"clues" before discovering the hidden alters?

That is exactly the problem though, and how your statements, as they were, were not only inaccurate, but misleading at that point. There are a lot of commonalities between the two conditions. There is no sense in this person bothering to try to distinguish this on their own. They require a specialist.

FractalHive wrote:That is exactly the problem though, and how your statements, as they were, were not only inaccurate, but misleading at that point. There are a lot of commonalities between the two conditions. There is no sense in this person bothering to try to distinguish this on their own. They require a specialist.

You are allowed your opinion, but I don't understand why what I say affects you so much when this isn't about you. They mentioned not knowing what it was and mentioned maybe schizophrenia, so that's why I said what I did. I also wasn't saying they have or do not have DID or schizophrenia. It's not for me to diagnose. I simply said some things that might be symptoms of schizophrenia since they brought it up, not that it was what they experienced though. I also suggested more than once that they see a professional to help them figure it out. I think you might have missed that. Either way, this wasn't about you.

It is such a tricky thing.

From what I've read it can sometimes be difficult to tell which is which.
I had a book years ago...it's title was something like "Trauma, dissociation and psychosis" (author might have been Valerie Sinason?) and how easily things could be misdiagnosed and the overlap between symptoms.

More recently I read a book (aimed at therapists) about dissociative disorders and in there it mentioned that many many symptoms of DID would potentially meet the criteria for first-rank/Schneiderian symptoms of schizophrenia...it's all in the interpretation.

There is such a thing as dissociative psychosis (google search it) and it is generally accepted these days that even severe PTSD or severe depression can have psychotic symptoms. People with severe PTSD can hallucinate or experience paranoia. Bring into the mix the varied experiences and varied awarenesses of different DID parts and it all gets rather messy!

I had previously been dx'd with severe PTSD, BPD, depression (at one point psychotic depression) and then in recent years (after a very re-traumatising event) I started hearing external voices but after a very thorough psych assessment they went with dissociative disorder (DDNOS or DID pending further assessment) and the psychiatrist said that certain aspects of my hallucinations had a "very strong dissociative element" and hence didn't recommend antipsychotic medications since she didn't think they be effective for this (other than sedative/anxiolytic effects.) She based her dx partly on my descriptions and on my psych notes over the last decade (some things I didn't remember) and my trauma history etc.

It sometimes feels like this brick wall and everything must be clear-cut. I can understand people with DID wanting to make the point that they aren't 'psychotic' of schizophrenic, given the historic misunderstandings and myths out there. But things on the trauma spectrum (PTSD, c-PTSD, BDP, DDNOS, DID) can indeed include psychotic symptoms.
And people with schizophrenia can score high on dissociative scales as well.
It's something that can be difficult to untangle.

I read something about a tendency for DID to have a greater number of voices, more continuous and of more varied ages and genders than in schizophrenia, but any of these things is still just an "average".

And of course, it is possible to have both DID and schizophrenia/bipolar/psychotic depression at the same time. It would be abysmally unlucky but possible.