The latest thinking about psychiatric diagnoses is to always have that question in mind, "How and to what degree is it negatively impacting the person's life?" This is intended to acknowledge that many conditions that once were automatically labeled mental illness or disorders really are not always that way....AND that some "issues" that were NOT considered "real problems" are indeed problems for some people.

So, let's say we're looking at people who dissociate:

One manages life okay and functions pretty much fine with a community of people in their head. (Yeah, people do that. I know a number of them *grin*.)

Another person is cool with work and the general responsibilities of life, but come the weekend all hell breaks loose--with consequences that are distressing to others inside their head.

A third person lives about eight different lives simultaneously and complete chaos is just one short step away.

A fourth person is at the mercy of flashbacks, acting-out insiders (I don't like the term "alters"--who's the "alternate" in here anyhow?) with SI and other injurious, problematic behaviors, etc. etc., in and out of psych units, the whole nine yards.

They ALL have "DID," but that second D stands for "disorder." Who is to judge what constitutes a "disorder"? The rewording of many diagnoses in the DSM to include the questioning about negative impact on life is intended to convey the idea that it's not always appropriate to consider something a "disorder" unless it really IS one.