people are from the same person that sprang off and developed in their own directions. And to be clear, the “original” personality is not going to be clear; what you will probably want to peg instead is the “main” personality, usually the host personality as described above.
There is, of course, a lot of controversy over whether this is even a real disorder or not. I don’t care if you think it is or isn’t, understand what it IS if you talk about it.
Schizophrenia is a psychotic disorder. It’s a completely different class of disorder than dissociative. It means that you have some sort of psychosis, which I’m not defining here so look it up if you don’t know it. Most everyone knows that people with schizophrenia have hallucinations. It’s much more than that, but we’ll start there since somehow that’s where people get stuff mixed up.
A hallucination is a sensory perception of something that doesn’t actually exist. The most common is auditory hallucinations. That means that a person hears something when there were no sound waves whatsoever. There are auditory, visual, tactile, and olfactory hallucinations, listed in order of what is most common.
People are often under the impression that people with schizophrenia have elaborate hallucinations involving people who don’t exist interacting with them. This is where the confusion with DID comes in. They both seem to be interacting with pretend people.
Please note the HUGE difference!
DID: You ARE multiple people! They are a part of you! ALL of the personalities ACTUALLY exist!
Schizhophrenia: You SEE other people who do NOT exist! They are not a part of you! It’s the same as interacting with any other stranger -except they are not real-!
Now that you will never, ever, EVER confuse the two ever again, let me clear up your misconceptions about schizophrenia.
They usually do not have huge, elaborate hallucinations. Like I said, auditory are most common – and it’s not like some sort of evil commands that they are hearing, it’s…their own thoughts. Let me explain. There are two parts in your brain, Broca’s area and Wernick’s area. Broca has to do with hearing things. Wernick has to do with speech, like what you’ll say. Which do you think is active during a hallucination? If you guessed Wernick, have a cookie. Schizophrenia’s auditory hallucinations are people thinking things to themselves, but hearing it as if someone else was saying it to them. Scary for them, don’t you think? Can you imagine how terrible that is? So unless the afflicted is thinking things like “Kill them, kill them all!” all the time, they’re not thinking instructions. It’s more likely they’re thinking things like “You idiot!” but as someone ELSE saying that to them, or “Is that safe?” but as someone ELSE warning them. And hey, if they DO hear a “kill them”, be honest. Haven’t you ever in your life thought something like, “Ugh, I wish that person was dead!”?
Now, hallucinations are just one small part of schizophrenia. Not all those afflicted with this awful disease even have them! The symptoms of schizophrenia are often divided into categories, although there’s some argument as to how many categories there should be and what they should be. I’ll mostly deal with positive and negative since we all seem to agree on those.
Positive symptoms include having behaviors that aren’t normal. Hallucinations therefore are one positive symptom. Another are delusions. A delusion is a belief that isn’t real. There are several types, two of the big ones are paranoid delusions and delusions of grandeur. A paranoid delusion would be something like, “the government is trying to read my brain through my mail!” or, “Aliens are trying to implant a chip in my brain!” whereas a delusion of grandeur would be like, “I am Napoleon!” or “I’m the King of Wonderland!” or “I’m the fairest of them all!”
People confuse delusions and hallucinations so here’s a way to remember: hallucinations are where you sense something when there’s nothing to sense. Delusions are where you believe something wildly untrue. There are some ridiculous things out there that are true for some people so obviously it’s not a delusion for them: only Napoleon can say he’s Napoleon without being delusional. Only Buffy (and Kendra and Faith) can say “I’m the Vampire Slayer” without being delusional. Uh, y’know. In the show.
Negative symptoms are lack of behaviors that are normal. Catatonia is one of the main ones. Lack of movement, or staying in one (possibly very uncomfortable-looking) position for an extended period of time, that’s catatonia. Another is lack of affect – as in facial expression and emotional response. You say, “my mother died”, they just kind of stare at you. You tell a seriously hilarious joke, they just kind of stare at you. (Side note, inappropriate affect can be a positive symptom – like laughing at news of your mother’s death.)
Finally, there is a disruptive category (which is disputed) and one of the symptoms there is also common. Disrupted speech, especially word salad. I would type an example here but I can’t mimic word salad, it just…it just makes no sense. It’s words together that maybe sound like they could be a real sentence, but it’s nonsense. It isn’t like a strew of random words, it’s a series of thoughts disrupted, stitched together, turned to words. It is ridiculously bizarre to hear someone with a word salad problem speak.
There are other details to this disorder; as it’s very complex, and there’s not just one set degree to which one has schizophrenia, there’s a lot to talk about. If you’re interested in the disorder, I highly recommend getting a hold of a copy of the DSM-TR-IV (or DSM-V if it’s out) and reading up on it. You can also talk to someone who knows a thing or two about it.
So now you know: schizophrenia is not just hallucinations. That is ONE possible symptom. One! So stop associating schizophrenia with only hallucinations. There’s way more to it. And stop confusing hallucinations with multiple personalities! It makes no sense!
Also please remember – the stereotypes that a person with DID has a violent/dangerous personality is not a good stereotype. DID is rare enough as it is anyway. And in fact, DID is guessed by some psychologists to be a variation of PTSD, sort of – I mean that if a traumatic event happens, one could develop PTSD or DID, depending on how he or she handle the event. So it’s not really fair to think of someone with DID as potentially dangerous. As for schizophrenia, PEOPLE WITH SCHIZOPHRENIA ARE RARELY DANGEROUS. So ESPECIALLY stop thinking that! They suffer, greatly. The world is terrifying to them! They are far more likely to be abused than a normal person. They are likely to be homeless – and if you pass by a homeless guy and he gives you a weird, piercing look, there’s a decent chance he’s doing that because via paranoid delusion thinks you might be trying to hurt him, might be a spy of some sort. Those with schizophrenia are not crazy villain murderer people. Unless their case is severe, they’re probably “normal” at least part of the time. DO NOT make someone a villain because they have schizophrenia. Do not add to the stereotype. Do not do it. You could have a villain with schizophrenia, but you’d best be careful to separate their villain status from their disorder…and because it’s so stigmatized and misunderstood, I really wouldn’t recommend it anyway.
So hopefully we all understand two mental disorders that the media loves to run with and misportray.