Diagnostic Struggles


Today as I was article-browsing, I came across an article at HealthyPlace that peaked my interested and echoed my inner struggle. I decided to write a post in response to, and in tangent of the post.

For those with DID and other dissociative disorders, the likelihood of misdiagnosis is high. Research shows that people with a dissociative disorder spend an average of seven years in the mental health system before receiving a correct diagnosis. When dealing with dissociative identity disorder, misdiagnosis leads to years of improper treatment and little to no symptom improvement. For some, symptoms may actually get worse.

I have spent the past eight years in search of a proper diagnosis, all in the public side of medicine here in my country. Over the years I/we have suffered from episodic depression and anxiety, panic attacks, psychotic breaks, sleep paralysis, night terrors, hypomania, eating disorders, dermatillomania and other obsessive-compulsive behaviors, suicidality, gender dysphoria, body dysmorphia, self-harm, dissociation, depersonalization, dissociative amnesia and derealization. I/we have been diagnosed with a Depressive Disorder NOS, Anxiety Disorder NOS, Demanding Personality Disorder, Paranoid Personality Disorder and Borderline Personality Disorder, and in the side of children’s psychiatry I/we were diagnosed in the past with Adjustment Disorder.

One of the difficulties in properly diagnosing DID is the similarity of DID symptoms with symptoms of other psychological disorders. Those with DID can show signs of anxiety, depression, substance abuse, borderline personality disorder, eating disorders, and/or mood disorders. Therefore, it is not uncommon for people with DID to receive several diagnoses before finally being diagnosed with DID.”


It is also possible for an alter to have symptoms of a mental illness that is not shared by the host. An alter may have an eating disorder and show symptoms whenever present, but the symptoms disappear when that alter is away. This can further complicate the process of receiving an accurate diagnosis and getting proper treatment.

While I do admit to having most of the diagnoses I’ve listed, I conceive of them as being secondary to my D.I.D – either exhibited by the system as a whole or exhibited by specific alters. Also, the diagnosis received from children’s/youth psychiatry have been received during a time when trauma was still continuous and more or less severe, a time after which an episode of difficult depression and suicidality ensued.

I can easily pick out the symptoms/disorders exhibited by specific alters: dermatillomania goes to Bunny, our age-sliding little who alternates between the ages of three and ten and who hates zits and other impurities brought on by puberty. Body dysmorphia is also something exhibited by the little(s), generally due to the fact that their preferred physical outlook differs rather violently from that of the adult female host. Gender dysphoria (as well as body dysmorphia) is exhibited by male-identifying alters, for obvious reasons: the host is biologically female and identifies as so. Eating disorders and obsessive-compulsive behaviors, like rigorous cleanliness or other perfectionist agendas, go to Moana, our analytical protector. Lastly, depression and suicidality go to our newest member, Lydia, whose sole purpose is to have and hold those two things.

DID and dissociative disorders, in general, continue to be the least explained and the most misunderstood of all psychological disorders.


How can professionals properly diagnose a person if they don’t have all of the knowledge they need to make an informed decision?


There is also continuing debate over the validity of DID. Some members of the professional psychological community do not recognize DID as a real disorder and, therefore, do not diagnose it. Then there are those that believe DID exists, but only in the exaggerated way DID is often portrayed in popular literature and media. Both beliefs can contribute to a delay in getting the right diagnosis.

My designated treatment crew at my clinic has all but admitted their lack of knowledge upon Dissociative Disorders. Just last month I was diagnosed with Borderline Personality Disorder, to which my doctor attributed the entirety of my dissociative symptomatics. I felt quite appalled that something that rules my life could be so belittled. “Well, BPD does attribute for some dissociative behavior,” is all my doc would say on the matter. Some dissociative behavior. I’d only just explained my rich dissociative history of switches and time loss and amnesia. And he attributes it to “some dissociative behavior”!

Luckily I have a therapist who’s on the right track about this. Not so luckily, she is only licensed to treat conversationally, not pharmacologically or diagnostically. The way it is here is that the diagnosis is made by a licensed psychiatric doctor, not a therapist, not psychologist, a doctor. So with my therapist’s wind under my wings, so to speak, I have sought out a specialized psychiatric doctor on the privatized side of medicine. This battle plan will cost me dozens more than what public healthcare provides, but I am willing to put my (very little) money on it. I have fought for long enough, it is time I start winning.



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