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SALT LAKE CITY -- Imagine waking up every morning as a child and not knowing who your mother would be.
That was the life of Tiffany Fletcher, a Utah woman whose mother suffered from the mental illness commonly referred to as multiple personality disorder.
Dissociative Identity Disorder is rare, with less than 1 percent of the U.S. population diagnosed. Severe stress and abuse cause a personality to split, and that creates confusion and fear for everyone else.
Every day was confusing -- sometimes frightening -- for Tiffany Fletcher growing up. The worst of it began when she was 4 years old and her grandmother passed away.
"It sent my mother into a tailspin. She was completely destroyed because of her mother's death," Tiffany said. Her mother became suicidal and was put into the hospital.
"When she came back I just remember thinking, ‘Where has my mother gone? She's not here anymore, she's different," she recalled.
Tiffany told of the mental and emotional abuse her mother suffered, leading up to this change.
"My grandfather told my mother that her purpose in life was to take care of her mother, that that was her reason for being born," she said. "So in doing that, when my grandmother died he told her that it would be her fault if that ever happened, because she wasn't taking care of her."
That's why, Tiffany said, when her grandmother died after suffering from both diabetes and cancer, "My mother really thought that it was her fault."
By the time she was a teenager, doctors had a diagnosed her mother's severe mental instability. The cause: incest at the hands of her father. The result: dissociative identity disorder, or multiple personalities -- 14 of them.
Tiffany describes what it was like seeing her mother turn into the different people that seemed to inhabit her mother's body.
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"When her face became that stone face, that stone-cold face, we needed to get the little kids out, because Bill was here and we needed to take precautions," she said. "Then when Sam came out -- the little 3-year-old, 4-year-old boy -- when he came out he would just rock back and forth and he was just sad."
Her mother was sexually abused by her father from the time she was 3 to the time she was 18, when she married Tiffany's father. But Tiffany's grandfather wasn't her mother's only abuser.
"She had several in her life, and every time that happened she dissociated from reality, and a certain alter came into being," she said. "There were several children, there were three men, the rest were women. All of them had their distinct facial features, distinct personalities. They had their likes, their dislikes, their different voices, they were all different. It's hard to explain until you're there and you see it."
Growing up, Tiffany and her older sister raised four younger siblings while caring for their mother. Their father, a mechanic, had no medical insurance to pay for medications then.
"There were times when she just couldn't do anything," Tiffany said. "We had to help clothe her, we had to help feed her, had to help get her ready for bed, had to help drag her to bed as best we could."
This took an enormous toll on Tiffany and her siblings.
"Growing up was really, really hard," she said. "It's hard to love someone who's hurting you, but at the same time it's hard not to love someone who you are caring for."
After Tiffany's mother was released from the hospital, "We did the best that we could with what little information we had available to us, which was pretty much a pamphlet at the time, 1994." She died 10 years later, in 2004.
Tiffany wrote a book about her experience, called "Mother Had A Secret." In it, she writes of healing. She learned that despite her mother's pain and struggle, she had protected herself and the other children from similar abuse.
Tiffany talked of words of wisdom she once heard: "He said, ‘Someone who had been abused as much as your mother usually becomes a perpetuator and usually abuses themselves, and the cycle continues. I have no doubt that your childhood memories are hard, but they are nothing compared to what your mother experienced on a daily basis. Because she built a bridge for you and stopped it, your childhood was better than hers and your children's childhood will be better than yours,'" she said. "He allowed me to see my mom in a totally different light and respect her for the sacrifices she had made so that my children can have a happy and a normal life."
Tiffany and her husband, Sean, have five children. They can say that cycle has ended and they are no longer keeping the family secret.
But the battle is not over, Tiffany said, because of the stigma that continues to surround mental illnesses.
"I do feel as though there is still a stigma in some areas. I think there's a stigma for people who are suffering," she said. "It's hard for them to share because so many people are unaware of mental illness and are afraid of it, and it makes it hard to accept something that is so unknown."
The dedication of her book reads, "For all of those who suffer in silence, may you finally find courage to speak."
"Everyone needs to be able to share their secrets so that they don't have to suffer in silence," she said. "They need to get the help and the peace that comes with knowing that they are not alone, that there are people out there to open up their arms and embrace them and love them and take care of them. We'll get through it together."