Diagnosis - kind of...

Una+ wrote:Like DID and DDNOS, C-PTSD is a dissociative disorder plus there are attachment issues. Borderline PD is a personality disorder, so necessarily includes attachment issues; dissociative symptoms might or might not be present. Treatment for all is psychotherapy, but there are significant differences.

So Una (& everyone) - sorry if I've asked this before - What's the difference between DDNOS type 1 and C-PTSD?
Is it just the level of dissociation?

Also, do people with BPD have parts

Thanks, Zel.

ZeldaZonk wrote:What's the difference between DDNOS type 1 and C-PTSD?

Complex PTSD is PTSD plus disordered attachment, but there are no persisting dissociated identities. C-PTSD can approach DDNOS type 1 because there may be some transient identity confusion and alteration. For C-PTSD the differential diagnosis generally includes PTSD on one hand and major dissociative disorders on the other. ISSTD guidelines recommend that any client presenting with PTSD symptoms be carefully evaluated for dissociative symptoms.

Not all people with DDNOS type 1 and DID have PTSD as well. I have coped with a major dissociative disorder for decades but my PTSD symptoms started only about a year ago.

Thanks Una,

Update:
I've been back to see my pdoc again and asked a few more questions.
She thinks my identity disturbance is due to a borderline personality structure.
So that means my dx is PTSD, bipolar and BPD I guess.

Next I'm going to ask her why she would choose BPD and PTSD over C-PTSD (maybe because it's not in the DSM?)...and would she still say I'm bipolar, or does my affective disorder fall under the PTSD/BPD umbrella? I notice a lot of people are diagnosed with this cluster of disorders.

My old psychiatrist and my psychologist are both a bit anti the BPD diagnosis I think - they'd rather use the labels directly related to trauma.
Some things I read about BPD certainly seem to fit though.

Best, Zel.

Diagnosing in mental health is,literally, a crapshoot. CPTSD was brought about to replace the stigmatizing diagnosis of BPD in order to recognize trauma- they are interchangeable 90% of the time. The diff b/w BPD and bipolar is often not easy to figure out- often it has to do with whether or not you respond to Lithium. Half of mental health professionals do not believe in the existence of DD and so do not even consider this in diagnosing. The DSM is bases 100% on symptoms (with the exception of PTSD) and the origins of the illness are NOT of any concern when diagnosing. This is how the DSM is designed. Part of this is because nobody can agree on etiology.

So where does that leave you? Stop worrying about diagnoses- they don't mean anything. What's important is that you are being treated for trauma and giventherapy to specifically address the trauma, affec dysregulation, any self harming behaviors, and dissociation. That is how therapy works. Diagnoses almost never change the overall goals and structure of therapy. It's ALL based on symptoms.

Good luck!

boopsy26 wrote:So where does that leave you? Stop worrying about diagnoses- they don't mean anything.

Thanks Boopsy,
I take your point.
I started re-examining my dx because I came across some stuff about DDNOS and thought that I might have it. I figured that if I did, therapy might need to be changed accordingly.

Now, I think maybe I should move my focus away from diagnosis as you suggested and just concentrate on therapy. I do get a bit obsessed.

Everything I've been diagnosed with is certainly in the ball park as far as I'm concerned so...
I guess it's just a desire to understand how/why I'm so screwed up. I don't have a lot in the way of memories so it's hard to see a cause and effect sometimes you know. And I know some of it's genes as well.

Also, I didn't realise BPD and C-PTSD can cause identity disturbance,

Anyway, thanks for your reply,
Zel.

ZeldaZonk wrote:I didn't realise BPD and C-PTSD can cause identity disturbance

They can do that. So can some other conditions. That is why diagnosis is so difficult and why it is so important to get a thorough assessment of the dissociation.

Thorough assessment makes a big difference because if you have an underlying major dissociative disorder and this is not understood, treatment is not likely to be effective. Even if you receive entirely appropriate treatment, if the treatment is not applied directly to the part of you that is the source of the distressing thoughts, emotions and behaviors, then it will not be of much help to you.

I would want the extent of the dissociation to be assessed using Marlene Steinberg's SCID-D-R, or at least Paul Dell's MID.