#like. i think i've mentioned this but a long time ago the diagnosis of BPD was given to me by someone -

[elytrafemme]

had a conversation with my therapist about the fact that whether or not I have BPD matters less than the fact that the diagnosis of BPD has been held over my head and almost forced onto me at times where i didn’t resonate with any symptoms, and then taken from me as a “it’s not at that level yet” in the times where i do resonate with that disorder (now). so really BPD has intrinsically be laced with people making assertions about my mental health that aren’t the same as I see it and now it’s like. a fight to feel like I can belong in BPD communities because I will never feel like I truly have the disorder, but impossible to fit into literally ANY other mental health space because I don’t feel like those stories will ever encapsulate the experiences I have had. it’s a very impossible situation for me but thankfully my therapist (though extremely opposed to diagnosis and therefore not going to diagnose me with BPD) is very validating that i do experience the symptoms i say I am and supports me using BPD terminology and looking there for resonance because nothing else clicks. so having her has made this be a lot less of an isolating experience; she really is one of the best things to happen to my mental health.

anyway, i just thought it was interesting and have struggled to find any other stories where people feel as if a certain disorder has been used as a tool of gaslighting more than an actual diagnosis a person has. 

[noomaserio]

Hi, so I've actually taken some time to think about this because I love character analysis and psychiatry used to be a major interest of mine a few years ago, so feel free to skip this but ty for giving me a reason to yap!

Disclaimer to anyone who's reading: I hope I used all of the correct terminology and nothing I wrote came off as stigmatizing, I'm absolutely open to being corrected or having people add their own opinions on the matter.

Some of the conditions I mentioned I actually have first-hand experience with, so there is zero ill intent.

Gale - I've seen theories about him suffering from NPD, but I personally don't buy it.

He may have narcissistic traits, especially the "communal" subtype (e.g the grandiose sense of self is directly tied to being some kind of martyr or saviour of the people), but honestly? That fits Wyll best.

And I'm absolutely NOT claming Wyll has NPD, just to be clear.

As someone else mentioned, Gale grew up as a gifted kid and later had a major burn out phase after his break up with Mystra, so having an inflated ego is nothing too absurd.

We also know he has a shit ton of insecurities, and some of them are a direct result of his past relationship, especially in the social sense: some mild social anxiety sounds like a reasonable guess.

Some people also HC him as autistic, which is often misdiagnosed as social anxiety and might tie nicely into the whole headcanon.

I'm aware neurodivergence is a different can of worms and it might not be the kind analysis we're talking about, but wasn't Gale canonically a child prodigy who could handle magic from a very young age? "Wizarding" includes TONS of reading, so hyperlexia (which is a common autism comorbidity) could also be worth looking into.

While mental health and neurodivergence are two distinct topics, being neurodivergent has a major impact on your self esteem and how you relate to the world.

Especially if it's undiagnosed, and of course it is, because there are no words in this setting to express the concept.

Gale being a brilliant, gifted kid and an exceptionally smart scholar while also feeling inadequate, awkward and out of place sounds like the average neurodivergent experience.

Some people argue he's suffering from depression, which is understandable given how brooding he seems to be through the game, but his ex literally put a bomb in his chest and doomed him to die.

I wouldn't judge his mood stability by the events of the game, rather on how he does when he doesn't have a bomb in his chest, which would get quite a few people down even in our world.

Most people experience depressive episodes due to environmental circumstances (e.g losing a job, the end of a relationship, grief) despite not suffering from a mood disorder, which might be his case.

Having said that, I encourage any Galemancer to add their two cents.

Astarion - He's an interesting one, and we have many different fanon theories.

I absolutely agree with anyone who says he's suffering from C-PTSD.

C-PSTD develops after long time and/or repeated trauma, and textbook examples fit his experience to a T (e.g the inability to escape, living in an abusive environment, the traumatic event lasting literal centuries)

C-PTSD has a lot of symptoms and presentations, so we could leave it at that, but it also has a lot of comorbidities.

This goes without saying, but he's obviously suffering from hypersexuality as a result of sexual trauma, which is a symptom in many traumagenic disorders.

Some people hypothize BPD, which is possible and I won't deny he does have some BPD traits (e.g black and white thinking, impulsive behaviour, paranoia, volatile mood, unstable relationships) but I feel like these are heavily tied to his current circumstances and are too vague to qualify for a diagnosis.

These symptoms are also common in every other Cluster B disorder.

I find NPD much more likely, especially the somatic subtype, which has the "subject" (for a lack of a better term) be obsessed with their own physical appearance – which we know Astarion is, especially since he stopped being able to see his reflection.

Let's take a look at textbook NPD symptoms:

• Sense of self importance and entitlement

• Preoccupation with beauty, power and success

• Interpersonally exploitative behaviour for their own gain

• Arrogance

• Lack of empathy OR highly selective empathy

• Compulsive need to be complimented/admired/positively validated

• Deep seated, internalized feelings of shame and paranoia

• Envy towards others and/or a firm belief in being envied by others

Now, that sounds much more Astarion to me, while also retaining the previous symptoms.

I would personally write off ASPD too, as ASPD's sense of grandiosity typically doesn't need constant validation, if a comorbidity with NPD isn't present.

And now, let's look at an interesting one! HPD:

• Constant attention seeking

• Feeling uncomfortable in situations where they aren't the center of attention

• Overly seductive, theatrical or provocative behaviour

• Showing emotions that appear to be shallow and/or change rapidly

• Speaking in hyperboles

• Being easily influenced by others

HPD and NPD are believed to be opposites, since NPD constantly seeks positive attention and HPD will gladly accept any kind of attention, but they're actually a common comorbidity.

One often presents itself as the "main" disorder, iirc, but they can coexist and they probably do in Astarion, at least imo.

There's also a theory about him suffering from the vampiric variant of an eating disorder: a mixture of anorexic behaviour (e.g starving himself in the shadow cursed lands due to the scarcity of living creatures to drink from) and binge eating (e.g draining the MC if they don't stop him during the bite scene, drinking an entire bear in the underdark).

EDs are common in both people with NPD, HPD and C-PTSD – which makes a lot of sense.

I wouldn't consider it a big part of my headcanon for him, but I do think it's plausible.

Durge - I'm honestly afraid of what could come out of this analysis.

First of all, let's look at common theories: I've seen someone mention schizo-affective disorder, DID and psychopathy in the comments.

Which are all very interesting and I'm glad they brought them up, because it helped me develop my own theories.

Schizo-affective disorder and DID are directly related to the urge, which I consider somewhat of an external force.

It influences him, but it's more of an environmental factor imo, so I don't really take it into account.

Though I'm not going to lie, given his age when Bhaal first took over and the amount of trauma he's been through, he was a perfect candidate for developing DID as a kid.

Psychopathy, on the other hand, is worth looking into.

It's technically labeled under "ASPD", which is short for Antisocial Personality Disorder and can be loosely split into sociopathy and psychopathy.

As far as I know, sociopathy is traumagenic and psychopathy is genetic, though these definitions change as psychiatry progresses.

Now, can Durge be considered psychopathic from a genetic point of view, since he's literally made of Bhaal's blood?

If the lore doesn't fail me, Durge starts off as a regular child in spite of his bloodline, and only started manifesting murderous behaviour after getting roped in the cult via the Urge pushing him to slaughter his foster family.

There have been many (futile) attempts at resisting, such as the whole paladin thing you discover when playing an Oathbreaker!Durge, and stuff like the "giving gold to the homeless" episode Sceleritas Fel mentions.

It seems like it took quite a bit of convincing and "forcibly shoving [Durge] into religious submission" to get him to comply with the Urge, so I wouldn't say antisocial behaviour is innate to him.

ASPD is basically a given at this point, but I lean more towards sociopathy (a "learned" trauma response) rather than psychopathy.

Weirdly enough, I've never seen anyone mention NPD given he does have a God complex, but is it really a God complex if you are an actual demigod?

However I had to scrap this theory myself, because grandiosity is not exclusive to NPD (it is quite common in ASPD), and there isn't a lot of "admiration seeking" behaviour on his part given the little canon info we have.

Except towards his Father.

So we do see a desperate struggle for validation, but it's not a "worship me" issue, rather a "forgive/accept me" one.

The constant search for confirmation of someone's love, longing for the absolute certainty they're not going to "abandon" you or reject you, and frequent feelings of dread over the smallest doubt – are closer to BPD than any other disorder we previously mentioned.

Now, we're talking about an evil cult, so this kind of relationship between a faithful and their God isn't unheard of.

What makes it so different? The fact that the God I mentioned is actually his father.

And not only that, but a father who literally abandoned him at birth and later slaughtered his adoptive family, while justifying it as a demonstration of love and a test of faith.

I find it horrifying how, throught the game, Sceleritas Fel reminds you of how much Bhaal "loves" Durge as an excuse for the acts he forces him to commit.

Kill Isobel? Well done, Father loves you and got you a gift!

Reject Bhaal? Bhaal guilt trips you, accuses you of being ungrateful and reminds you of "everything he's done for [Durge]".

This kind of twisted, parasocial relationship is exclusive to Bhaal and his literal son.

He wouldn't do this for any other faithful, and Orin is living proof of that.

Speaking of Orin, we can clearly see how much she despises Durge and openly threatens him in her letters, compared to the oddly paternal way he addresses her.

The way Durge refers to her as a "little sister" in his letters, then proceeds to harshly criticize her and tear apart her entire worldview, is VERY telling and also deeply disturbing.

At the same time, the narrator implies Orin was able to attack Durge because he didn't believe she would ever do such a thing, and the whole thing is canonically referred to as a "betrayal".

My brother in Christ, take off the idealization glasses, she literally TOLD you she wanted to kill you.

Not to mention the ambivalence in his how he describes Gortash in his letters, switching between admiring his genius and referring to him as a "supposed chosen", highlighting how laughable and squalid Gortash looks in Durge's eyes.

I won't go in depth about the textbook symptoms of ASPD because it's pretty self explanatory in his case, however I will go in depth about textbook BPD:

• Feelings of emptiness (the narrator puts major emphasis on this during his Origin run)

• Emotional instability

• Paranoia and disturbed patterns of thinking

• Impulsivity

• Difficulty controlling anger

• Intense but unstable relationships (Orin, Gortash, Bhaal himself, the fact Ketheric Thorm dislikes Durge and no actual reason is given for this in-game)

• Frantic idealization and demonization of loved ones and people in general, also known as "splitting" ^

• Desperate attempts to prevent real or imagined abandonment

• Subconsciously choosing a specific person to latch onto and direct the majority of symptoms towards, also known as "favourite person" – usually a romantic partner, close friendship or a family member. One can latch onto more than one FP, though it's less common ^

• Unstable self image (ranges from self idealization to violent self hatred) and internalized feelings of shame/failure – which the narrator, his character intro AND the letters clearly show.

Needless to say, ASPD and BPD are an extremely common comorbidity.

The amnesia MIGHT be enough to spare him C-PTSD, at the very least.

But that's it.

I'm done yapping.

I would love to see a psychiatrist or something do a psychoanalysis on Gale, Astarion, and Durge. What disorders burden thee?

[illnessfaker]

do you have any resources on OSDD? like more in depth than just the diagnostic criteria, i'm very familiar with those, i guess more...people talking abt what it feels like? I have cptsd and I've been noticing things very similar to what you described in your post for a long time now. I thought I had DID for sure a while ago, but I was also actively manic/psychotic, so when that calmed down I assumed I had just been delusional. But the identity disturbances and dissociation persist. I don't think it's DID now it's osdd if it's anything but I'm wary of saying that for sure and rly would like some i guess more descriptive accounts of how symptoms are for someone with it. Sorry if this is a lot/you don't have anything of that nature, I'm glad to hear you're figuring out your own multiplicity and hope the understanding helps you in your healing process!

firstly, thank you for your kind words 😊

@/this-is-not-dissociative has a lot of info about did/osdd-1 (and other dissociative stuff) as well as having did/osdd-1 vs. dissociation in bpd/cptsd - though it's possible to have did/osdd-1 and bpd/cptsd of course - and did-research.org talks about osdd-1 a little bit (especially vs. having full-blown did). these are probably the best resources i can point you towards even though they don't contain many personal accounts. the first blog is staunchly against self-dx iirc and there's a lot of "you should speak to a professional about this" but u know how it is (at the very least they provide a lot of info and resources on how to go about doing that, it seems.)

some posts in particular that may be informative/helpful to you (there are probably many reasons to dislike this blog but it's what i've found most informative so yeah):

anp and ep, + an explanation of structural dissociation and how it models ptsd, cptsd, bpd, osdd-1, and did.

anp and avoiding trauma

an example of did vs. osdd-1

parts in bpd/cptsd vs. osdd-1

parts in cptsd vs. osdd-1 (this mod "kevin" has osdd-1, by the way)

parts vs. fragments vs. alters

alters not being easy to recognize

identity confusion vs. identity alteration

( read-more bc this got long despite it being past my bedtime lmao )

the problem w personal accounts of stuff and did/osdd-1 is presentations of these diagnoes will differ from person to person, sometimes greatly. contrary to media depiction they're also covert disorders by nature - they're psychological coping mechanisms for intense distress, and part of those coping mechanisms is being ignorant to the fact that your sense of self is fragmented / there are parts of your sense of self that are attached to trauma. i know of several folks who were initially diagnosed with osdd-1 but then later re-diagnosed as having did because the severity of their situation was very effectively hidden from them by this dissociation.

( another problem is that ppl are flawed and can give bad/wrong info on how stuff works or trends can give the wrong impression and unfortunately that's very common w did/osdd-1 spaces online. e.g. u don't have to know the name, age, etc. or know who's "fronting" or whatever with elaborate tagging systems and pages on ur blog with said info abt ur parts or "alters" to have did/osdd-1. worrying abt that stuff too much can worsen dissociation. )

it's not common for someone to have did/osdd-1 and for it to be obvious to themselves or others (who don't know what to look for, that is). this is why no small number of folks with did/osdd-1 are seemingly well-functioning on the outside since different dissociated parts often serve "everyday life" purposes such as going to work/school and these parts are the ones disconnected from traumatic "materials" as they're called. part of the reason why i'm wanting to conceptualize my experiences as osdd-1 is due to the fact that my default state (the "host"?) is emotionally dissociated from my trauma - i know it happened, but it seemed like it happened to "this body" rather than "me" and i don't feel anything about it until i get triggered. "apparently normal parts" that handle everyday life are usually trauma-avoidant or separated from the trauma like this in some way.

that being said, i'm still not totally sure if i qualify for an osdd-1 diagnosis or not tbqh. my situation is most like the "some individuals with OSDD-1 lack both amnesia and highly distinct parts" mentioned in the page i above linked (but yesterday and this morning/afternoon i was convinced i did - go figure). i'd been researching did/osdd-1 for a while (not necessarily because i thought it was what i was experiencing) which is part of what helped me come to terms with having experienced dissociation for a long time, and i thought up until like...the other day i definitely didn't have it. i came to believe i had some weird bpd/cptsd/szpd-like situation where emotional states had been "locked away" in boxes that i rarely touched as a defense mechanism against psychological distress. i also had a metaphor for my "emotional part(s)" as it/them being like, (a) ghost(s) that follow me around and aren't evil but occasionally "wrap their hands around my throat" to remind me that they're there.

then i saw someone w an osdd-1 diagnosis talk abt how they have parts whose "job" is to "feel sadness for them" as a defense mechanism against that kinda distress and then i was like...huh. and then i thought about how seeing my parents again felt kinda weird and distant. and that's kinda what tipped me off, despite having a pretty unstable sense of self and dissociation issues for a while. the "seeing my parents" thing is somewhat more major, because it felt different from my "default setting." thinking about it is uncomfortable and weird.

ur gonna have to do a lot of reading, tbh, and doing it in moderation is probably a good idea since thinking too much abt dissociation can trigger it. another thing is that conceptualizing yourself as having did/osdd-1 when you don't actually have that experience can worsen dissociation/identity issues as well so u gotta be careful abt how u approach it. but at the same time, cptsd and did/osdd-1 have mostly the same treatment methods anyway (and technically u gotta have cptsd to have did/osdd-1, not as like a diagnostic requirement really but a "you have to be traumatized from long-term traumatic experiences at a young age" sense) so many resources abt did/osdd-1 may be helpful to u regardless of whether you "have" them or not.

i can't tell u how to differentiate between symptoms of psychosis and did/osdd-1 (the blog i mentioned may have posts about that topic - there's two in their master-posts but neither were particularly helpful i don't think) since afaik i'm not psychotic but i wish you luck!

[real-did]

(1) I was never fully diagnosed with any sort of DID or ddnos (other than a doctor saying its a possibility). Along with my feelings of dissocation and depersonalizations, I've had these "others" as I would call them, that are a part of me, that I would feel come out , switch, and talk to me in my head. I've even had a friend tell me they've had issues with one who was extremely aggressive to them. I've brought it up long ago to my mother who never believed me and my psychiatrist who never payed

(2) any attention to it but focused on other things (my anxiety etc). I don't think my past wasn't anything compared to what most people with these issues go through, but I don't remember to much from it other than what has resurfaced over the years and long lasting issues, things like emotional problems at the home, loneliness, occurrences of sexual assault that resurfaced from repressed memorys that to this day I haven't told anyone, not even my partner, and religious issues that still has me f**ked up. I feel maybe these things have something to do with how I developed something that had given me a symptom of these "Altars" (I don't like to use the word since it's not mine to use, but its the best I can describe it). I've always been so confused and feeling so broken I just really wish I could figure out what's going on with me, but it's been so hard trying to find a Psychologists... I hope this was ok to message you about

-

Emotional and sexual abuse are generally “enough” for a dissociative disorder, you don’t need to worry about invalidating that! I’m sorry to hear all of this is going on and I can definitely help suggest some things that might be going on. This site might help you find a therapist, you can search by insurance. Find someone who deals with trauma work probably, and ask over the phone if they have experience with dissociative disorders and/or cPTSD. Alternatively you can google “(your state/city) mental health resources” and see if there’s a statewide line or a city center or something that provides services. 

One thing that might be going on is cPTSD fragments, possibly combined with BPD (borderline personality disorder). Sometimes with cPTSD, but commonly when combined with BPD, we can see emotion-based fragments split off from trauma. A common experience with that would be something like:

“I’m sorry I got so upset at you earlier. I don’t even remember it well, it didn’t feel like I was myself or in control. I’m not normally that angry.”

Some common fragments that might split off are- an inner hurt child, a joyful or trauma free fragment, a critical self voice, an angry/rage fragment, etc. 

With this, it’s pretty important not to split them off further. Naming them or developing them as “not you” would make your mental health worse and would make it more difficult to heal and recover. If you meet the criteria for BPD and cPTSD this might be worth looking into. 

Do your “alters” have names/identities? Do they “take over?” Do you lose time/memories to them (when they’re out, you don’t remember anything)? 

If yes to all of those, DID is a possibility! DID requires alters to be fairly developed and that dissociative amnesia be experienced at least some of the time between fronters. 

If no, to some, you might be looking into OSDD-1. This is the “new” term for the DDNOS diagnosis you were mentioning. OSDD-1a is “DID without highly developed alters,” and OSDD-1b is “DID without significant dissociative amnesia.” 

I think you should, if possible, seek therapy to cope with and heal from recovering those memories. What you’ve been through sounds traumatic and I want you to feel better. Please let me know if you have any other questions, you’re not alone in this.