In Germany the ICD (International Classification of Diseases) is what we use in clinical context, for insurance purposes etc. Compared with the DSM there are some differences, for example the definition of PTSD is different in both systems. Some conditions don’t appear in the ICD at all, so it is difficult to convey to the health insurance the severity of the patient’s disorder (this is needed in order to have the treatment granted). In these cases the therapist’s creativity is needed…
Just like the DSM, the ICD is also in a constant development, and sometimes after years we find changes that have been in the DSM already long time ago.
Usually the definition of a disorder also includes criteria for the amount of dysfunctionality needed in order for the diagnosis to be given. So that there is a line between just normal changes of mood and a mental disorder. But that line is of course somewhat artificial.
As @Mat already pointed out, making a proper diagnosis is a useful thing. I used to explain the different criteria of a diagnosis to my patients, and as also pointed out by @Vimala and @Cara this is generally most helpful! In certain cases, especially for serious disorders like DID (Dissociative Identity Disorder, formerly called multiple personality disorder), I would also use the diagnosis manuals in order to make the diagnosis, assessing all the listed criteria very carefully (and this usually is not to be done in a short time).
@jimisommer: Thank you for the courage to share your story here. This is really sad to hear, but unfortunately quite common! One of my patients who at the time fulfilled all criteria of a borderline personality disorder was a medical student and one day heard a lecture about BPD - she came to me shocked! The lecturer had said that this disorder cannot be treated, that these people are just impossible to make arrangements with - in other words: they are bad people and better to be avoided!
Unfortunately this attitude is not an exception in the German professional “psycho-scene”. The knowledge about this kind of disorders among practising psychiatrists and in psychiatric hospitals is sometimes very shallow which not only leads to devaluing people but also to wrong diagnosis as your case has shown. And of course a treatment on the basis of a wrong diagnosis won’t help! I’ve seen so many people from the trauma and BPD spectrum who suffered serious harm from treatment in psychiatric hospitals or with practising psychiatrists!
As @AnagarikaMichael beautifully explained, people with a BPD should find a therapist trained in Dialectical Behavioral Therapy (which - by the way - explicitly uses mindfulness as a skill to be developed). And as the overlap of symptoms between BPD and the various posttraumatic disorders is about 75 - 80 % it would be good if the therapist also has a training in trauma treatment. I’ve met many people with this kind of problems, and they were usually lovely people. Working with them I found mostly very rewarding as many of them feel so grateful to finally find the help they need after many bad experiences! BPD is treatable!
As for the autistic spectrum, as @Mat also mentions, it didn’t occur in my professional training at all (just as if autism is only something children can have, and when working with adults we don’t need to consider this… ). I only learned about it after encountering some people concerned. I could probably have done better justice to some of my patients if I had known earlier.
This isn’t quite true for disorders of the trauma or dissociative spectrum or for some personality disorders. Too often have I seen traumatised people misdiagnosed with pschychotic disorders and given antipsychotic medication which only made it worse! Also, traumatised people should not be treated with classical psychoanalytical techniques but rather trauma-specific techniques, such as for example PITT (Psychodynamic Imaginative Trauma Therapy) developed by Luise Reddemann or EMDR (Eye Movement Desensitization and Reprocessing) developed by Francine Shapiro - the latter being mainly a technique for confronting the trauma which has to be embedded in a broader therapeutic concept.
May all afflicted people find the right doctor for their condition!
Or rather: