#udd

Dissociative Identity Disorder (DID)

– “Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession (...)” and “marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory-motor functioning.”

"Two or more": keep that in mind! There is a minimum number of two alters a system can have (host included, the host is also an alter), but no maximum. This is due to how individual each DID experience can be! Someone can have exactly two alters in their system, while others can have 100+. (These experiences are known as polyfragmented DID. This type of DID is developed under very specific circumstances, highly complex, and highly under-researched, to the point where I'm only not going over it longer because I feel as if it warrants its own post.)

The average reported system count is around 8-13. If you need a baseline, go off of that!

Marked discontinuity in "sense of self and agency" can be a lot of different things; affect and motor functioning refers to tone, cadence, the way you speak and move and hold yourself, cognition/perception/memory refers to amnesiac barriers, outlook, morals, likes and dislikes -- everything down to the way you think can and will differ.

People with DID often feel indecisive, or inconsistent, and don't understand quite why until it's revealed (if ever). You can have one opinion one day and the complete opposite the next because of conflicting interests in alters. You may have to explain why your feelings and views contradict so frequently without consciously remembering that conflict happening.

It's also noted that changes in behavior may be noticed by others, but not always. And if they do, it rarely is thought to be DID -- my sibling, for example, while I was still in high school, would notice blatant switches and assume I was just having a "weird day" or I was "stressed". They noticed the consistency in behavioral changes, but thought nothing of it because I'd always been like that. EXTREMELY subtle symptom presentation is the norm.

– “Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting.”

Day-to-day life, important events, personal details, years and years of childhood and later, will just be gone. It's not there. Inaccessible. You might not even notice it's missing, either.

Due to the nature of dissociative disorders being dissociative, these gaps are very good at camouflaging themselves. You aren't paying attention to these things like your peers are, so you don't pick up on warning signs right away. And it takes even longer to notice patterns.

This can also look like having the same realization about the same thing multiple times. And it feeling new, and world changing, Every Time. It can feel like you're going in circles indefinitely with everything you do.

– “The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

It's A Disability If It Disables You Basically. Again, some level of dissociation is normal to experience, it is the severity that is the problem. Like how daydreaming itself is fine, but could become maladaptive and disrupting in daily life.

– “The disturbance is not a normal part of a broadly accepted cultural or religious practice. Note: In children, the symptoms are not better explained by imaginary playmates or other fantasy play.”

This is why tulpamancy is not and should not be lumped in with dissociative disorders. It is a religion-specific practice, and something only a Tibetan Buddhist can speak on, which I am not, so I can't. What I will say: the implications you might see from people that tulpamancy is in any way comparable to a trauma-centric dissociative disorder are both ableist (implying OSDDID is a "practice" or something somebody can decide to "do") and extremely culturally insensitive (there is nothing disordered about Buddhist practices).

On topic again:

(Additionally: the idea of "tulpas" the way most Westerners practice it when divorced from the religion is a skewed interpretation of something only lightly "inspired" by Tibetan Buddhism. It is a very similar situation to how white people will talk about the "seven chakras" when that is nothing at all close to what chakras are. Not only is it appropriation, people are also defining it incorrectly! I plan on compiling my own post about misinformation related to these things once I have enough applied knowledge to be able to do that.)

(Update (September 1, 2025): Tibetan Buddhism in itself is NOT a closed religion! It is open for people to practice! I wasn't aware of this and have corrected it! That said, practices are still related to that sect of Buddhism, and the appropriation I was referring to was when people say they're practicing tulpamancy separate from Buddhism and divorced from the context, which is literally when appropriation happens. And which I see people doing all the time, specifically IN system spaces, trying to equate things that cannot be equated. THIS is what I was referencing, people that are not Buddhist and say they are not Buddhist trying to redefine what Buddhism is.)

(The religion is open but that does not mean its practices shouldn't be handled with respect. That is what I meant by "taking inspiration," when people that otherwise have no interest in the faith are only ever involved for one thing they think Looks Cool. That Sucks. And, STILL, a cultural practice of religious significance is still not the same as a complex trauma response.)

If the experiences line up with cultural or religious practice and are not disabling to the person, it is not OSDDID because it did not form the same way. If a child is engaging in escapism via fantasy play and said play is controllable by the child, it is not OSDDID because the motions are voluntary.

These experiences are all still real! And deserve respect! But they cannot be categorized the same -- like how generalized epilepsy and psychogenic non-epileptic seizures present similarly in some ways but aren't the same thing, or how a fainting spell might look like a seizure but isn't a seizure. It'd do a disservice to both to lump them in with one another, if that makes sense!

– “The symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or other medical condition (e.g., complex partial seizures) (American Psychiatric Association, 2022).”

Speaks for itself but I'm Including It Anyway.

— All criteria backed by the DSM-5. All quoted text brought from the linked organization (DID Research) and goes into further detail than I have, if that's something you're interested in. (And you should be! Don't take my word alone for it, look deeper!)

———

All other types (OSDD, P-DID) are disorders that mostly fall under this criteria, but diverge in some significant way. This does NOT make anyone with these disorders "less real", it only means they have a different experience with structural dissociation -- and structural dissociation is highly individual, dependent on the person and their situation (so you'll be hard pressed to find two systems that experience their disorder the exact same way).

This is just something that happens. Very confusing disorder to have!

———

Partial Dissociative Identity Disorder (P-DID)

– All criteria for DID diagnosis is met, EXCEPT:

– “(...) the person still experiences a disruption of their identity, like in DID, but there is a ‘dominant’ personality which is usually at the front. Intrusions from other parts are infrequent and irregular, perhaps only happening during a particularly distressing or emotional experience.” — “What are the Dissociative Disorders?”, International Society for the Study of Trauma and Dissociation

By "intrusions", people mean switching, or executive control. Different terms that mean the same thing.

In OSDDID cases outside of P-DID, alters will have the ability to take executive control of the body -- this is something that, most of the time, is not present in P-DID. I've seen it described by a P-DID system through the roommates allegory: that collective is there in the building, and they all share the space, but only one of them answers the door.

This is usually the case, but a P-DID system can break out of that -- switching, etc. can still happen in some P-DID systems, particularly when under severe distress.

P-DID, as said by the International Society for the Study of Trauma and Dissociation, is most commonly recognized and diagnosed outside of North America. P-DID is also the least discussed from what I've seen, which may or may not be correlated in some way. (Again, how these things are labeled and understood will vary from place to place and group to group! It's important to get multiple perspectives on a given subject for that reason.)

———

“Other specified dissociative disorder (OSDD) is a dissociative disorder that serves as a catch-all category for symptom clusters that do not fit neatly within another dissociative disorder diagnosis.” — “DID Versus OSDD-1”, DID Research

Otherwise Specified Dissociative Disorder, Type 1A (OSDD-1A)

– All criteria for DID diagnosis is met, EXCEPT:

– Alters are not distinct enough for the circumstances to be treated the same as DID. For this reason, this particular type of system will especially go under the radar, often misdiagnosed as PTSD or BPD, or not read as a disorder at all.

Otherwise Specified Dissociative Disorder, Type 1B (OSDD-1B)

– All criteria for DID diagnosis is met, EXCEPT:

– Inter-identity amnesia is not present. Emotional amnesia is more common than complete blackouts; I hear the term "greyout" used quite often in reference to this kind of amnesia.

NOTABLY: I distinguish between the two here because they used to be more heavily utilized in the diagnostic process, but aren't anymore. It is NOW mostly refered to as OSDD-1 and that is IT, but I wanted to include this information anyway because of how often it circulates. The labels may be outdated in some places, but they will come up in research so it's handy to at least know what they mean.

AND ANOTHER THING TO ADD: because of this some systems with OSDD have been diagnosed under the old criteria and may self-identity as having 1A or 1B instead of OSDD-1 on its own. It is their right to self-label how they feel fits their circumstances. Please do not go around telling people not to call their disorder the name they've been using for forever. It's not like the case of autism versus "Asperger's" it is NOTHING like that the context is SO different PLEASE!!

Back on topic, and As Said Above. Both of these OSDD types above fall under type 1. Types 2, 3, and 4 are also considered OSDD, but are not system disorders.

Presentation of a dissociative disorder, overt and covert, is also nearly never this cut-and-dry. [For all intents and purposes you CAN be very straightforward as you build your character at first, but the disorder is complex and messy, so if somebody doesn't seem to fit cleanly into one type as you write at first, that's alright!]

What About UDD?

Unspecified dissociative disorder (UDD), from my understanding, is used in the way that DDNOS (dissociative disorder not otherwise specified) used to be. A medical note of UDD is there to clarify that a given patient has a dissociative disorder, but it is not yet clear which category they fall into.

UDD encompasses any disordered experiences outside of specific known conditions, and many (but not all) people with a UDD diagnosis are given more specific names for their condition later -- someone could have P-DID and have UDD in their medical record because they haven't got the chance to be fully evaluated yet, for example!

“This diagnosis, along with Other Specified Dissociative Disorder, act as a "residual category for dissociative symptoms which do not fit within a more specific category" and either the clinician decides not to specify the reason that the criteria for other Dissociative Disorders aren't met, or not information information exists to make a more specific diagnosis.”

“If a reason can be specified, e.g., dissociative trance, then Other Specified Dissociative Disorder should be diagnosed instead.” — “Unspecified Dissociative Disorders”, Trauma Dissociation

The ICD approaches unspecified dissociative disorder the same way the DSM does: “it cannot be diagnosed when a more specific diagnosis is appropriate.”

If your character is going to have experiences that would fall into the unspecified category, then go right ahead! Because people do have experiences that may fall outside of a typical presentation for a dissociative disorder, but still have a dissociative disorder. UDD just encompasses all of those cases, so be very specific with what kind of experiences you're going to be writing so it isn't unrealistic or disrespectful. Make sure you don't write something contradictory without intent!

Writing Complex Dissociation: Narrow Down What Type, Then Do Specific Research

Overall: I ask that you be very mindful of exactly what condition you're writing and why. (And where -- remember, regional differences can impact labels, perception, treatment, everything!) But if your character's story is a more complicated one, that's perfectly fine, I'd even say it's more realistic! The nature of complex dissociation is that it isn't clean and clear-cut and easy to define!

Nothing is as blatant or linear as how it looks on paper. I recommend before starting any specific writing, of course, to pinpoint which type of structural dissociation you're going to be modeling off of and what you want to achieve by doing that; we can get into all the gritty details once that foundation is established!

And again, this is a GENERAL post! I did not go NEARLY as in-depth as I could have and encourage everyone to do their own research (with discretion)!

———

References:

– DID Research.

– International Society for the Study of Trauma and Dissociation.

– Trauma Dissociation.

———