Date First Written: August 2017 ; Date Last Updated: March 2021
Why We Do Not Have A OSDD Diagnosis (But Have A DDNOS Diagnosis)
Introduction
Upon stating that we do not have Dissociative identity Disorder we have sometimes been asked if we have the only other dissociative disorder that includes the existence of plurality as a symptom. Before 2013 (when the DSM-5 came out) we could say we did, but after 2013 we have had to say we do not (sort of). That is because in the DSM-IV we fit the disorder DDNOS and we were even diagnosed with it in late 2010, but we could not be diagnosed with the disorder OSDD which replaced it in the DSM-5. This is because of the small changes to the criteria that came along with the name change and the fact that our symptoms had changed thanks to therapy or self-work. Ever since the DSM-5 came out, none of the mental health professionals we have seen has felt we fit the criteria for OSDD or found diagnosis necessary.
Our System, A Mental Health Professional, and A DDNOS Diagnosis
DDNOS came in several forms. One of the several possible presentations of DDNOS is the presence of alters but the lack of amnesia between them. Specifically, it states "Clinical presentations similar to dissociative identity disorder that fail to meet full criteria for this disorder. Examples include presentations in [...] b) amnesia for important personal information does not occur." This category of DDNOS is often called DDNOS1b. That is our multiplicity in a nutshell: many in one body but without any dissociative amnesia between us anymore. We used to have issues with dissociative amnesia but we haven't ever since we overcame the barriers between us when it came to awareness and memories. The endeavor that took about over a year of hard work to make a lot of progress and a few years more to make it become the natural state of things. After we archived full coconsciousness in the winter of 2009 "blackouts" haven't been a symptom of our multiplicity.
It was because we had overcome our issues with blackouts on our own before we finally were able to see a mental health professional, that we were given a DDNOS diagnosis rather than DID. She even said as much. She could only go off of our symptoms as we presently experienced them and we no longer experienced dissociative amnesia which was part of the DID diagnosis. So no DID diagnosis, but a DDNOS diagnosis only. That was in late 2010. So that was the diagnosis we had on the books for a few years.
Our System, 4 Other A Mental Health Professionals, and A Lack Of A Re-diagnosis
OSDD is fairly similar to DDNOS in many respects, but they are not the exact same disorder.
Within the DSM-5, OSDD is described as "This category applies to presentations in which symptoms characteristic of a dissociative disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class. [...] Chronic and recurrent syndromes of mixed dissociative symptoms. This category includes [...] alterations of identity or episodes of possession in an individual who reports no dissociative amnesia." This category of OSDD is specifically called OSDD1b. The added disclaimer in the criteria that the symptoms must "cause clinically significant distress or impairment" is what now complicates things even more. We still fit one of the "examples of presentations that can be specified using the 'other specified' designation," but the opening statement about "significant distress" leads us to not so clearly fit the criteria for OSDD. We certainly do not think that our multiplicity impairs our functioning and the mental health professionals we have seen since the DSM-5 has come out have agreed. Of course, it is far from perfect: things are not always easy and sometimes we do have disagreements, but who doesn’t? We do not feel "disorderly" nor act "disorderly" in relation our multiplicity. Us being multiple is weird, but it hasn’t stopped us from functioning. Being multiple is not enough for a diagnosis.
Between mid 2011 to present day we have had 4 different mental health professionals (had to change mental health professionals due to moving, etc). Ever since the DSM-5 has come out they have had to use the criteria for OSDD, but because it now requires "significant distress" and we have overcome the distress we had originally from being multiple, we haven't been re-diagnosed. We still technically have a DDNOS diagnosis in our paperwork but because it no longer exists, it is just a note in our paperwork. The people we have seen since the DSM-5 have even noted our past symptoms meet current criteria for OSDD1b (and our even earlier symptoms met criteria for DID), but they have to go with our symptoms now in the present (which is after years of therapy and self-work). Thus, no new OSDD diagnosis has ever been noted into our paperwork. This hasn't stopped them from accepting our multiplicity, however. They acknowledge that our loss of certain symptoms once connected to our multiplicity doesn't negate our multiplicity entirely.
Conclusion
So that is where we are as far as a diagnosis in relation to our multiplicity. We are many sharing one body, that is for certain, but we do not meet criteria for OSDD as it is laid out in the DSM-5 and have not been diagnosed with it though we were once diagnosed with DDNOS. We also think it is rather unlikely we will ever be diagnosed with OSDD given our ever still growing cooperation within our multiple system. We will not and do not claim we have Other Specified Dissociative Disorder if we've never been diagnosed. We will not claim to have it either for sake of being accepted either. We have an old DDNOS diagnosis and that is all.
End Notes:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000, pages 532-533.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association, 2013 pages 306-307.
Bibliography:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-III. Washington, DC: American Psychiatric Association, 1980.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association, 1994.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association, 2013.
Upon stating that we do not have Dissociative identity Disorder we have sometimes been asked if we have the only other dissociative disorder that includes the existence of plurality as a symptom. Before 2013 (when the DSM-5 came out) we could say we did, but after 2013 we have had to say we do not (sort of). That is because in the DSM-IV we fit the disorder DDNOS and we were even diagnosed with it in late 2010, but we could not be diagnosed with the disorder OSDD which replaced it in the DSM-5. This is because of the small changes to the criteria that came along with the name change and the fact that our symptoms had changed thanks to therapy or self-work. Ever since the DSM-5 came out, none of the mental health professionals we have seen has felt we fit the criteria for OSDD or found diagnosis necessary.
Our System, A Mental Health Professional, and A DDNOS Diagnosis
DDNOS came in several forms. One of the several possible presentations of DDNOS is the presence of alters but the lack of amnesia between them. Specifically, it states "Clinical presentations similar to dissociative identity disorder that fail to meet full criteria for this disorder. Examples include presentations in [...] b) amnesia for important personal information does not occur." This category of DDNOS is often called DDNOS1b. That is our multiplicity in a nutshell: many in one body but without any dissociative amnesia between us anymore. We used to have issues with dissociative amnesia but we haven't ever since we overcame the barriers between us when it came to awareness and memories. The endeavor that took about over a year of hard work to make a lot of progress and a few years more to make it become the natural state of things. After we archived full coconsciousness in the winter of 2009 "blackouts" haven't been a symptom of our multiplicity.
It was because we had overcome our issues with blackouts on our own before we finally were able to see a mental health professional, that we were given a DDNOS diagnosis rather than DID. She even said as much. She could only go off of our symptoms as we presently experienced them and we no longer experienced dissociative amnesia which was part of the DID diagnosis. So no DID diagnosis, but a DDNOS diagnosis only. That was in late 2010. So that was the diagnosis we had on the books for a few years.
Our System, 4 Other A Mental Health Professionals, and A Lack Of A Re-diagnosis
OSDD is fairly similar to DDNOS in many respects, but they are not the exact same disorder.
Within the DSM-5, OSDD is described as "This category applies to presentations in which symptoms characteristic of a dissociative disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the dissociative disorders diagnostic class. [...] Chronic and recurrent syndromes of mixed dissociative symptoms. This category includes [...] alterations of identity or episodes of possession in an individual who reports no dissociative amnesia." This category of OSDD is specifically called OSDD1b. The added disclaimer in the criteria that the symptoms must "cause clinically significant distress or impairment" is what now complicates things even more. We still fit one of the "examples of presentations that can be specified using the 'other specified' designation," but the opening statement about "significant distress" leads us to not so clearly fit the criteria for OSDD. We certainly do not think that our multiplicity impairs our functioning and the mental health professionals we have seen since the DSM-5 has come out have agreed. Of course, it is far from perfect: things are not always easy and sometimes we do have disagreements, but who doesn’t? We do not feel "disorderly" nor act "disorderly" in relation our multiplicity. Us being multiple is weird, but it hasn’t stopped us from functioning. Being multiple is not enough for a diagnosis.
Between mid 2011 to present day we have had 4 different mental health professionals (had to change mental health professionals due to moving, etc). Ever since the DSM-5 has come out they have had to use the criteria for OSDD, but because it now requires "significant distress" and we have overcome the distress we had originally from being multiple, we haven't been re-diagnosed. We still technically have a DDNOS diagnosis in our paperwork but because it no longer exists, it is just a note in our paperwork. The people we have seen since the DSM-5 have even noted our past symptoms meet current criteria for OSDD1b (and our even earlier symptoms met criteria for DID), but they have to go with our symptoms now in the present (which is after years of therapy and self-work). Thus, no new OSDD diagnosis has ever been noted into our paperwork. This hasn't stopped them from accepting our multiplicity, however. They acknowledge that our loss of certain symptoms once connected to our multiplicity doesn't negate our multiplicity entirely.
Conclusion
So that is where we are as far as a diagnosis in relation to our multiplicity. We are many sharing one body, that is for certain, but we do not meet criteria for OSDD as it is laid out in the DSM-5 and have not been diagnosed with it though we were once diagnosed with DDNOS. We also think it is rather unlikely we will ever be diagnosed with OSDD given our ever still growing cooperation within our multiple system. We will not and do not claim we have Other Specified Dissociative Disorder if we've never been diagnosed. We will not claim to have it either for sake of being accepted either. We have an old DDNOS diagnosis and that is all.
End Notes:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000, pages 532-533.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association, 2013 pages 306-307.
Bibliography:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-III. Washington, DC: American Psychiatric Association, 1980.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association, 1994.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association, 2000.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association, 2013.