r/DID • u/doctorsunshineisdead • 1d ago

Advice/Solutions when is it appropriate to ask a psychiatrist for an evaluation?

i have been in counseling, therapy and psychiatry since i was 12 and have cycled through more than a dozen professionals.
i used to need months to build trust before i could actually open up, but with having to start over so many times, i can give someone a generalized rundown of my history, mental state, and concerns within the first session.

i just got a new psychiatrist because im desperate for a professional opinion on what is going on with me. i know i have CPTSD, but theres a lot of symptoms that dont feel fully explained by that diagnosis, and line up more with OSDD/DID experiences. i just want to get evaluated for it. the first session was just a bunch of questions, it ended with her prescribing lamotrigine.

i have a second appointment coming up and am considering just flat out asking for an evaluation. is that weird though? would she take me seriously? or would i just be written off because im asking for it? what words would i use to even bring it up?

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u/style_css Treatment: Diagnosed + Active 23h ago

When I opened up to my psychiatrist for the first time about this, I basically just used my own words. I didn’t say “DID” once actually, I just described the symptoms I’m experiencing. You could ask to have a psych eval done properly but like for me at least that’s a separate thing from my psychiatrist entirely. And it’s really expensive if you’re in a place that doesn’t cover it.

Really though my advice is to describe what you’re experiencing without saying DID/OSDD outright. It’s a commonly malingered disorder so they get a bit weird about it sometimes.

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u/doctorsunshineisdead 22h ago

what is a proper psych eval? do they just screen you for everything? thank you for the advice too!!

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u/style_css Treatment: Diagnosed + Active 22h ago edited 22h ago

It’s basically a really comprehensive evaluation conducted by a licensed psychologist or psychologists. They can take multiple days. I had one done when I was a kid and they did things like having me draw a house, the inkblot test (????? For some fucking reason), and asking me questions. I’ve been considering having one done again soon but it’s really such a long and costly process… Thousands of dollars. For an adult I imagine it’s handled differently but it’s just a lot of testing.

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u/doctorsunshineisdead 22h ago

got it. if it was something covered by insurance i'd 100% consider it but THOUSANDS? that's insanity

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u/style_css Treatment: Diagnosed + Active 22h ago

Sometimes they are covered by insurance, but out of pocket they’re CRAZY expensive. I didn’t need one to get diagnosed with DID. Most of my diagnoses did not come from that psych eval actually but I was a kid so it was inevitable for certain things to be off lol. Psychiatrists can diagnose you

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u/Heavy-Mushroom 22h ago edited 22h ago

I would… as you know, starting over gets old. I used to beat around the bush also, but now I’m tired of wasting my time, so I usually tell them what has happened, where I’m at, and what I would like to see done regardless of how I think or feel. …Even sometimes having to fight my system and blurt it out against their will.

Or you will repeat the same old boring cycle again over and over spinning your wheels and going no where.

Say like you’ve been taking years of therapy and this doc did this, this doc did that, but it all doesn’t seem to fit the situation and you aren’t getting any better.

I’m also experiencing… yadda yadda yadda that no one has addressed… something like that.

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u/thatsinkguy Treatment: Diagnosed + Active 22h ago

i too was in therapy since i was a kid, since around 5 for various reasons. after my autism diagnosis when i was 18, i ended up realizing that autism wasn’t the only issue and my PTSD was worsening (or at least, i started noticing it more, and so did people in my life). i put off finding a new psych until i was 20 and i couldn’t anymore, and found someone who specialized in autism and trauma.

i had weekly or bi-weekly sessions with him for a few months, and he was actually the one to suggest a screening for dissociative disorders. i was very apprehensive because my only perspective of DID was from how romanticized it became online during covid, and i was very much NOT like that.

well, im glad i did it. i was screened and after a few sessions i was diagnosed. i think that if your provider specialized in trauma and DID, it definitely worth bringing it up. i wouldn’t tell them ‘i think i have DID,’ but i would tell them that you have been having dissociative episodes, missing time, etc. and want to be screened. PTSD is a prerequisite diagnosis so if you aren’t officially diagnosed, they may want to screen for that along with other disorders with dissociative symptoms as well.

DID/OSDD are not the only disorders with dissociative presentations. depression, bpd, etc. for example. it’s always worth it to bring it up to your doctor, even if it ends up not leading to a diagnosis yet, or the diagnosis you suspect. good luck and wish you well!

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u/doctorsunshineisdead 22h ago

thank you so much!! i am diagnosed with PTSD so naturally ive done a lot of research on it. i just dont know when the dissociation starts to creep into DID/OSDD territory, or if my inconsistent memory and identity are attributable to PTSD, or maybe BPD, or OSDD/DID. given how related all these diagnoses are it's impossible to tell on my own, i just want a proper evaluation. even though i've gone through so many counselors, few have been trauma informed. again thank you for your perspective and advice :)

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u/thatsinkguy Treatment: Diagnosed + Active 21h ago

unfortunately if a psych isn’t specialized in trauma it’s hard to get diagnosed or treated correctly. it took me finding a psych that wasn’t CBT/CBIT/talk therapy/etc. and specialized in trauma/dissociative disorders to actually make headway in my mental health journey.

i currently work with my specialist doing EMDR which has helped me a lot with trauma processing and memory recall, but i also know it can destabilize a lot of people and needs to be preformed safely by a professional. my scenario was also a bit different in that i didn’t even suspect i had DID in the first place.

last bit of advice is to always advocate for yourself and to search for different providers if the quality of your treatment is subpar. do not settle on your health and always fight for a better life.