#polyfragmented systems

I am diagnosed with this right now instead of DID and I see very little explanation of it online anywhere so I want to parrot what my therapist told me. (I am in the US and speaking specifically about the DSM and why these are diagnosed in the US. I am not sure if it is the same elsewhere.) First off, about unspecified diagnoses. My therapist said that in her training for the DSM 5 they are taught to diagnose unspecified disorders mostly as a stand in diagnosis. Meaning a diagnosis that is put down until a specific diagnosis can be made. They are diagnosed typically when there is obvious signs of a certain kind of mental illness but for whatever reason they are unable to have enough info to diagnose what it specifically is at that time. This is often very useful because you can still bill insurance with them to cover the same treatment any specified diagnosis would. As well as still being covered under ADA protections and the ability to get accommodations for jobs or school.

Unspecified dissociative disorder is commonly diagnosed before a diagnosis of OSDD or DID is made. It is also diagnosed in other situations in people without alters before a diagnosis of a different dissociative disorder is made. Not everyone with this diagnosis is a system. Because of how long a diagnosis of any dissociative disorder can take, someone may have this diagnosis for a long time. Some systems may choose not to have their records changed to a diagnosis of OSDD or DID for whatever reason even after further testing. Some systems who were originally diagnosed with this may resonate with UDD as a label more than DID or OSDD so they may consider themselves a UDD system and there is nothing wrong with that as it does not effect treatment in any way. Although almost anyone with alters will fall under the label of DID or OSDD because of how broad the OSDD-1 category is in the DSM-5. A lot of people think of the old criteria from the DSM-4 for DDNOS which was slightly different than OSDD in the DSM-5 and less broad. (The DDNOS diagnosis criteria is also where OSDD-1a and OSDD-1b comes from. It is not an actual part of the DSM criteria for OSDD 1 anymore but can be a helpful distinction.)

DSM-5 criteria for OSDD-1

Chronic and recurrent syndromes of mixed dissociative symptoms: This category includes identity disturbance associated with less-than-marked discontinuities in sense of self and agency, or alterations of identity or episodes of possession in an individual who reports no dissociative amnesia.

DSM-4 TR criteria for DDNOS-1

Clinical presentations similar to Dissociative Identity Disorder that fail to meet the full criteria for the disorder. Examples include presentations which a) there are not two or more distinct personality states, or b) amnesia for important personal information does not occur.

So if someone gets the diagnosis of UDD it will at some point, if further testing is done, likely be changed to DID or OSDD if they want it to be.

Originally in older editions of the DSM both OSDD and UDD did not exist. DDNOS was in the place of both diagnoses and became OSDD and UDD in the DSM-5 in 2013. Some systems who were diagnosed with DDNOS before then still use it as a label instead of OSDD.

In the DSM-5 there are no not otherwise specified diagnoses left anymore and they were all changed to either unspecified or other specified.

Us: We think we're splitting are we splitting?

Gatekeepers: yes we are splitting

Us: ….

For those who have self diagnosed with DID take care to make sure you are not misunderstanding OCD symptoms as DID/OSDD. When I was diagnosed with UDD my therapist made sure it wasn't just a symptom of my OCD. OCD can sometimes cause extreme focusing and preoccupation with categorizing yourself, possibly even to the point of thinking you have parts even when you do not. If you are extremely focused on categorizing yourself to the point that it distracts you from daily life it may be an OCD thing not a DID thing. This may also manifest as an extreme preoccupation with categorizing your every action with many different mental illnesses. (Also not everyone with multiple mental illnesses is doing this as many many different things are co-morbid) If you do have OCD not DID, treating it like DID could seriously harm you.

This is not a post trying to say that all self diagnosed systems just have OCD or something but I did know someone who thought they had OSDD and it turned out they had bad untreated OCD.

I watched this video a while ago and I found it super interesting. Its about dissocation but it goes into some other stuff. Pretty long and wordy but has a lot of great info. I don't remember anything super triggering but it's been a bit since I watched it and it may have case stuff in it that could be triggering so watch at own risk if you may be upset by that.