Dissociative identity disorder (DID) and other specified dissociative disorder (OSDD) are two similar but distinct dissociative disorders. Both involve having two or more distinct personality states called alters, along with memory gaps between those alters. However, there are some key differences between DID and OSDD when it comes to the number of alters and the degree of amnesia between them. This article will provide an overview of DID and OSDD, explain the diagnostic criteria, and help you determine which you may have.
What is Dissociative Identity Disorder (DID)?
Dissociative identity disorder (DID), previously known as multiple personality disorder, is a severe dissociative disorder characterized by having two or more distinct personality states called alters. The alters often have different memories, behaviors, emotions, perceptions, and senses of identity. There are memory gaps between the alters, with the main identity having little to no memory of what other alters did or experienced.
DID develops as a coping mechanism in response to severe, repetitive childhood trauma, such as abuse, neglect, violence, or extreme loss. The child dissociates, or mentally separates their identity, memories, and emotions to protect themselves from the trauma. As the child grows up, these dissociated parts develop into distinct alters with their own names, voices, manners and personalities.
Some key facts about DID:
– People with DID have at least two distinct, complex alters who regularly take control of behavior.
– There are substantial memory gaps between the alters, called amnesia. The main identity has little to no access to memories of other alters.
– The symptoms cause significant distress and dysfunction in work, social settings, and other areas of life.
– The symptoms are not better explained by another disorder, medical condition, or substance use.
– The symptoms are directly caused by past severe trauma during childhood.
What is OSDD?
Other specified dissociative disorder (OSDD) is a milder form of dissociative disorder. Like DID, people with OSDD have two or more distinct personality states and experience dissociative amnesia or memory gaps between those alters.
However, people with OSDD do not fully meet the criteria for a diagnosis of DID. There are a few subtypes of OSDD:
– OSDD-1a: This is similar to DID but people have fewer distinct alters and less amnesia between them.
– OSDD-1b: This is similar to DID but people experience less amnesia between alters. The alters are not as distinct and developed.
– OSDD-2: People have PTSD and dissociative amnesia but do not report having distinct alters.
– OSDD-3: People have some dissociative symptoms like depersonalization and derealization but do not meet criteria for other dissociative disorders.
The main difference is OSDD has less severe dissociation and fewer fully distinct alters than DID. But like DID, OSDD develops from childhood trauma and causes distress and dysfunction.
Signs and Symptoms
There is significant overlap between the signs and symptoms of DID and OSDD-1. Here are some of the main symptoms:
– Having two or more distinct personality states called alters who take control over behavior. The alters often have their own names, voices, manners, perce
| DID Symptoms | OSDD Symptoms |
|---|---|
| Having two or more fully developed, distinct alters | Having fewer, less distinct alters |
| Frequent blackouts and amnesia between alters | Less severe amnesia between alters |
| Substantial memory gaps for personal history and trauma | Less severe gaps in autobiographical memory |
| Alters have elaborate differences in speech, behavior, emotions | Alters have less pronounced differences |
| Extreme dissociative amnesia between alters | Mild to moderate dissociative amnesia |
– Having memory or identity gaps and “losing time” – finding yourself somewhere but not remembering how you got there
– Hearing internal voices or conversations inside your head between different alters
– Having rapid switches between alters – sudden shifts in mood, demeanor, speech, mannerisms
– Having identities that are different ages, genders, have different skills or preferences
– Finding unfamiliar items among your possessions – evidence of other alters’ actions
– Being told by others of behaviors or conversations you don’t remember
– Depression, anxiety, suicidal thoughts, PTSD symptoms
– Feeling detachment or disconnection from yourself, emotions, memories, surroundings (dissociation, depersonalization)
Both DID and OSDD cause significant distress and problems functioning in relationships, work, or other areas. But DID causes more severe symptoms and amnesia between alters.
Causes
DID and OSDD both develop as a result of severe childhood trauma. The most common causes include:
– Childhood abuse – physical, sexual, emotional
– Violence or neglect within the family
– Having a serious medical illness as a child
– Experiencing or witnessing violence, disasters, accidents or war
– Extreme, repeated trauma during childhood overwhelms the child’s coping skills. To survive psychologically, the mind dissociates itself into parts or alters.
In DID, the dissociation is very severe, leading to complete amnesia between alters. In OSDD, the dissociation is milder. But even in OSDD, early trauma leads to dissociating parts of identity that grow into alters.
Risk Factors
Certain factors can increase a child’s risk of developing DID/OSDD after trauma:
– Having a history of attachment issues or insecure attachment to primary caregivers
– Having a family history of mental illness or dissociation
– Not having adequate support systems to manage trauma
– Being very young (under age 9) when the trauma began
– Experiencing repeated, chronic trauma including emotional abuse or neglect
– Having a parent or caretaker who encouraged avoiding or escaping the trauma
Genetic and biological factors like how the brain manages stress may also contribute, but severe childhood trauma is the central cause. OSDD seems to develop when these factors or trauma are less extreme.
Getting an Accurate Diagnosis
DID and OSDD are often misdiagnosed or undiagnosed, due to being complex disorders. Getting an accurate diagnosis involves:
– Ruling out other possible causes – Physical illnesses, seizures, or substance abuse could cause similar symptoms. A doctor will do tests to rule these out.
– Looking for root trauma causes – A dissociative disorder specialist will look for trauma history markers like anxiety, depression, unexplained somatic symptoms, self-harm, or PTSD.
– In-depth specialized interviews over multiple sessions – An expert will build trust to uncover dissociative symptoms.
– Using diagnostic checklists like the DDIS – Structured interviews help systematically assess dissociative symptoms.
– Looking for corroborating evidence – Collateral information from loved ones can confirm symptoms like amnesia or identity switching.
– Assessing degree of functional impairment – The level of problems at work or in close relationships can indicate severity.
– Carefully distinguishing between DID and OSDD – The number and separation between alters and degree of amnesia helps differentiate.
Getting properly diagnosed requires an experienced dissociative disorders therapist. They can rule out other causes and carefully identify DID vs OSDD based on alter distinctiveness and amnesia severity. Self-diagnosis is risky without expert assessment.
DID vs OSDD Treatment
Treatment for DID and OSDD focuses on:
– Building trust and communication between alters – Having alters work together therapy can improve functioning.
– Processing trauma memories – Slowly addressing early traumas can help integrate dissociated memories and emotions.
– Teaching coping skills – Grounding techniques, emotional regulation, stress management helps stabilize mood and functioning.
– Adjunct approaches like EMDR or creative therapies – Other modalities in conjunction with psychotherapy can aid trauma recovery.
– Treating co-occurring disorders like PTSD, depression – Managing mental health symptoms supports dissociative disorder treatment.
– Safety planning – Preventing self-harm or destructive behavior is crucial, especially with suicidal alters.
The overall goals are creating internal cooperation between alters and processing trauma sufficiently to improve day-to-day functioning. Medications are not used for DID or OSDD itself but may help with co-occurring issues like depression. Treatment is usually long-term, depending on severity.
Key Differences in Treating DID vs OSDD
| Treating DID | Treating OSDD |
|---|---|
| More focus on carefully mapping all alters and their functions | Less emphasis on mapping alters |
| Heavy emphasis on recovering severely dissociated memories between alters | Less focus on recovering memories between alters |
| Prioritizing internal communication and stabilization due to frequent switching | Less crisis intervention needed between alters |
| Expecting slower progress on trauma processing due to severe amnesia | Able to move more quickly to direct trauma processing |
| Higher risk of destabilization and switching due to severe symptoms | Lower risk since dissociation is less ingrained |
In DID, managing severe amnesia and achieving cooperation between highly dissociated alters requires meticulous system mapping and stabilization work before directly processing trauma. In OSDD, progress in trauma therapy may be somewhat faster since dissociation between alters is less extreme. But both require patience and skill to treat safely.
Living With DID or OSDD
Daily life with DID or OSDD can be very challenging. Some tips for coping:
– Keep a routine schedule for eating, sleeping, work/school so alters share a stable lifestyle
– Use calendars, lists, notes, and alarms to compensate for memory gaps
– Label your belongings with your system name so items stay in place
– Carry ID and medical info that all alters can access in emergencies
– Keep your home safe and remove potential means of self-harm
– Have a support system of friends or family who understand your diagnosis
– Participate in dissociative disorder peer support communities to reduce isolation
– Practice grounding techniques, meditation, breathing exercises for stabilization
– Avoid drugs and alcohol which can worsen dissociation and amnesia
– Make time for calming activities like light exercise, music, arts, being in nature
– Use therapy to build cooperation between alters and make day-to-day functioning easier
The impact may be greater in DID due to more frequent switching and severe amnesia. But both conditions benefit from stability practices, social support, and therapeutic work to improve functioning over time.
Hope for Recovery
Living with chronic childhood trauma is unimaginably difficult. DID and OSDD reflect incredible strength and resilience in the face of horror. With compassionate professional help and support, integration and recovery are possible. Many learn to manage their symptoms, establish inner communication, and lead fulfilling lives.
Healing takes time and courage, but people with DID and OSDD have enormous reserves of both. There is hope, there are treatment options, and full integration may not be required for meaningful recovery. Meeting your alters with genuine curiosity and kindness is the first step. A dissociative disorder specialist can guide your journey toward health and wholeness. You deserve to feel empowered and at peace.
Conclusion
Determining whether you have DID or OSDD requires careful expert assessment over time. While challenging, both are treatable disorders, and people can go on to live healthy, stable lives. Seeking accurate diagnosis and specialized care for dissociative symptoms is the beginning of reconnecting with yourself and overcoming trauma. You have survived and persevered this far. With support, you can continue your recovery journey, wherever it may lead.