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DID is characterized by the presence of alternate identities, often referred to as alters. These identities are often complex, with their own unique histories and physical and behavioral traits. For example, an adult may have a child alter. You may notice changes in voice and physical movement, in addition to changes of attitude and preferences. As different alters present, the person may report loss of memory or a sense of lost time, as they may not be aware when an alter is present. Moving between alters is referred to as "switching" People with DID may also experience anxiety, depression, self-harm, sleep disturbances, and/or drug and alcohol abuse. Severity of symptoms varies greatly among individuals. People experiencing mental disorders often do not seek or comply with treatment because of stigma associated with being mentally ill. This may be particularly true for people with DID, as it isn't universally accepted as a disorder, despite its inclusion in the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders describing diagnostic criteria for all mental disorders. Avoid contributing to the shame and embarrassment a person with DID may already feel. Acknowledge how difficult it must be to manage the reactions of others. This will show you understand the complexity of living with a mental disorder. Is the individual is a friend or family member, ask about their experiences to show you care. Strangers may feel very uncomfortable with questions about their mental health, so do not pry. Ask how they feel before and after "switching" to get a better understanding of their experience. Express empathy by recognizing how frightening, confusing, and frustrating these experiences must be.
Know the symptoms. Suspend your judgement. Ask questions, if you are familiar with the person.