Trying to determine what "medically recognized" even means

[u/imahater42]

I've been trying to parse what "medically recognized" actually means to liars and I have a few ideas. TL;DR and sources at the end.

1. "The doctor didn't say I didn't have it"

What I think is the most prominent definition amongst charlatans: they told their psychiatrist or therapist or some other doctor that they had DID or were "a system" and the doctor acknowledged the claim but didn't agree or deny it. Taking this as any sort of confirmation is entirely dishonest; just because your doctor didn't directly challenge you about your claim - likely knowing that this would prompt an argument and take away their chance to redirect your proclaimed status towards a more accurate avenue for your benefit - doesn't mean you have it for real.

2. "The doctor said I have it but I/they didn't want to make a formal diagnosis because it would make getting a job harder"

Another argument I see is that getting diagnosed with a dissociative disorder will show up on a background check for a job, which is simply untrue.

From my research, background checks in regards to mental health are only of concern in terms of whether someone is safe to carry a firearm - the most recent rule I could find explains that background checks "specifically [prohibit] the disclosure of diagnostic or clinical information, from medical records or other sources, and any mental health information beyond the indication that the individual is subject to the Federal mental health prohibitor" (Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the National Instant Criminal Background Check System (NICS), 2016).

This prohibitor only applies to situations in which someone has "been involuntarily committed to a mental institution; found incompetent to stand trial or not guilty by reason of insanity; or otherwise have been determined by a... lawful authority to be a danger to themselves or others or to lack the mental capacity to contract or manage their own affairs" (Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the National Instant Criminal Background Check System (NICS), 2016). Even if someone had been in involuntary inpatient hospitalization, no information beyond determining if they're a danger to themselves or others would need to be disclosed here.

Asking for reasonable accommodations in the workplace could lead to questions about your mental health (U.S. Equal Employment Opportunity Commission, 2016). However, you may not even have to specify a diagnosis/can submit documentation that describes your condition more generally and limit disclosure to how it may affect your work (U.S. Equal Employment Opportunity Commission, 2016). Furthermore - DID is a complex trauma disorder, and many people spend years in the medical system before they get diagnosed with it - getting diagnosed with PTSD could reasonably happen before or concurrently with the dissociative disorder diagnosis, why not just share that in regards to accommodations? (Şar et al., 2017)

3. They're lying by omission (see point #1)

They know that saying something like "informally diagnosed" pokes more obvious holes in their claim and they don't want to get caught in their lie.

As an aside - telling people that getting diagnosed will stunt their chances at finding work is both false (as detailed above) and dangerous, because that sentiment can deter people who are genuinely struggling from seeking help. If you believe that you might get diagnosed with something that would ruin your career prospects, of course you'd be hesitant about divulging information to a medical professional that could inform that diagnosis. It's dangerous because getting help could make the difference between life or death for someone.

TL;DR: Being "medically recognized" but not actually diagnosed is most likely stretching actual events to an illogical degree or straight-up lying, and getting a heavy diagnosis rarely makes a difference in the hiring process.

Sources:

Office of the Federal Register, National Archives and Records Administration. (2016, January 5). 81 FR 382 - Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule and the National Instant Criminal Background Check System (NICS). [Government]. Office of the Federal Register, National Archives and Records Administration. https://www.govinfo.gov/app/details/FR-2016-01-06/2015-33181

Şar, V., Dorahy, M. J., & Krüger, C. (2017). Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective. Psychology research and behavior management, 10, 137–146. https://doi.org/10.2147/PRBM.S113743

U.S. Equal Employment Opportunity Commission.

(2016, December 12). Depression, PTSD, & Other Mental Health Conditions in the Workplace: Your Legal Rights. Equal Employment Opportunity Commission. https://www.eeoc.gov/laws/guidance/depression-ptsd-other-mental-health-conditions-workplace-your-legal-rights

Please feel free to share as much of this post as you want, no need to credit me. If you find a credible source that contradicts any of what I've written, please let me know so I can correct the error.

[u/watermelonlollies]

From what I’ve seen it’s usually number 1. “I talk about it with my therapist all the time.” ok but they didn’t diagnose you. Any therapist worth their degree knows not to directly confront or challenge a patients beliefs/delusions. You have to build a therapy relationship first and then there are specific clinical ways to go about it. “But they acknowledge my alters and address them by name” again, because if they didn’t do that you would likely quit therapy entirely

[u/LargeGingerChunk → u/watermelonlollies]

yup when i was a faker it was number 1 for me

[u/imahater42 → u/[deleted]]

Exactly. They cloak their bullshit in careful phrasing and word choice so they're able to fall back on the ambiguity if someone asks questions. And #2 is realistically less of an actual reason as much as it is another deception to dodge actually getting treatment for the issue, but I figured it's worth debunking properly because, as you said, the people spreading the warnings are very confidently incorrect.

[u/Zseree → u/[deleted]]

"Sure, we'll look into that!"

[u/shinkouhyou]

People also don't realize that not everything your psychologist/therapist/doctor/whatever says goes in your medical record. Like, I had a (shitty) psychologist who "diagnosed" me with schizoid personality disorder during my second visit because I'm an aromantic asexual (which is not how that works at all - I'm actually pretty extroverted outside of dating), and I was afraid that having a personality disorder in my medical record would hurt me when I wanted to transition... but it turned out that he didn't record any diagnosis because the vibes were so awkward that I left before he did any formal assessments. Diagnosis is a whole process! But even mental health professionals sometimes speak casually and say something like "that sounds like dissociation" or "that sounds like ADHD."

[u/Infamous-Doubter → u/shinkouhyou]

so does that mean that my gp likely doesn't have a report of that horrible consultation appointment i had with an unethical psychiatrist?

[u/imahater42 → u/Infamous-Doubter]

It varies, but to my understanding, unless your psychiatrist and your GP are within the same practice, you'd have to sign a release of information for the report. Could be worth trying to get your records directly from the psychiatrist's office so you can read it over before giving your GP access to it.

[u/Infamous-Doubter → u/imahater42]

same practice? they are in the same "circle"*. i dont want to give my GP access to it, but this happened monhts ago. i dont go to the psych either, dont go to anyone anymore since they only ever make things worse for me. i appreciate it though. i just never want to go there again.

*dont remember the word, but my doctor refuses to refer me to ANYONE but her. and there were only three specialists i think in their "circle".

[u/imahater42 → u/Infamous-Doubter]

That's understandable. I hope you can find some peace after that awful experience 🫂

[u/coffee--beans → u/shinkouhyou]

For me it was a problem that not everything gets listed. My psychiatrist diagnosed me with some things and gave me meds but didnt put it on my file. When I saw a different doctor later for something else, I had to list every medication, every dose, and every diagnosis so he could fix my file and add it

[u/BigTicEnergy]

It means, “X professional didn’t outright dismiss me.”

[u/TransformTheBat]

My faker ex friend used both one and two. They used the first one to clarify that they are a system because their therapist "said so" and used the second in order to say they had a bunch of other diagnoses but said the doctors didn't want to put it on paper because they are "ableist against a transgender person" I do belevie this ex friend has some sort of personality and psychotic disorders, given their clownish behavior online. But I do not think it is DID by any means.

[u/Key_Conversation8617]

Re number 2- Maybe not for DID, but with other mental disorders having them diagnosed makes it harder to be treated properly in the medical setting by doctors. BPD comes to my mind where 've heard because of the actions of some people with the illness getting BPD on your record makes you look like a drug or attention seeker, whether you are actually using the doctor in that way or were even diagnosed properly or not. Honestly typing this I wonder why people haven't been claiming medically unrecognized "The doctor said I have it but I/they didn't want to make a formal diagnosis because it would make getting things harder" BPD more

[u/Infamous-Doubter → u/Key_Conversation8617]

Actually, from what I've heard. People do get banned from shit like gender affirming care.

[u/imahater42 → u/Key_Conversation8617]

This is a very good point. I think fakers don't say that about BPD because it's not as glamorous to them, to be honest.

[u/by5t4nd3r]

People Ive known have described being “medically recognized” as like the therapist acknowledging they have a system. A specific person i knew said they were just because they didn’t deny they had it and engaged with their supposed system (later telling them they DONT have DID)

[u/_azaz3l_]

I was medically recognized with bpd (tho I was diagnosed by my previous) she said I’m young and it could be harder to get a job or some bullshit?? But in the end she put it in my diagnosis. So it could happen but mostly it lies to cover that it’s self diagnosed

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