I’m a 16-year-old girl. I have been told my whole life that I have two personalities. Recently this has become a serious issue. People have told me I suddenly act aggressively — that I hit, swear, and throw things — then behave as if I have done nothing wrong. It’s like I am aggressive and angry one minute, but then quickly return to being my cheery, lovable self. The worst part is I never remember the times when I am aggressive like this. What is wrong with me?
You say you are typically cheery and lovable, but then act rageful and have no recollection of your behavior: you must feel like Dr Jekyll and Mr Hyde! For whatever reason, you are experiencing abrupt mood swings where you suddenly become angry and violent but then have no memory for these mood episodes. It makes sense that you are concerned, and your symptoms should be taken seriously.
Not knowing much about you or your history, I certainly cannot tell you what is accounting for your mood instability. The reason for your symptoms could be quite complex. Potential explanations may not be psychological in nature and might instead have medical origins or be attributed to neuropsychiatric (brain or central nervous system) causes. A number of medically-based problems or disorders could contribute to your unstable mood: drug use, medication side effects, metabolic disorders, hormonal imbalances, an undiagnosed seizure disorder, or even a brain tumor can all cause severe mood swings. To rule out these potential causes, you may need to see several types of physicians, such as an endocrinologist and a neuropsychiatrist to help diagnose and treat you.
On the “psychological” front, your memory lapses suggest you could be dissociating when you experience the mood swings you describe. Dissociation is considered “a disruption in the usually integrated functions of consciousness, memory, identity, or perception” (Diagnostic and Statistical Manual, DSM-IV-TR) and is believed to originate from traumatic events. Several psychological disorders are associated with dissociation, including post-traumatic stress disorder (PTSD), bipolar disorder, certain personality disorders, and various dissociative disorders. An individual who dissociates is disconnected from his/her own thoughts, feelings, memories, behavior, and/or identity. There are different degrees to which a person can experience dissociation. On the severe end, someone might act a certain way within one conscious state and then act another way while “switching” to a whole new consciousness. An extreme example is that of “Sybil”– the famous account of a woman who suffered sadistic childhood abuse and had Dissociative Identity Disorder (DID) (formerly referred to as Multiple Personality Disorder). She experienced frequent shifts in consciousness, emotions, identity, and behavior when triggered by stressful events.
By now you may be panicking, thinking you either have some serious medical illness or suffer from DID! Let me reassure you that I have no means currently of determining whether either of these scenarios is true; it is also possible that a completely different explanation exists altogether. The complexity of what you are describing means that various physicians first need to carry out comprehensive medical work-ups. This may potentially involve, but may not be limited to, blood work, brain scans, EEG recordings, etc. Once medical causes have been ruled out, you will hopefully be referred to a psychologist for evaluation and therapy and to a psychiatrist for medication. It may take a while before the reasons for your behavior are determined and you will likely need to undergo various medical, psychiatric, and psychological evaluations. While undergoing this stressful process, you may wish to seek the support of a counselor or psychologist to help you cope until an accurate diagnosis is made. In the meantime, please know that the answers, and corresponding treatment, are out there. It just may take some time to find them.
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