Diagnostic Panic That Doesn't Make Sense

[Sideways]

And yeah, when he told me I didn't have it, it was the beginning of the end. I ended up with a new doc within months. May not go that way for you, but one person telling you something "for sure" with DID? Means didley squat. 6 different docs will give you 6 different opinions on it, and you just find the one that feels right.

 

[EveHarrington]

Does DDNOS still exist?

I'm quite surprised given all you discuss that you wouldn't have DDNOS given that your dissociation seems to me to be beyond that which exists in PTSD alone. Then again is it a matter of the dsm v restructuring with the dissociative subtype? Not sure.

 

[Ronin]

Does DDNOS still exist?

Yep, name change to OSDD but exists.

Seconding both you and Ragdoll here. Just because a therapist finds it easier to deny a condition she does not know all that much about does not negate lived reality.

 

[shimmerz]

I thought I had one. This therapist said I didn't.

Dissociation is a spectrum. DID is high end of spectrum. You can still be highly dissociative without having DID.

Dissociation, leaving one's body (or checking out mentally) may well be having the effect of 'I just want to disappear'. It comes with the territory, I believe.

An important question that has already been asked, but I didn't notice the answer to: 'Are you seeing a therapist who specializes in trauma?'

Also, your panic about this diagnosis absolutely makes sense. You are trying to figure out who 'you' are right now, and it sounds like what the doctor is saying to you doesn't fit with your experience in life right now. That is scary.

 

[theshadowoftheliving]

Made it safely through the night, so that's a good thing. Still feeling thrown by all of this and really unsure of myself, like what I thought I finally knew is actually false.

I'm terrified that I'm malingering, that I'm dramatic, that I'm exaggerating what isn't actually a problem.

I'm also just really confused. This is my fourth therapist in the last year and half. Each sees something different in me. Each wants to treat me with a different method. The first therapist just said I had PTSD, and didn't need therapy because I could handle things on my own. The second thought I was so broken and depressed that I should be in a hospital. The last one never even asked me about my safety and talked exclusively about dissociation. And now with this new one I'm back to PTSD and depression. (which I'm not questioning - just wondering if there is also dissociative issue at stake). And now I'm just confused as to what is actually happening and not happening.

This is a trauma therapist. And I've switched in front of her. And she has also asked me if I, in the past, referred to parts as separate people or as parts. So I don't understand why suddenly there is the retraction of the idea that dissociation is an issue for me.

To add to it, I can't hardly remember the session. So I'm not totally sure what happened in it. There's a bit of irony, I guess, in dissociating during a conversation about how I don't have a dissociative disorder.

@Ragdoll Circus Did you go looking for a therapist that would give you the DID diagnosis, or was that just a coincidence about how the switch in therapists worked out? I'm really worried about seeking out such a diagnosis. Where is the line between me recognizing something and seeking treatment for something that is clearly happening and what is the line where I am just malingering and wanting to be ill? (I don't think that is what is happening, but what if it is?) Sometimes I don't think it fits. Sometimes it fits so well. And sometimes I just have so much trouble explaining things that happen with any other explanation.

@Cashew Thanks for your support. I'm not sure what to do now, because she believes in DID, just not for me.

@shimmerz I am panicked. Thank you for putting a word on it. Absolute panic because the explanation definitely doesn't fit the experience at all.

I'm also worried that a pattern is repeating itself that has been happening my whole life. I look put together. On the surface I function really well. But I'm also a mess. And I can't explain why I can try to kill myself one night and then, an hour later, prep for a big meeting the next day at work, show up for it, and get praise from my supervisors. My actions don't square. I know that. And because my actions don't square with my emotions (the fact that work- me doesn't actually FEEL emotions or physical pain and isn't in distress, yet there are these other really sad and angry parts that come out and hurt me) and it's easier to just believe the part that looks healthy and fine, no one believes me that something is really terribly wrong.

 

[Poofycat]

Just want to second what @shimmerz said

You can still be highly dissociative without having DID.

I am highly dissociative and have pretty defined parts, but I'm not DID. My understanding is, and I could be wrong on this because it is pretty confusing, but DID means you have more than one primary part that functions in your daily life. My parts take over in very specific ways and can't fully function in my daily life, so I'm not DID. Is it possible that your parts function in a similar way and this is why your therapist say's you're not DID? Have you asked her to fully explain her reasoning?

 

[Ronin]

she believes in DID, just not for me.

She should reconsider her 'model D.I.D.' may not fit real people and it's the other way around: people don't fit concepts.

Concepts are made to help people and explain what happens to people.

Happy you got through the night, been worried a lot.
You're not making a problem out of 'nothing'; if it sends you spinning into blind panic and acute suicidality, it damned IS a 'real problem'.

 

[joeylittle]

I'm sorry you're struggling, @theshadowoftheliving.

The first therapist just said I had PTSD, and didn't need therapy because I could handle things on my own.

That's just useless, and you should write that person off and never think of them again. Bad therapist.

The second thought I was so broken and Depressed that I should be in a hospital.

That person wasn't the right person for you - you self-describe as highly functioning with deep inner problems; you need a therapist who is willing to support the high-functioning side of you, while working on the stuff underneath. You were right to leave.

The last one never even asked me about my safety and talked exclusively about dissociation.

That's just annoying.

And now with this new one I'm back to PTSD and Depression. (which I'm not questioning - just wondering if there is also dissociative issue at stake). And now I'm just confused as to what is actually happening and not happening. This is a trauma therapist. And I've switched in front of her. And she has also asked me if I, in the past, referred to parts as separate people or as parts. So I don't understand why suddenly there is the retraction of the idea that dissociation is an issue for me.

OK - so this one is at least recognizing the PTSD and depression. Do you mind sharing more specifics of the conversation in which she said you don't have an issue with dissociation?

Like others in the thread said, it's a spectrum. You can be dissociating without specifically having DID. The nomenclature (I think) isn't as important right now as is working on the symptoms you are experiencing and having distress from. I don't know if it's a problem (right now) that she isn't confident in attaching the right letters to what's going on (DID, OSDD, PTSD, dissociative subtype, and etc, etc).

But it matters that she help you navigate, manage, and survive the symptoms you are having right now.

I'm also worried that a pattern is repeating itself that has been happening my whole life. I look put together. On the surface I function really well. But I'm also a mess. And I can't explain why I can try to kill myself one night and then, an hour later, prep for a big meeting the next day at work, show up for it, and get praise from my supervisors. My actions don't square. I know that. And because my actions don't square with my emotions (the fact that work- me doesn't actually FEEL emotions or physical pain and isn't in distress, yet there are these other really sad and angry parts that come out and hurt me) and it's easier to just believe the part that looks healthy and fine, no one believes me that something is really terribly wrong.

I really, really suggest you share this with her.

To be honest - I have lived with this schism almost my whole life. When you describe being in deep despair one night, and the next being able to ace it at work - that's been me for a long time. When my PTSD presented itself, that continued to be me, just with a little more struggle. I'm sometimes not sure of the real differences between compartmentalization and 'switching', when there isn't a loss of time involved, and when you are aware that you are still you, even though your ability to feel is out of sync with what you believe your true core is. I think one has to take into account many small details, and be very wary of assigning a diagnosis before it's truly presented itself.

But that should never, ever, ever stop the treatment of the symptoms that are causing the most distress. You are in distress about the disconnect between your functioning in various environments, if I'm reading you correctly. Your therapist should be able to work on that, no matter what it's called. If they are literally denying your symptoms, telling you that what you are experiencing inside yourself isn't valid - that's cause for termination.

 

[EveHarrington]

<that moment when you realize the OP has you on ignore cuz nothing you say is responded to, not even direct questions>

 

[Sideways]

@theshadowoftheliving - I had to switch docs a couple of times. I largely ignore the diagnosis these days. I settled with the doc that helps me manage my reality. At that point, the diagnosis no longer mattered to me.

As for malingering- doubt very much that you could fake this even if you tried. But the deal is, you started recognising what was going on before you sought out the diagnosis, not the other way around.

What do you actually have according to the textbooks? Idk. But your T needs to help you manage your reality. If they're doing that? Stick with them. If not? Their diagnosis isn't the problem.

 

[theshadowoftheliving]

I am highly dissociative and have pretty defined parts, but I'm not DID. My understanding is, and I could be wrong on this because it is pretty confusing, but DID means you have more than one primary part that functions in your daily life. My parts take over in very specific ways and can't fully function in my daily life, so I'm not DID. Is it possible that your parts function in a similar way and this is why your therapist say's you're not DID? Have you asked her to fully explain her reasoning?

I think that this is the reason? And maybe it is a valid reason. What I struggle with is the gaps in my memory. So I'm not sure what did or did not happen at any point, or what "part" of me, whatever that means, is in front sometimes. I'll give entire presentations at work that I can't recall later. Like, big, massive gap can't recall. So was that just me checking out or a part taking over? Who knows. But I wish I did know.

I haven't asked her. Not yet. I don't see her till next week, anyways.

Happy you got through the night, been worried a lot.
You're not making a problem out of 'nothing'; if it sends you spinning into blind panic and acute Suicidality, it damned IS a 'real problem'.

It's a problem when that happens. But once I'm in my work-self, it seems so childish and dumb and I feel like I'm just exaggerrating and need to get over myself.

OK - so this one is at least recognizing the PTSD and depression. Do you mind sharing more specifics of the conversation in which she said you don't have an issue with dissociation?

To be honest, I can't. I know that she told me that I didn't have DID, and then I just remember the interior panic/alarm bells/voices arguing and I can't recall much else until suddenly she said the session was over even though it felt like only a few minutes had passed.

When my PTSD presented itself, that continued to be me, just with a little more struggle. I'm sometimes not sure of the real differences between compartmentalization and 'switching', when there isn't a loss of time involved, and when you are aware that you are still you, even though your ability to feel is out of sync with what you believe your true core is. I think one has to take into account many small details, and be very wary of assigning a diagnosis before it's truly presented itself.

Sometimes I know that I do lose time, though. That's what scares me, because it doesn't feel like moving between different headspaces, it feels more dramatic than that in terms of identity. But I never do anything crazy. I feel like every dramatic account I read of DID includes people traveling far away by accident or suddenly acting like a different gender or something super obvious. The things that I do when I can't remember and I switch? I'm not sure. Not always, but evidence I find later points to things like paying bills, doing work, and reorganizing things. Sometimes I write. Or draw. But because nothing is usually bad when I check out completely, I feel like I don't even take it seriously sometimes. But it still happens.

You are in distress about the disconnect between your functioning in various environments, if I'm reading you correctly. Your therapist should be able to work on that, no matter what it's called. If they are literally denying your symptoms, telling you that what you are experiencing inside yourself isn't valid - that's cause for termination.

I don't think that she was denying my symptoms? I'm not sure. I'm just not sure. I wish I could remember that conversation.

<that moment when you realize the OP has you on ignore cuz nothing you say is responded to, not even direct questions>

Eve, please don't give me credit for even knowing how to put someone on ignore! I'm sorry that I upset you. I thought that I did reply but it must have gotten lost in the fragmented time that I wrote this in. I was at work and kept closing browser windows abruptly ....

But the deal is, you started recognising what was going on before you sought out the diagnosis, not the other way around.

This is exactly why I'm afraid I'm just making it all up.

 

[joeylittle]

I don't think that she was denying my symptoms? I'm not sure. I'm just not sure. I wish I could remember that conversation.

Bring it up next time.

Because dissociation is a spectrum, it's really possible that she is right - that you don't conform to DID, but one of the different dissociative disorders. Not having DID doesn't invalidate your experience. When do you see her next?