WASHINGTON — Confronting a barrage of accusations about his personal life — including claims he threatened women and paid for an abortion despite his public opposition to the procedure — Herschel Walker has repeatedly invoked his history of mental illness in his defense.“As everyone knows, I had a real battle with mental health, even wrote a book about it,” Mr. Walker, the Republican candidate for Senate in Georgia, said in a television ad released at the height of the abortion controversy. “And by the grace of God, I’ve overcome it.”In the ad, and on the campaign trail, Mr. Walker, a former football star, does not elaborate. But in his 2008 memoir, “Breaking Free,” he revealed that he had been diagnosed with dissociative identity disorder, formerly known as multiple personality disorder. He described his 12 “alters” — distinct identities that helped him cope with the trauma of being bullied as a child. He wrote of rage and “out-of-control behavior”; he played Russian roulette with a loaded gun.Now, as he tries to steady a campaign that could determine control of the Senate, Mr. Walker often speaks of these events in religious, not medical, terms. He either denies the accusations or says he does not remember what happened. Still, he casts himself as a redemption story, saying he is a Christian “saved by grace.”But experts say Mr. Walker’s assertion that he has “overcome” the disorder is simplistic at best: Like other mental illnesses, dissociative identity disorder cannot be cured in the classic sense. Psychiatrists say that while patients can learn to manage this disorder — and even live symptom-free for extended periods — the symptoms can recur, often triggered by stress.“You can get better,” said Dr. David Spiegel, a Stanford University psychiatry professor who studies and treats dissociative identity disorder. “But it doesn’t just evaporate.”Dr. Spiegel and other experts interviewed for this article have not treated Mr. Walker and could not speak to the specifics of his case.Mr. Walker’s retelling does not account for other complicating details. Experts say the disorder does not cause violent behavior. Some of the episodes — including an ex-girlfriend’s accusation that he had threatened her — took place after Mr. Walker claimed to have his disorder under control.The Walker campaign did not respond this week to questions about his health history and has not released his medical records.Last Friday night, during a debate with his Democratic opponent, Senator Raphael Warnock, Mr. Walker said he no longer needed treatment: “I continue to get help if I need help, but I don’t need any help. I’m doing well.”The State of the 2022 Midterm ElectionsBoth parties are making their final pitches ahead of the Nov. 8 election.G.O.P. Gains Edge: Republicans enter the final weeks of the contest for control of Congress with an advantage as the economy and inflation have surged as the dominant concerns, a Times/Siena poll found.Codifying Roe: President Biden pledged that the first bill he would send to Capitol Hill next year if Democrats expand their control of Congress in the midterm elections would be legislation to enshrine abortion rights into law.Florida Senate Race: In the only debate of the contest, exchanges between Senator Marco Rubio and his Democratic challenger, Representative Val Demings, got fiery at times. Here are four takeaways.Aggressive Tactics: Right-wing leaders are calling on election activists to monitor voting in the midterm elections in search of evidence to confirm unfounded theories of election fraud.In an interview with Axios last year, Mr. Walker likened his condition to a broken leg, saying, “I put the cast on. It healed.”A supporter at a Walker campaign event. Mr. Walker casts himself as a redemption story, saying he is a Christian “saved by grace.” Nicole Craine for The New York TimesDemocrats have said Mr. Walker’s description of his mental illness does not fully explain his previous behavior. In a statement, Mr. Warnock’s campaign manager, Quentin Fulks, said only that Mr. Walker had “not given Georgians an honest accounting of his violent past.”Health issues have been front and center for other candidates this year; in Pennsylvania, John Fetterman, the Democratic candidate for Senate, is facing questions from Republicans about whether he is fit to serve after a stroke. Even Republican strategists say Mr. Walker should answer similar questions.“I think it’s fair, and Herschel obviously thinks it’s a big part of his life,” said Scott Jennings, a former adviser to Senator Mitch McConnell, the minority leader. “If I were Herschel’s campaign I would say Americans live with mental health challenges every day — we just happen to be the first campaign to talk openly about it.”Dissociative identity disorder, known by its acronym D.I.D., is a relatively rare psychiatric condition usually triggered by childhood trauma, including sexual or physical abuse, or war. Studies show it affects about 1 percent of the population, said Dr. Paul S. Appelbaum, a professor of psychiatry at Columbia University, though “many of those people may have quite mild cases and do not experience problems from it and never come to clinical attention.”It is characterized by changes in behavior that occur when a patient fails to develop a unified sense of self, and instead “disassociates” into competing “self-states” that emerge in different situations. Many patients experience amnesia.Dr. Spiegel drew a comparison to healthy people who opt to act like “a different person” in different settings. But people with dissociative identity disorder, he said, “often don’t experience having choice.”Treatment typically involves intensive therapy; Dr. Spiegel often uses hypnosis, he said. While there is no medication to treat this disorder, some patients take medicine for conditions that occur alongside it, such as depression. Patients are required during treatment to take responsibility for their behavior; Mr. Walker says he has done so.“One of the core aspects of successful treatment for D.I.D. is holding people with the disorder responsible for their behavior, even when they say they don’t remember it, or that another self-state did it,” said Dr. Richard J. Loewenstein, a professor of psychiatry at the University of Maryland and a leading expert in the disorder, which was known as multiple personality disorder until 1994, when the name was changed to reflect a more nuanced understanding of the condition.In his book, written with two ghostwriters, Mr. Walker recounts his childhood as a “daily assault of verbal and sometimes physical abuse” by classmates who thought he was stupid because he stuttered. His doctors later told him he had created other personalities to help him cope.He says his “alters” were at times a positive force, helping him to “forget most of the awful things that had happened to me.” After he understood them, he wrote, he gave them titles.The General, or Coach, oversaw the other identities. The Hero “put on the facade” of a tough guy. The Sentry served as an emotional guard who “never let anyone get really close to me.” The Warrior “loved the physical contact” of football and did not feel pain; in the book, Mr. Walker describes having his wisdom teeth extracted without anesthesia. The Indifferent Daredevil “didn’t care about what other people would think or what was right and wrong.”In a 2014 ESPN documentary. he said he thought that in high school he might join the Marines, because it would give him license to “shoot people.” Instead, he pursued a career in sports. Football became his “coping mechanism.”But after he retired from the Dallas Cowboys in 1997, Mr. Walker wrote, his life spun out of control. He had an extramarital affair. He played Russian roulette, “risking my life with a gun at my head.” (The book does not recount an episode in which his ex-wife, Cindy DeAngelis Grossman, said he put a gun to her head and threatened to “blow my brains out.” Mr. Walker has not denied the allegation, but says he does not remember doing so.)In 2001, Mr. Walker writes, things came to a head when he grew enraged at a car salesman who was late in making a delivery. He could feel “my jaw pulsing and my teeth grinding,” he wrote, as a voice prodded him to pull out his pistol and kill the man. Another voice countered: “No Herschel, that’s wrong. You can’t shoot a man down in cold blood over this.”At that point, Mr. Walker sought help from Jerry Mungadze, a therapist who gave him a diagnosis of D.I.D. and arranged for him to be treated as an outpatient at Del Amo psychiatric hospital in Torrance, Calif., where doctors confirmed the diagnosis, Mr. Walker wrote.Walker has, at times, used his campaign to urge others to speak more candidly about mental illness.Nicole Craine for The New York TimesDr. Mungadze, who wrote the introduction to Mr. Walker’s book, has since stirred controversy with his methods. Dr. Mungadze, who holds a doctorate in “counselor education,” according to his website, and is not a medical doctor, specializes in Christian counseling and employs a technique he calls brain mapping, in which he diagnoses patients by asking them to color in a map of a brain. Experts say it has no basis in science.Mr. Walker has not said whether he still sees Dr. Mungadze, who declined an interview request.Dissociative identity disorder has long been the subject of intense debate; some psychiatrists say it is vastly over-diagnosed, and others have questioned whether it exists.Americans are most likely familiar with it from popular culture: It is central to the 1957 film “Three Faces of Eve” and to the 1973 blockbuster book “Sybil,” about a woman with 16 personalities. There is now a growing D.I.D. community on TikTok.In a 2011 book, “Sybil Exposed,” the writer Debbie Nathan reported that the personalities were pressured into existence by the therapist, who was invested in the idea of having a patient with the condition so she could speak about it at professional meetings. She cites a letter in which the real “Sybil” wrote that she was “essentially lying” — only to later recant.“In my view, it’s a metaphor rather than a true condition,” said Dr. Allen J. Frances, chairman emeritus of the Department of Psychiatry at Duke University School of Medicine. “It’s a way of expressing distress in people who have an internal conflict.”In 1994, while leading a task force that revised the Diagnostic and Statistical Manual of Mental Disorders — often called “psychiatry’s Bible” — Dr. Frances sought to eliminate “multiple personality disorder” from the manual. Instead, the task force changed the name. Dr. Frances said diagnoses often surge when the disorder turns up in popular culture.Dr. Appelbaum, who is also a past president of the American Psychiatric Association, said there was a consensus in the field that D.I.D. is “a real phenomenon, a real disorder.”Admissions of mental illness were once a barrier to a career in politics. In 1972, Thomas Eagleton was forced to drop off the Democratic presidential ticket as George McGovern’s running mate after disclosures that he had been hospitalized for depression and treated with electroshock therapy. But those stigmas are easing, and some mental health experts give Mr. Walker credit for raising awareness.As he campaigns, Mr. Walker has cast himself as a “champion for mental health,” and hits back at critics by saying they are perpetrating a stigma. At Friday night’s debate, he railed against “people like Senator Warnock that demonize mental health.” (Mr. Warnock has introduced a series of bills to expand mental health services.)Then, Mr. Walker turned to the camera, as if to deliver a public service announcement, and declared, “I want to tell everyone out there, you can get help.” More
