OSDD (Otherwise Specified Dissociative Disorder), DDNOS (Dissociative Disorder Not Otherwise Specified), and DID (Dissociative Identity Disorder) are all types of dissociative disorders. Each of these disorders involves varying degrees of dissociation, but they differ in the number and organization of identities (or alters) present in the individual. Additionally, it's important to note that the terms OSDD and DDNOS are no longer officially used as of the release of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), which came out in 2013. Instead, the DSM-5 introduced a new category called Other Specified Dissociative Disorder (OSDD) and Unspecified Dissociative Disorder, encompassing some of the previously described cases under DDNOS.
Dissociative Identity Disorder (DID):
- Formerly known as Multiple Personality Disorder, DID is characterized by the presence of two or more distinct identities or personality states that control the individual's behavior, consciousness, and memory. These identities may take control of the person's body at different times, and there is typically an amnesic barrier between them.
- Switching between identities can be triggered by stress, trauma, or other emotional triggers. Each identity may have its own name, personal history, mannerisms, and preferences.
Other Specified Dissociative Disorder (OSDD):
- OSDD is a category that includes individuals who experience significant dissociative symptoms but do not meet the full criteria for DID.
- OSDD may involve having distinct identities or personality states, but the amnesic barriers between them may be less pronounced than in DID. Alternatively, individuals with OSDD may experience strong identity disturbances without fully formed separate identities.
Unspecified Dissociative Disorder:
- This category is used when the symptoms of a dissociative disorder are present but do not fit the criteria for any specific dissociative disorder, including DID and OSDD.
It is possible for an individual to have more than one of these disorders, and it's not uncommon for the presentation of dissociative disorders to be complex and multifaceted. In some cases, an individual may initially receive a diagnosis of one type of dissociative disorder, but as treatment progresses and more information is gathered, the diagnosis may be refined or updated.
When an individual has more than one dissociative disorder, the symptoms can vary and may include:
- Experiencing both fully formed distinct identities with amnesic barriers (DID) and identities with less pronounced barriers (OSDD).
- Experiencing strong identity disturbances without the presence of fully formed identities (OSDD).
- Dissociative amnesia, where the individual may have gaps in memory and difficulty recalling important personal information.
- Depersonalization and derealization, where the person feels detached from their body or the world around them.
- Identity confusion and identity alteration, where aspects of the person's sense of self may shift or change in response to stress or trauma.
Given the complexity and potential co-occurrence of dissociative disorders, a comprehensive evaluation by a qualified mental health professional experienced in working with dissociative disorders is crucial for accurate diagnosis and appropriate treatment planning. It is also essential to consider the individual's unique history and experiences to provide the most effective care and support.