While not everyone with dissociative identity disorder also has a depressive disorder, I’d wager at least 50% live regularly with some type of depression. As for me, I have major depression and dysthymia. The former is a real pain; the latter is far more manageable. I’ve never taken either one very seriously and I think the magnetic relationship between dissociation and depression is the primary reason why.

When I was in college I confided in a friend about an incident at a party that left me feeling taken advantage of. Initially I was taken aback by her outrage on my behalf. A few days later, I was equally shocked by her hostility towards me. It took many years before I understood that Dissociative Identity Disorder played such a large role in the party incident that I came away with an impression of it that wasn't accurate at all. By reporting it to my friend, I essentially told a lie, though I didn't realize it at the time. Today her wildly varying reactions make sense to me because I have a much better understanding of the potential pitfalls of my dissociative memory.

The Courage to Heal is a self-help book – “A Guide for Women Survivors of Child Sexual Abuse” - that has enjoyed widespread popularity among both those living with Dissociative Identity Disorder and many of their treatment providers since its first publication in 1988. I first read it six years ago and found it helpful in some ways. But subsequent readings have illuminated for me the book’s biggest flaw: its reckless approach to traumatic memory.

How many times have those of you with Dissociative Identity Disorder drawn a boundary of some kind and later felt awash in guilt and anxiety? If you're like me, the answer is "just slightly less than always." And it's not just those of us with DID that struggle with boundary setting. That backlash of guilt and anxiety isn't unique to Dissociative Identity Disorder. But I suspect the path to resolving it might be.

I write about Dissociative Identity Disorder in part because I'm disturbed by the sheer volume of false and misleading information about DID. It bothers me that an overwhelming number of online resources are teeming with misconceptions so profound that the end result is a definition of the disorder that further shrouds it in mystery and controversy. Not to mention the fact that nobody seems able to explain it without relying on a misnomer, Multiple Personality Disorder, to do so. It took me a long time to wade through all the jargon and arrive at a definition of Dissociative Identity Disorder that accurately explains my experience of it.

Managing the self-sabotaging behaviors that make life with Dissociative Identity Disorder so difficult doesn't mean getting rid of them. It means learning to live with them; recognizing and investing in the opportunities for growth inherent in self-sabotage. For me, that requires (1) acceptance of those behaviors, no matter how repugnant, (2) honest communication devoid of the power struggle that characterizes instinctual responses to self-sabotage, and (3) welcoming compromises that allow me to keep moving. When I discovered an alter was blocking internal communication, I was surprised to learn that all three of those things are possible. But it was the compromise that amazed me the most, and ultimately changed my life.

I define self-sabotaging behaviors within Dissociative Identity Disorder as any thought, feeling, or action by any member of the system that actively impedes the intentions and goals of any other member of the system. Self-sabotage, by my definition, is a regular part of life with DID. And what most of us do when an alter disrupts our lives in some way is attempt to change the disruptive behavior. It makes sense, but it's counter-productive. Before you know it, you're entrenched in a power struggle that ultimately solves nothing. Without even realizing it, I engaged in a power struggle for years with an alter who effectively blocked all internal communication. Once I became aware of the situation, I stopped trying to change it. I now believe acceptance is the first step in managing self-sabotaging behaviors. And communication, I think, is the second.

Remember when I said I didn't know what to do about mental health warning signs when they flare up? The past two weeks of my life painfully demonstrate the consequences of that ignorance, along with some of the ugly truths about dissociative identity disorder. I knew my mental health was deteriorating. I was talking about it, writing about it, and actively looking for solutions. I saw the edge of the cliff and did everything I could not to fall. But fall I did.

Self-sabotage is hard for anyone to deal with. But I think managing self-sabotaging behaviors when you have Dissociative Identity Disorder is more difficult. So when I say that I think doing so is a matter of acceptance, communication, and compromise, I don't mean to over-simplify the monumental challenge that it is. Accepting things that directly impact your life in negative, destructive ways is frightening to say the least. But the most life changing negotiation with an alter I've ever had wouldn't have happened if I hadn't done exactly that.

You really want to lose weight but you keep stocking your pantry with junk food, "for the kids." This is self-sabotage, the frustrating outcome of conflicting conscious and subconscious desires. If you have Dissociative Identity Disorder, self-sabotage is more complex. Alters have the ability to A) assume control of the mind and body, and B) exert enough influence to impact the thoughts, feelings, and behaviors of other system members. Add to that the fact that Dissociative Identity Disorder exists in part to compartmentalize conflicting perceptions and it's not surprising that many people with DID experience particularly pervasive and disruptive forms of self-sabotage.